If you have not heard during the past few weeks that there are midterm elections coming, you might have been living in a cave or a foreign country. However, in an unsettled time it helps to consider longer term consequences of what we do now.
Here are some reasons why the midterm elections Nov. 6 â€” one week from today â€” matter for seniors and older Americans. By the way, opinions indicated below, while based in facts as currently known, are intended to reflect my individual views and might or might not reflect those of others.
Once you reach age 65, you currently have Medicare and the essential health insurance benefits that program brings. However, until you reach that point, whether you are 30, 50 or 60, health insurance is a critical component of your regular needs. You might be fortunate and have an insurer who offers health insurance coverage, especially if you work for a major company. However, if you are self-employed or work for a small employer, individual health insurance coverage matters.
This is the gap that the Affordable Care Act, otherwise known as Obamacare, is intended to cover whether through the Marketplace with subsidies, or through Medicaid expansion. Especially important is the provision that prohibits insurers from denying coverage to people with preexisting conditions.
It is important to note that no health care â€śsolution,â€ť including the Affordable Care Act, is without its flaws. There is no magic pill. Higher deductibles, limited networks and cost are a problem everywhere throughout the health care system.
However, the question is â€śwhat is the direction to which we are moving?â€ť Should there be hope to have coverage for the majority of Americans and, in particular, should the prohibition against insurers denying coverage for preexisting conditions be kept along with other provisions not affecting seniors directly?
The preexisting condition issue is one reason why the Affordable Care Act matters and the Act itself has been, as has been noted, on the chopping block with Congress for some time now. This is a question for those in their 50â€™s and 60â€™s until Medicare is reached.
While we are on the subject of health care, seniors 65 and older have primarily lived in the comfortable assumption that Medicare will always be available for basic benefits either alone or combined with a Medicare Supplement that covers various co-pays and deductibles depending on the Supplement chosen or instead, a Medicare Advantage plan.
The message from some members of Congress has been Medicare needs changes to reduce costs noting that it is too expensive. Medicare is expensive for various reasons. However, Americans who have paid into the system through most of their working lives expect coverage in later life. There is nothing wrong with reducing costs if it does not affect services. While there needs to be some recognition that Medicare presents a challenge for the future and there needs to be bipartisan discussion of alternatives, the question could be is a potential “cure” worse than the condition.
One idea in particular advanced by some â€” which is to use vouchers to buy health insurance â€” raises concerns. Medicare was established in 1965 at least in part because insurers were unwilling to insure seniors at reasonable rates for health insurance. There was an obvious reason. Seniors could be expected to need more health care at projected higher cost to the insurer. A voucher to buy health insurance is not the same as having Medicare for future health insurance.
One factor to be considered is Medicare is important. Its future needs to be reviewed and ways found to make sure it continues for seniors and for future generations. Consideration needs to be given to whether insuring with the private sector alone would protect Medicare or not. My personal view is it would not.
One point on which Republicans and Democrats might agree is: prescription drug costs need to be contained. A major driver of higher costs for Medicare and for health insurance itself is the high cost of prescription drugs. Some manufacturers have instituted programs for those unable to handle the cost but there are drugs on the market needed under life or death circumstances where the cost cannot be handled even by those with insurance.
No-one will have a final answer, but the direction is all important now, you can consider what direction we should take and vote on Tuesday.