Health Care Ain’t Easy for Those Pre-Medicare

I don’t think I’d be betraying any confidences if I reveal here that my father is no great fan of the Affordable Care Act. That said, he could not have been happier the day he turned 65. He loves his Medicare. Before that time, while he was somehow able to find insurance for himself, the plan cost somewhere around $15,000. That was before the $5000 deductible. I think I could heal the cheers all the way across the country the day he became eligible for Medicare. My mother, on the other hand, still hasn’t hit 65. She’s counting the days.

Let’s face facts. Too few people age 55-64 can afford that expense. But that’s what insurance costs on the individual market. That’s if you’re able to find an insurance company to issue you a plan. So many Americans in that age range find themselves uninsured or under-insured. In a recent Issue Brief, the Kaiser Family Foundation looked at that group specifically. They found that just under two-thirds of them have employer-based insurance. An additional 16% qualify for Medicaid or Medicare for one reason or another. Six percent are insured through individually issued plans. This leaves 14% of them uninsured. As we’ve discussed before, many of these people delay needed care because they’re trying to make it to Medicare, when that care is far, far more affordable. KFF sought to see how access and cost affected people age 55-64, with and without insurance, compared to those who are on Medicare:

  • About four in ten (41%) uninsured adults aged 55 to 64 reported having unmet needs or delaying care in2010, with concerns about costs cited ad a factor in almost every instance (96%). Almost one-third (30%) of uninsured adults ages 55 to 64 lived in families that had problems paying medical bills.
  • Medicare seniors report significantly lower rates of unmet needs or delayed care (8%) than uninsured adults aged 55 to 63 (41%) and similar rates to adults aged 55 to 64 with private insurance (17%), after controlling for health status, income, and other demographic factors.
  • Over the years, the share of individuals with problems accessing care had remained relatively constant among seniors on Medicare (from 7% in 2004 to 8% in 2010); in contrast, it has significantly increased among uninsured adults aged 55 to 64 (from 32% in 2003 to 41% in 2010) and among same-age adults with private insurance (from 11% in 2003 to 17% in 2010).
  • Medicare appears to have muted the effects of rising costs for prescription drugs for seniors between 2003 and 2010 relative to adults aged 55 to 64 with private insurance, likely because of the addition of a Medicare drug benefit in 2006. However, problems paying medical bills increased for insured 55- to 64- year-olds and Medicare seniors alike.

Let’s tick off what we know. Being uninsured while 55-64 means having unmet medical needs and delaying care because of costs. Seniors on Medicare have fewer unmet needs or delayed care than either uninsured or privately insured people age 55-64. While things have been stable for those on Medicare, they’ve been getting worse for both uninsured and privately insured people age 55-64.

What will be done for them if the Affordable Care Act is struck down or repealed?

[Cross-posted at The Incidental Economist]