By Jon Healey
2:01 PM PST, December 12, 2012
Medicare may not be the third rail of American politics -- that distinction belongs to Social Security -- but politicians who alter it put their careers at risk. For proof, just look at how Republicans lost a congressional seat in a conservative upstate New York district in early 2011 after the Democratic underdog made an issue of the Medicare overhaul proposed by House Budget Committee Chairman Paul Ryan (R-Wis.). One might also blame the Medicare provisions in the 2010 healthcare law -- particularly the reductions to Medicare Advantage subsidies -- for helping the GOP take over the House in that year's elections, although that was just one of many problems for Democrats back then.
Against that backdrop, it's surprising to see elected officials in Washington flirting publicly with the idea of raising the minimum age for Medicare eligibility. Top House Republicans have called for the minimum age to be increased gradually from 65 to 67, which would bring it into line with the minimum age for collecting full Social Security benefits. And President Obama has said he'd consider doing so as part of a deficit-reduction deal.
The issue has sharply divided liberals in and out of Washington. For example, when columnist Jonathan Chait at the New Republic wrote that he could see raising the eligibility age in order to win some concessions from the GOP, he was blasted by left-of-center writers across the blogosphere, including his own magazine.
With the cost of the Medicare program as a whole rising faster than the economy is growing, however, the government has only three options, as The Times' editorial board noted recently: It can reduce the number of people covered by the program, lower the amount spent per beneficiary and/or raise more money to pay for it. Raising the minimum age for Medicare falls into the first category; if it were put into effect immediately, it would keep about 7 million seniors off the Medicare rolls.
The Congressional Budget Office has estimated that the federal government could save $125 billion over the coming decade from such a change. But opponents note that the feds would simply be shifting costs from Medicare onto other payers, whether they be private employers, retirees or Medicaid.
A study by the nonpartisan Kaiser Family Foundation estimated that raising the eligibility age would actually cause total U.S. spending on healthcare to increase, even as it saved the federal government money. The study predicted that costs would go up for both the seniors newly ineligible for Medicare -- they'd obtain coverage from less cost-effective private insurers -- and for those who stayed in the program, because the Medicare population would be older on average and riskier than before.
Nevertheless, some advocates of the change insist that, like Social Security, Medicare needs to respond to the significant gains in longevity that have occurred since it was created in 1965. Seniors are living about eight years longer on average now than they were 45 years ago. They're working longer too, and the current system lets employers offload their oldest workers' healthcare costs onto the federal taxpayers.
So where do you come down? Take our wildly unscientific poll, leave a comment below or do both.
Follow Jon Healey on Twitter @jcahealey
Copyright © 2013, Los Angeles Times