PAHCF Opposes Medicare Expansion, Suggests Extending ACA Policies

June 01, 2021 - The Partnership for America’s Health Care Future (PAHCF) has voiced their opposition to Medicare expansion, which would open up Medicare coverage to younger Americans in a recent statement which HealthPayerIntelligence received by email.

The statement comes after more than 150 House Democrats proposed to lower the Medicare age of eligibility to 60. 

PAHCF recommended extending the Affordable Care Act (ACA) enhancements to expand affordable coverage.

“Not only would opening up seniors’ Medicare to younger Americans mainly absorb those who are already covered or have access to coverage, research shows the unaffordable costs would be passed on to taxpayers and could hasten the Medicare program’s bankruptcy, all while threatening patients’ access to quality care,” Lauren Crawford Shaver, executive director of the PAHCF, said in the statement.

“Instead of creating government-controlled health insurance systems like ‘Medicare at 60’ or the public option, lawmakers should build on and improve what is working in health care.”

PAHCF defended the idea by citing various financial downsides to the proposed expansion.

Lowering the Medicare age of eligibility to 60 could shift the expansion costs to taxpayers and increase Medicare expenditures due to the number of Americans that would move from private plans to Medicare, according to the statement.

PAHCF also said that expanding the program would bankrupt the program. Medicare’s trustees have predicted that the trust fund would be depleted by 2026. According to PAHCF, the expansion could cause that to happen two years earlier in 2024.

The statement also touched on the possible effects that the expansion could have on care quality, hospitals, and other providers.

Citing a Kaiser Family Foundation report, PAHCF noted that extending Medicare to younger Americans could lead to lower revenues for hospitals and other providers who treat older adult Medicaid members.

They warned of the reimbursement cuts that could lead to hospital closures based on the fact that Medicare already underpays providers. Patients in rural and underserved areas may suffer this potential consequence the most.

An alternative to expanding Medicare is making the enhancements to the Affordable Care Act permanent, according to PAHCF’s statement.

Due to President Joe Biden’s COVID-19 relief package, the American Rescue Plan Act, premiums on the ACA marketplace are lower especially for newer enrollees, making it an attractive option for Americans ages 60 to 65 who are not eligible for Medicare.

The policies included in the American Rescue Plan Act are active through the end of 2022, which includes the higher subsidies that have lowered members’ premiums.

Under an enhanced ACA model, the number of uninsured Americans would decrease by 30 percent by 2023, the statement said.

PAHCF also mentioned how extending the ACA is backed by many political players. A number of Democrats have urged President Biden to permanently expand the new subsidies. Solidifying these changes would ensure low premiums, which could appeal to low-income 60 to 65-year-old Americans who may otherwise shift to a Medicare plan if the expansion came to fruition.

The statement highlighted how extending the ACA enhancements would reduce the number of uninsured Americans. However, a past Avalere study noted that lowering the Medicare age of eligibility could also potentially cover 24.5 million individuals, 2 million of whom are currently uninsured.

Medicare expansion could also benefit employers. According to a brief from the Peter-Kaiser Family Foundation, lowering the age of eligibility to 60 could decrease employers’ healthcare spending by 15 percent. These savings could lower employers’ premiums and increase employees’ salaries.

However, lower-income individuals could potentially have higher premiums under Medicare coverage compared to private health plans like employer-sponsored plans, according to the Avalere study.

Part of PAHCF’s defense could be supported by an Urban Institute report which claimed that uninsurance could fall by 14 percent if the ACA subsidy increases were made permanent.