The ACA & Medicare

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Medicare provides health insurance to nearly 57 million individuals (17% of the U.S. population) in three categories: those who are over the age of 65; those under 65 who receive social security disability insurance; and those under 65 with end-stage renal disease (ESRD). As described by the Commonwealth Fund’s Medicare at 50 Years series, Medicare beneficiaries are “the nation’s oldest, sickest, and most disabled citizens.” In 2013, 30% of Medicare beneficiaries were either over 85 or disabled and under 65. Seventy-five percent of beneficiaries have one or more chronic condition and 25% rate their health status as fair or poor.

Before the Medicare program, 48% of adults over the age of 65 did not have health insurance; that figure has fallen to 2%. The intentions of the Medicare program were and are two-fold: (1) ensure that beneficiaries have access to health care; and (2) protect beneficiaries from health care-related financial hardship. By the numbers, Medicare has been an immense success. Only 13% of older Americans now pay out of pocket for their health care costs (versus 56% in 1966). Medicare has also increased life expectancy at 65 by five years.

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