What Biden’s proposed Medicare changes could mean for you
Access to health care for more Americans was a major promise in candidate Joe Biden’s campaign platform, especially as highlighted in the midst of a global pandemic. Now as president, his administration has turned to which policies he intends to push forward. Much of his plan (and of some in Congress) involves changes to Medicare, so here are the possible items that Medicare participants should know about.
Ending the waiting period for individuals with disabilities
There has been discussion about changes to the Social Security Disability Insurance (SSDI) program which provides Medicare coverage for those under age 65. Some are calling for the elimination of the fivemonth waiting period before disability benefits begin, and this affects when Medicare becomes available to these former workers with disabilities – usually 24 months later.
Others suggest eliminating outright the two-year waiting period for Medicare when someone qualifies for SSDI. While both are expensive propositions, there can be value — as the coronavirus pandemic has shown. Access to health care is integral for containing societal costs from events like a global pandemic, especially for the most vulnerable members of society, such as those suffering from debilitating medical conditions.
Part D
The high cost of prescription drugs has been a hot topic in health care for some time. It’s likely that the political divide in the House and Senate will hinder legislation focused on reducing prescription drug costs for consumers. However, proposals with bipartisan support, such as capping out-of-pocket spending under Medicare Part D and imposing limits on drug price increases, could gain ground.
Also, many are waiting to learn if Part D rules proposed under the previous administration that would allow insurers to deny coverage for six protected drug classes will be revised. That proposed rule would make it harder to get medicines that treat illnesses like HIV/AIDS, cancer, bipolar disorder, epilepsy and schizophrenia.
Part A
The plan to extend the life of Medicare Part A remains a difficult challenge. Currently, the Hospital Insurance Trust Fund that supports Medicare Part A is projected to become insolvent before 2026. This could affect hospital coverage for Medicare’s 62.5 million beneficiaries.
The Biden administration has proposed lowering the age of eligibility for Medicare from 65 to 60, which could help with the funding shortage by increasing the number of patients paying premiums. The 60-65 age bracket also is more likely to be made up of healthier, and therefore lower-cost patients, possibly spreading costs out for insurers as well.
With so much focus on the COVID-19 relief bill and vaccine efforts, it’s still too soon to know how many of these proposed healthcare reforms will pass and how political divisions will alter the Biden Administration’s planned changes. It’s clear, however, that preserving Medicare and widening access to health care remains a priority.
Bethany Cissell is an Account Manager at Allsup, a nationwide benefits firm based in Belleville, Ill., that provides guidance and education on alternative healthcare coverage options for employees and retirees. Bethany works for the Allsup Benefits Coordination service, a Medicare plan selection service available nationwide.