Social Security ― often called the third rail of American politics ― is getting some competition for that title from another issue: health care for seniors.
The American Health Care Act, the Republican Party’s Obamacare replacement, causes disproportionate pain to older Americans ― a demographic that few sane politicians have ever wanted to intentionally annoy. Older people? They vote.
The denouncement of key parts of the AHCA measure that target older people came swiftly after it was released a week ago, most notably from AARP, which argued that it was an “age tax.”
AARP said the new plan will shorten the life of Medicare, hike premiums for older workers, and risk seniors’ ability to live independently ― all the while giving tax breaks to big drug companies and health insurers. The GOP has countered by insisting that Obamacare is failing and going to collapse.
And while the AHCA disproportionately affects older Americans, people of all ages should be concerned, because those older Americans are our parents and grandparents, and will be us one day.
Here are four of the ways the AHCA targets the 55+ crowd:
1. Premiums will go up significantly for older people.
Medicare kicks in at age 65. Those who are in their 50s and early 60s are the bologna in the sandwich when it comes to health coverage. They are too young to be eligible for Medicare and too old to be considered young and healthy ― which makes them less attractive to private insurers. Older people are more prone to illness and require more medical care.
Currently, the most an insurance company can charge an older worker is three times whatever younger workers are being charged in a scale that is age-rated. Under Trumpcare, that ceiling jumps to five times.
The bipartisan Congressional Budget Office weighed in on Monday about what the AHCA would cost older people, and the ensuing shudder could be felt across the nation. The CBO projected that older people with lower incomes will likely opt out of securing coverage for themselves because the proposed regulation allows insurers to charge them higher rates than they do now ― and the financial assistance provided doesn’t sufficiently offset that.
2. Nursing home assistance will no longer be a sure thing.
Medicare ― the federal health coverage plan for those 65 and older ― does not cover long-term nursing home stays. Those who need nursing home care most often enter a facility as a private pay patient.
The average nursing home in California costs $91,250 a year for a shared room, according to Genworth. Once in the nursing home, the patient must spend down his or her assets to the level where Medicaid ― the federal health plan for low-income people ― kicks in to subsidize the stay.
While Obamacare gives states the money to pay for all those who are eligible for Medicaid services, Trumpcare does not. The GOP plan instead will give states a block grant ― a lump sum per person ― and allow each state to decide how to spend it. This means that states will have to choose who they want to help between the most costly consumers of health care: older people and children.
That’s where younger adults come in: Who will care for the elderly when they can no longer care for themselves? Family caregivers, that’s who.
3. Companies will no longer be mandated to offer health insurance to workers.
Under Obamacare, companies with 50 or more full-time employees must provide those workers with health coverage or face a penalty for not doing so. That mandate is being lifted, which leads to this question: Will corporate America voluntarily continue to be the portal for most Americans’ health coverage? The consensus is divided, but a lot of smart minds are saying no.
Untethering health insurance from our jobs may not be the worst thing that could happen ― if meaningful safeguards are in place. But that’s a big caveat.
The ACA protected people with pre-existing conditions. Under the GOP’s replacement plan, insurers still have to cover pre-existing conditions, but they can charge more for people who are recently uninsured.
4. Early retirement could become a thing of the past.
People retire early ― before they reach full retirement age as defined by Social Security ― for many reasons that include having to take care of an elderly parent or sick spouse, having health issues themselves, or simply losing their jobs and not being able to find another one.
The ability to find affordable health insurance under the ACA has made retiring early a possibility for those who need to. The Republican plan could shut the door on that.
For now, all eyes are on the House budget committee, which will combine the two individual bills pending into one piece of legislation that will eventually go on to a full vote on the House floor. This is scheduled for Thursday.
The budget committee cannot make substantive changes to the legislation’s content but can recommend amendments for the House rules committee to consider.