Health Care And Medicare In The 2016 Presidential Campaign

Some people believe that the presidential election is a choice between the “lesser of two evils” or that their vote doesn’t make a difference. But elections ARE important and elections have consequences. Of particular consequence is the fate of the Affordable Care Act or Obamacare and Medicare. The result of this year’s presidential election may have serious ramifications that could affect millions when it comes to their health insurance and access to health care.

One of the things that happens at each party’s convention is the development of that party’s platform. Most voters don’t pay any attention to the party platforms when making their choice on which candidate to vote for. But party platforms are vitally important since those party platforms are the agenda that the President and members of congress from that party expect to adopt should they get elected. In essence the party platforms are a framework for what the party hopes to accomplish once elected.

This year the choice, especially involving health care and Medicare, couldn’t be greater. One party platform wants to expand Medicare and build on the ACA while the other party wants to restrict Medicare and repeal the ACA. Anyone can do an internet search or walk into the party’s local office and be able to read the party’s platform.

The platform of the Democratic party and Hillary Clinton is to expand Medicare to allow individuals age 55 through 64 to be allowed to “buy into” Medicare. Currently anyone under age 65 can only qualify for Medicare if they have been receiving disability benefits two years, have end stage renal disease or ALS (Lou Gehrig’s Disease). This would affect only those who are not covered through their employer’s plan.

To me, this makes a lot of sense and is long overdue. Many individuals who are not disabled often retire early, are self employed or somehow not covered through an employer plan. A case that I am working with right now perfectly illustrates this point. The husband is turning 65 in a month and he will come off his employer’s health insurance and go on Medicare. But the wife is only 61 years old and she is also coming off the group insurance. Since she is not eligible for Medicare, she must get health insurance through the health care exchanges. Policies at her age are between $550 and $700 per month (unsubsidized) with deductibles from $2500 to $6500. Allowing her to buy into Medicare could save her thousands in costs a year.

From the standpoint of Medicare and the health insurance exchanges, allowing those individuals age 55 through 64 to buy into Medicare makes good sense as well. By allowing those people to buy into Medicare, it greatly improves the risk pool for the health insurance exchanges by removing from the exchange risk pool the oldest people. Those people covered through employer group plans are not part of the exchange risk pool. By adding non disabled people age 55 through 64 to buy into Medicare also improves the Medicare risk pool since now Medicare is insuring more younger and healthier people than the regular Medicare population.

Improving the health care exchange risk pool and the Medicare risk pool would have the effect of lowering premiums for policies purchased on the exchanges and would reduce Medicare’s costs by insuring a healthier population.

Meanwhile the Republican platform is proposing to increase the eligibility age where one automatically qualifies for Medicare from the present age 65 to age 67. The Republican platform also proposes turning Medicare into a voucher program where Medicare beneficiaries are given a voucher so they can purchase a health insurance policy issued by a private insurance company.

However according to the Congressional Budget Office, this plan would not save Medicare any money and could increase Medicare’s costs. Increasing the eligibility age from 65 to 67 would remove from the Medicare risk pool its youngest and most healthy risks while at the same time increasing the costs for the Medicare disability account. Medicare beneficiaries who are under age 65 and on Medicare because they are receiving social security disability benefits are paid under a separate pool. When that beneficiary turns age 65, their benefits under the disability pool end and their benefits are paid out under the regular Medicare risk pool. The disability risk pool is most subject to insolvency.

According to the CBO, the voucher plan proposed by the Republican party would end up shifting more of the health care costs to the beneficiary since it is estimated that the voucher may not be enough to cover most services currently provided by Medicare. This voucher plan would end Medicare as it has been known for more than fifty years and replace it with plan where it is completely privatized.

As far as the ACA, Hillary Clinton wants to build on what has already been working, establish a “public option” for the exchanges and make it work better. At the same time Republican nominee Donald Trump is calling for the repeal of the ACA and its replacement with “something terrific”.

So when you cast your vote this year, please understand what the candidates are running on with their party’s platform. It could make a big difference with your health care in the future.

Lee Kamps

Lee has been working with Medicare, Medicaid and private health insurance since he began working at the Erie County Welfare Department in January 1973 where a major part of his job was determining eligibility for Medicaid. He went into the private insurance business in 1977 with Prudential Insurance Company and within a short time had become one of the company’s top sales agents. In 1982, he was promoted into management where he managed two field offices and as many as thirteen sales agents. After leaving Prudential in 1986, Lee decided to become more focused on health insurance and employee benefits. He has advised many local employers on how to have a more cost effective employee benefit program as well as conducted employee benefit meetings and enrollments for many area employers. The companies Lee has worked with ranged from small “mom and pop” businesses to local operations of large national companies. Lee received his B.S. degree from Kent State University where he has been active in the local alumni association. He has completed seven of the ten courses toward the Certified Employee Benefit Specialist designation. He has taught courses in employee benefits and insurance at Cleveland State University and local community colleges. In addition, Lee is an experienced and accomplished public speaker. He has been a member of Toastmasters International where he achieved the designation of “Able Toastmaster – Silver” in 1994. He has also served as a club president, Area Governor and District Public Relations Officer in Toastmasters as well as winning local speech contests. Lee has also been a member of the Greater Cleveland Growth Association’s Speaker’s Bureau where he was designated as one of the “official spokespeople for the Rock and Roll Hall of Fame” prior to the hall’s opening in 1995. He has given talks and presentations before many audiences including civic organizations, AARP chapters and many other community groups. With the implementation of the Medicare Modernization Act (Medicare drug bill) in 2006, Lee has shifted his focus to Medicare and helping Medicare beneficiaries navigate the often confusing array of choices and plans available. As an independent representative, Lee is not bound to any one specific company or plan, but he can offer a plan that suits an individual person’s needs and budget. In addition, Lee is well versed in the requirements and availability of various programs for assistance with Medicare part D as well as Medicaid. While he cannot make one eligible, he can assist in the process and steer one to where they may be able to receive assistance.

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Volume 8, Issue 9, Posted 9:12 AM, 09.02.2016