Medicare at age 55+?

[Mark1]

A .5% increase in Medicare payroll tax, matched by the employer.

I FIREd at 54 years of age once I was vested and eligible for Megacorp retirement medical/pension, etc., so I see your point and generally agree with your goal. However, if I do a little quick math for a company like Amazon (1.1 million workers at an average salary of $75,000) the annual additional cost is roughly $0.4 billion dollars/year. Maybe businesses would support this kind of plan (or at least stay quiet), but I doubt it.

 

[pb4uski]

My sense is that you are proposing is a first step towards Medicare for all, which I reluctantly support. Health care is too expensive in the US, which in turn, makes health insurance too expensive.

I would like to see health insurance separated from employment. The reasoning for it was dubious to begin with and it creates problems for families where the member with employer provided health insurance changes jobs, etc.

 

[GenXguy]

Medicare and related healthcare costs with the different parts, supplemental, out of pockets costs, and uncovered services are already too expensive for people 65+ without adding younger people on there, while only collecting a 0.5% increase in tax dollars. That won't cut it. I wouldn't support it. Those costs are also going up at an extremely fast rate. But no worries - the current legislators are actually proposing cutting healthcare even further than what was lost with the enhanced subsidies ending and the OBBB cuts, in order to budget more for defense spending (such as the current war). So, to be clear, that's additional cuts on top of those! So, it's not going to happen that they are going to lower the Medicare age to 55.

Note, those MAGI cliffs mentioned here are much smaller for individuals. Many millions are not married.

 

[Just_Steve]

My sense is that you are proposing is a first step towards Medicare for all, which I reluctantly support. Health care is too expensive in the US, which in turn, makes health insurance too expensive.

I would like to see health insurance separated from employment. The reasoning for it was dubious to begin with and it creates problems for families where the member with employer provided health insurance changes jobs, etc.

Could you explain further? My read of history is it was an unintended consequence of the govt mandated wage freeze. Am I missing something?

 

[DangerousNachos]

I FIREd at 54 years of age once I was vested and eligible for Megacorp retirement medical/pension, etc., so I see your point and generally agree with your goal. However, if I do a little quick math for a company like Amazon (1.1 million workers at an average salary of $75,000) the annual additional cost is roughly $0.4 billion dollars/year. Maybe businesses would support this kind of plan (or at least stay quiet), but I doubt it.

@Mark1 Employers who lose older workers from their group plans see reduced premium volatility and cost liability. The white paper frames it as replacing unpredictable insurance costs with a predictable payroll contribution.
One more point worth adding: Medicare Secondary Payer rules already govern how Medicare coordinates with employer group plans. For retirees with employer retiree coverage, Medicare is primary, and the employer plan pays secondary, reducing what the employer plan actually pays out. The Medicare Bridge doesn't change that framework. It applies existing law to a younger cohort. We're not reinventing the wheel, just moving the starting line. Please continue to ask questions. There are a lot of moving parts, and this kind of pushback is exactly what makes a proposal stronger.

 

[DangerousNachos]

My sense is that you are proposing is a first step towards Medicare for all, which I reluctantly support. Health care is too expensive in the US, which in turn, makes health insurance too expensive.

I would like to see health insurance separated from employment. The reasoning for it was dubious to begin with and it creates problems for families where the member with employer provided health insurance changes jobs, etc.

@pb4uski No, expanding access isn't the same as universalizing it. The Bridge follows the same deferral framework that already governs Medicare at 65. If you have affordable employer coverage, you defer enrollment. We're applying existing rules to a younger cohort — not creating a new entitlement.

 

[pb4uski]

Could you explain further? My read of history is it was an unintended consequence of the govt mandated wage freeze. Am I missing something?

No, you are not missing anything. Since the government had frozen wages, to attract and keep good employees, employers offered a health insurance benefit that probably would never have been offered absent the wage freeze.

Fast forward to today and employer provided health insurance has grown into a dysfunctional monster and is a huge cost to employers.

IMO, one shouldn't have to fret about their personal insurance if they change employers and they shouldn't have coverage gaps or have to restart deductibles. Those problems would be moot if there was no employer provided health insurance. They do have such issues with home insurance or renters insurance or car insurance or umbrella insurance, so why for health insurance. Ditto for employer provided life insurance and disability insurance. Get rid of it and let people buy it on their own.

My son has made some job changes and has to jump from employer provided health insurance to ACA to employer provided health insurance, etc. Luckily I understand it and can help him navigate it all but it is way too complicated for most people. It's ridiculous.

Another example is that a couple years ago my DSIL changed jobs while DD was pregnant. While both employers offered health insurance there was a 30 day gap. During that 30 day gap DD needed an expensive test done so they had to either defer the test or pay $$$$ for COBRA coverage for that 30 days. Crazy that our health care system puts people in positions like that.

The other distasteful thing with employer provided health insurance is that employee contributions are tax advantaged in that employee contributions reduce W-2 income so neither income nor payroll taxes are paid on that income. OTOH, the poor schmuck who doesn't have employer provided coverage and buts individual health insurance themselves doesn't get a tax break. There is no good reason for giving a tax break in one case but not in the other. That costs the US government, including the SS Trust Fund, $350-$400 billion annually so not chump change.

