Readers’ questions on means testing Medicare and state exchanges

Here are two:

  1. What would be the economic effects of adding more means testing to Medicare?
  2. What are the biggest problems the administration will face with all the different state exchanges?

A start — but only that — to an answer to 1 is in the recent Urban Institute publication that includes a scoring of additional means testing of Medicare for 65 and 66 year olds. One thing to think about their proposal is whether it would be appropriate to include an asset test for retirees. After all, a very wealthy retiree could choose to draw a low income, thereby qualifying for subsidies. Does that make sense?

The second question is also very good, but I have even less of an answer than my meager one to the first, particularly if I interpret it as “what are the technical problems?” I don’t know the answer to that one. I do anticipate the administration will have substantial political problems. That is, there will be some technical glitches, areas of confusion, and associated disruption in some states. Count on it. Then count on those, however insignificant (if they are, which they  may not be) to be dramatically amplified by those who wish to paint the whole enterprise as a boondoggle (which it may be, but not necessarily).

Early 2014 will not be an easy time for health reform, just as early 2006 was not an easy time for Medicare Part D, which is far simpler to administer.

Anybody have better answers to these or care to pose other questions? Comment away.


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