Who is worrying about ACA going away???

[npage]

Not Really, it should be based as it is now on how many years one has paid into it. I think it is a 10 year qualification now, that should not change.

From Medicare Site.

"You are eligible for premium-free Part A if you are age 65 or older and you or your spouse worked and paid Medicare taxes for at least 10 years. "

Right, I meant picking some random age assumes someone is able to work until some point in time or afford ACA type premiums. For a whole host of reasons many will not.

Most people are happy with Medicare, let everyone enjoy that happiness. If private insurers come up with a plan others want to buy instead, so be it. It's time to end the silliness of healthcare being the main reason for most bankruptcies. We all end up paying that anyways.

If one was to be "conservative" you'd run healthcare like a big bank or whatever and look for the most logical and efficient way to cover your fix costs. Baked into that of course would have to be the assumption that everyone having healthcare is a need (fixed cost) and that is where it gets ugly and we just go in circles.

 

[camfused]

I thought Medicare was going to run out of money too. If the age is lowered to 60, or ACA gets merged into it and millions more join it, then won't it run out even sooner? Something(someone) would have to pay for this?

But, +1 for Medicare at 60!

 

[npage]

Hard to discuss this without it going political. All sorts of things run out of money including private companies the govt. bails out. No one ever asks does that road make a profit, does that dam damn make a profit, we just decide some things are necessary and pay for them collectively.

That said a very strong argument can be made that if Medicare ran like a private insurance company cash flow improves. Right now Medicare gets really bad adverse selection with more unhealthy old people only in the pool.

If young people were paying in premiums and taking less than they pay in well it becomes more solvent. My guess and papers I have seen say that if right now I pay $800 a month to blue cross, simply cutting out the overhead (Executive salaries, profit, approx 30%), I would pay $560 (30% less) to Medicare instead. Doctor and everyone else in the chain could be paid the same. In other words the money could flow to the providers more. Now if a bunch of 20 and 30 year olds paying in a few hundred a month who do not take much out (hint, this is how profit insurers make money), it looks even better.

Devil is in details but it takes thinking of Medicare in a slightly different form than today.

 

[GTFan]

I think a lot of folks would agree with you about Medicare expansion but 90% of the insureds are on employer insurance and most of them like it that way.

Costs are hidden, premiums are tax-subsidized, entrenched HI companies/lobbies etc.

We'll try everything else first, then come up with a good way to move forward.

 

[audreyh1]

We can only hope. CNBC coverage of Supreme Court discussion today.

Supreme Court appears willing to leave Obamacare in place
https://www.cnbc.com/2020/11/10/supreme-court-appears-willing-to-leave-obamacare-in-place-.html

 

[Montecfo]

Overturn unlikely

It looks like the Supremes are unlikely to overturn ACA. Sounds like they may carve off and kill the individual mandate.

A path forward might be to work to improve ACA, but it is tough to have pre-existing conditions covered AND require policies to be issued to anyone applying. So people can go uninsured, get sick and then get insurance.

That figures to leave a dwindling number of insurers offering policies, and no inexpensive ones to entice the young folks.

To me, the basic insurance should be minimalist, so as to create an incentive to buy into ACA. As it is, I do not see how ACA, minus the mandate, really works over the long term.

 

[pb4uski]

If Medicare is to be expanded to younger people then there are a few ages that might align better with other aspects of retirement.

One could argue for medicare at age 62 since 62 is the earliest that someone can start SS retirement benefits. One could argue for medicare at age 59 1/2 since that is when one first gets penalty-free access to tax-deferred accounts without a age-based severance requirement... and under that construct then perhaps 60 is close enough.

I think 55 is a long-shot as that only really align with the age of 55 rule for 401ks and that is premised on leaving service at 55 (or I guess technically in the calendar year that you turn 55 as I recall).

Also, what we don't know is how premiums would be structured for medicare beneficiaries at those earlier ages what the cost to taxpayers would be.

 

[timo2]

It is a relief to me that the Supremes didn't seem too anti-ACA, as removal of the entire ACA regulatory framework would cause a tremendous amount of disturbance in our health care plans we rely upon, even my Medicare. DW is not on Medicare yet, so a sudden change would affect her more and we really don't have any idea how to replace what she has.

As others here have noted, the ACA is the comprehensive regulatory framework for all health care in the USA, including the employer provided insurance. Everything health care is affected by the ACA. It's not just the mandate or the exchanges. The preventive care coverage requirements affect all medical insurance plans in the nation as much as the pre-existing coverage requirements. Also the Part D donut hole removal is part of the ACA that affects many people.

 

[Gumby]

Do we know this for sure or is it speculation?

No one ever actually knows until the opinion is released, but people try to divine the Court's position by questions and comments the justices make during oral argument.