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Nearly 23M Individuals May Be Eligible for Medicare Coverage Under Biden Proposal

Summary

Avalere analysis finds that former Vice President Joe Biden’s proposal to lower the Medicare eligibility age from 65 to 60 could increase access to Medicare coverage for an additional 23 million individuals.

On April 9, as part of a broader response to the economic downturn and unemployment resulting from the COVID-19 pandemic, presumptive Democratic nominee Joe Biden revealed a proposal that would make individuals aged 60 and older eligible for Medicare. Newly eligible individuals would have the option to enroll in Medicare, continue receiving health insurance through their existing source of coverage (i.e. employer, exchanges, Medicaid), or access insurance through Biden’s proposed public option.

By extending Medicare eligibility to individuals aged 60 and older, Biden’s proposal could potentially shift enrollment into Medicare from a variety of existing health insurance coverage sources, depending on consumer decision-making. Specifically, 13.4M individuals enrolled in employer-sponsored insurance, 3.8M in Medicaid, 3.2M in the individual market, and 600K in other government insurance programs (e.g., TRICARE, Veteran’s Affairs, Indian Health Services) could become eligible for Medicare under Biden’s plan.

Notably, Medicare expansion could provide access to another form of insurance for 1.7M previously uninsured individuals ages 60–64.

Figure 1. Composition of Individuals Newly Eligible for Medicare Under Biden Proposal, Ages 60–64, 2018
Figure 1. Composition of Individuals Newly Eligible for Medicare Under Biden Proposal, Ages 60–64, 2018

“Expanded Medicare eligibility could provide one more option to older Americans, helping reduce the number of uninsured or underinsured in the market,” said Chris Sloan, associate principal at Avalere Health. “Uptake will vary by state, depending on the cost of other forms of coverage, number of uninsured individuals over 60, and level of subsidies to reduce beneficiary out-of-pocket spending.”

Figure 2. Newly Eligible Medicare Beneficiaries by State, Ages 60–64, 2018
Figure 2. Newly Eligible Medicare Beneficiaries by State, Ages 60–64, 2018

Decisions to enroll in Medicare would depend on both the generosity and cost of Medicare plans compared to existing coverage, as beneficiaries will weigh relative cost sharing and premiums. The policy does not provide details on the availability of Medicare Advantage or Medigap plans for newly eligible beneficiaries.

Table 1. Composition of Individuals Newly Eligible for Medicare By State Under Biden Proposal, Ages 60–64, 2018
State Total Employer-Sponsored Insurance Medicaid Individual Market Other Government Uninsured
National 23M 59% 17% 14% 3% 7%
AL 240K 59% 17% 10% 4% 11%
AK 40K 60% 17% 5% 9% 9%
AZ 340K 55% 20% 12% 4% 9%
AR 120K 51% 27% 12% 3% 8%
CA 1.7M 56% 23% 13% 2% 6%
CO 280K 61% 14% 14% 4% 7%
CT 210K 69% 14% 11% 1% 5%
DE 60K 67% 17% 9% 3% 4%
DC 30K 58% 31% 7% 1% 4%
FL 1M 52% 14% 17% 4% 13%
GA 500K 58% 15% 11% 5% 11%
HI 80K 67% 17% 8% 4% 3%
ID 80K 56% 12% 17% 5% 10%
IL 650K 64% 17% 11% 1% 6%
IN 340K 64% 16% 11% 2% 7%
IA 180K 68% 14% 13% 1% 4%
KS 160K 64% 13% 12% 4% 7%
KY 210K 58% 25% 9% 3% 5%
LA 200K 53% 25% 12% 3% 8%
ME 80K 61% 11% 14% 5% 9%
MD 330K 67% 16% 10% 3% 5%
MA 350K 67% 20% 10% 1% 3%
MI 520K 65% 18% 11% 1% 5%
MN 280K 65% 17% 13% 2% 3%
MS 140K 54% 20% 10% 3% 13%
MO 340K 64% 13% 11% 3% 9%
MT 60K 56% 15% 16% 4% 9%
NE 110K 67% 10% 14% 3% 7%
NV 150K 58% 18% 10% 5% 9%
NH 80K 71% 12% 9% 2% 7%
NJ 490K 70% 14% 10% 1% 6%
NM 90K 50% 29% 11% 5% 6%
NY 950K 62% 22% 10% 1% 5%
NC 520K 59% 14% 13% 5% 10%
ND 40K 63% 10% 19% 4% 4%
OH 630K 64% 18% 10% 2% 6%
OK 190K 57% 14% 11% 7% 10%
OR 190K 57% 19% 15% 4% 6%
PA 710K 66% 16% 11% 1% 6%
RI 60K 66% 21% 11% 1% 1%
SC 250K 58% 15% 13% 5% 10%
SD 50K 58% 12% 20% 6% 4%
TN 350K 59% 16% 11% 3% 10%
TX 1.3M 56% 16% 11% 3% 14%
UT 140K 65% 10% 16% 3% 6%
VT 30K 58% 21% 15% 3% 3%
VA 460K 64% 10% 11% 7% 9%
WA 370K 62% 17% 12% 4% 6%
WV 90K 59% 21% 8% 4% 7%
WI 340K 68% 13% 12% 2% 5%
WY 40K 64% 9% 14% 4% 9%

Methodology

To estimate the number of newly Medicare-eligible enrollees, Avalere analyzed the number of individuals aged 60–64 in each state by using the American Community Survey 2018 1-year sample of health insurance coverage in the United States.

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