Medicare open enrollment begins today and lasts through December 7. It’s an opportunity for seniors to ask what they want out of Medicare and choose an option that moves them toward that goal. But those options could change significantly in the near future, for the better—or for the worse.
Let’s start with the worse—Medicare for All.
M4A as proposed by Democratic presidential candidates Bernie Sanders and Elizabeth Warren doesn’t actually expand Medicare to everyone. It ends Medicare as we know it and replaces it with a single-payer health care system. To put it bluntly, if you like your Medicare plan, you will not be able to keep it.
Several other Democrats are backing a type of buy-in to the Medicare program, which they sometimes refer to as “Medicare for More.”
Under most of those plans Medicare itself wouldn’t change. It would just allow people under the age of 65 to buy into Medicare or Medicare Advantage—thus establishing the left’s long sought “public option.”
President Donald Trump is taking a different approach. He issued an executive order on October 3 criticizing M4A proposals and requiring the Department of Health and Human Services (HHS) to explore ways to create Medicare options seniors want.
As the president announced: “Instead of ending the current Medicare program and eliminating health choices for all Americans, my Administration will continue to protect and improve Medicare by building on those aspects of the program that work well, including the market-based approaches in the current system.”
Most of his proposed changes require HHS review and won’t be available for at least a year, which, probably not coincidentally, tees them up right before the November election.
In addition, Medicare Administrator Seema Verma recently announced new flexibilities in Medicare Advantage plans that insurers are immediately incorporating.
AARP reports: “For example, someone with diabetes could get transportation to a doctor’s appointment, to a diabetes education program or to a meeting with a nutritionist. MA plans can even pay for cooking classes as part of improving someone’s diet. For someone with heart disease, an MA plan could provide heart-healthy produce or other food. If you have asthma, the plan could cover home air cleaners or even pay to shampoo a member’s carpet to remove the irritants that often trigger asthma attacks.”
According to the Roper Center, 52 percent of seniors voted for Trump in 2016, vs. 45 percent for Clinton. If it appears that M4A will take away their Medicare—and it will—we’re likely to see that percentage grow in 2020.
Improving Medicare is probably a winning political issue; imploding it is not.