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Biden’s Medicare at 60 Proposal Could Cover 23M Under Medicare

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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 320K 62% 12% 13% 5% 9%
AK 50K 53% 24% 5% 8% 11%
AZ 470K 51% 21% 14% 5% 9%
AR 190K 53% 19% 15% 5% 8%
CA 2.7M 52% 27% 14% 2% 6%
CO 400K 56% 16% 17% 5% 7%
CT 280K 66% 16% 13% 0% 4%
DE 70K 67% 18% 9% 3% 3%
DC 40K 54% 30% 9% 1% 5%
FL 1.5M 51% 12% 21% 4% 13%
GA 640K 61% 10% 13% 4% 12%
HI 100K 66% 16% 13% 3% 2%
ID 120K 59% 8% 19% 3% 11%
IL 910K 63% 16% 13% 2% 6%
IN 460K 64% 14% 13% 3% 6%
IA 230K 65% 15% 16% 1% 4%
KS 200K 68% 6% 16% 3% 8%
KY 300K 56% 26% 11% 3% 5%
LA 330K 53% 24% 12% 3% 8%
ME 110K 64% 8% 17% 4% 6%
MD 450K 68% 15% 10% 3% 4%
MA 530K 64% 24% 9% 1% 2%
MI 760K 64% 18% 13% 1% 4%
MN 410K 64% 17% 13% 2% 3%
MS 190K 54% 16% 14% 4% 12%
MO 410K 64% 9% 16% 3% 8%
MT 90K 49% 16% 21% 5% 10%
NE 130K 71% 4% 18% 2% 5%
NV 200K 55% 19% 12% 4% 9%
NH 110K 71% 9% 11% 2% 7%
NJ 660K 66% 15% 11% 1% 7%
NM 150K 48% 29% 13% 5% 6%
NY 1.5M 59% 26% 9% 1% 4%
NC 660K 60% 11% 16% 4% 9%
ND 60K 68% 10% 14% 4% 4%
OH 880K 65% 16% 11% 2% 6%
OK 250K 57% 9% 12% 10% 11%
OR 320K 55% 22% 16% 3% 5%
PA 990K 64% 16% 15% 1% 5%
RI 80K 59% 26% 11% 1% 3%
SC 340K 58% 12% 15% 4% 10%
SD 60K 65% 3% 20% 6% 6%
TN 460K 59% 13% 13% 4% 10%
TX 1.7M 58% 11% 13% 3% 15%
UT 170K 65% 8% 19% 1% 6%
VT 60K 55% 23% 14% 2% 6%
VA 580K 64% 7% 15% 6% 7%
WA 540K 60% 17% 14% 4% 5%
WV 150K 54% 21% 12% 3% 9%
WI 440K 61% 14% 18% 3% 4%
WY 40K 64% 9% 16% 3% 8%

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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