 

[pb4uski]

@pb4uski No, expanding access isn't the same as universalizing it. The Bridge follows the same deferral framework that already governs Medicare at 65. If you have affordable employer coverage, you defer enrollment. We're applying existing rules to a younger cohort — not creating a new entitlement.

How is that different from a first step towards Medicare for all? Thou Roth protest too much.

You're proposing 55+. After that is done someone else comes along and proposes 45+. A few steps later it is universal.

BTW, I don't have a problem with Medicare for all conceptually given how broken our health care system is.

 

[DangerousNachos]

Medicare and related healthcare costs with the different parts, supplemental, out of pockets costs, and uncovered services are already too expensive for people 65+ without adding younger people on there, while only collecting a 0.5% increase in tax dollars. That won't cut it. I wouldn't support it. Those costs are also going up at an extremely fast rate. But no worries - the current legislators are actually proposing cutting healthcare even further than what was lost with the enhanced subsidies ending and the OBBB cuts, in order to budget more for defense spending (such as the current war). So, to be clear, that's additional cuts on top of those! So, it's not going to happen that they are going to lower the Medicare age to 55.

Note, those MAGI cliffs mentioned here are much smaller for individuals. Many millions are not married.

@GenXguy Thank you for the reply. One correction: the 0.5% is the employee portion only. The employer matches it, so the combined funding is 1.0%. Double what you referenced.
As for the current political climate, I understand the skepticism. The problems of job lock, rising healthcare costs, and workforce displacement will still be waiting once today's priorities shift, and they'll only be harder to address later.
I'm not expecting this to move this week. I'm planting a seed. If even one person picks it up and runs with it, that's further along than we are right now.

 

[TripleLindy]

Luckily I understand it and can help him navigate it all but it is way too complicated for most people. It's ridiculous.

100% agree. I’d take it a step further in that if employer sponsored insurance was eliminated without a universal plan, the complicated environment of a private market would only intensify.

@DangerousNachos while I don’t believe your suggestion addresses the underlying issues with the U.S. healthcare system, I’d certainly support it as a step in the right direction.

 

[DangerousNachos]

How is that different from a first step towards Medicare for all? Thou Roth protest too much.

You're proposing 55+. After that is done someone else comes along and proposes 45+. A few steps later it is universal.

BTW, I don't have a problem with Medicare for all conceptually given how broken our health care system is.

@pb4uski I didn't choose age 55 arbitrarily. It aligns with existing retirement plan language—the IRS Rule of 55 and 72(t) distributions. It is a threshold that already has meaning in retirement planning. It wasn't chosen to set up a future expansion to 45.
And the eligibility is specific by design. Not everyone 55+ qualifies. Only those without employer coverage who choose to enroll. We already see this at 65. Some workers stay on employer coverage past Medicare eligibility and defer enrollment entirely. The Bridge works the same way. It applies to those it applies to, and only if they elect it.
If someone frames this as Medicare for All, that's a distortion. This proposal is targeted, voluntary, and defined by specific circumstances. That's the opposite of universal. Great questions for clarity. Keep them coming.

 

[DangerousNachos]

100% agree. I’d take it a step further in that if employer sponsored insurance was eliminated without a universal plan, the complicated environment of a private market would only intensify.

@DangerousNachos while I don’t believe your suggestion addresses the underlying issues with the U.S. healthcare system, I’d certainly support it as a step in the right direction.

@TripleLindy Yes. The U.S. healthcare system is a rabbit hole for another day. What Medicare has going for it, despite its faults, is that it's the devil we know. It already has negotiated pricing, it carries the weight of the federal government, and it has decades of infrastructure behind it. Claims drive premiums, and negotiating power matters.

There's also meaningful room to improve efficiency and fraud prevention, and to reduce administrative waste, without jeopardizing coverage. Building on an existing system that already works, however imperfectly, beats starting from scratch. The Medicare Bridge doesn't reinvent the wheel. It just moves the starting line. Thank you for the support.

 

[pb4uski]

@pb4uski I didn't choose age 55 arbitrarily. It aligns with existing retirement plan language—the IRS Rule of 55 and 72(t) distributions. It is a threshold that already has meaning in retirement planning. It wasn't chosen to set up a future expansion to 45.
And the eligibility is specific by design. Not everyone 55+ qualifies. Only those without employer coverage who choose to enroll. We already see this at 65. Some workers stay on employer coverage past Medicare eligibility and defer enrollment entirely. The Bridge works the same way. It applies to those it applies to, and only if they elect it.
If someone frames this as Medicare for All, that's a distortion. This proposal is targeted, voluntary, and defined by specific circumstances. That's the opposite of universal. Great questions for clarity. Keep them coming.

TO BE CLEAR... I didn't frame it as Medicare for all. I framed it as a first step towards Medicare for all.

While I understand the reasons for choosing 55+ and all, we can agree to disagree beyond that. I think that the proponents of Medicare for all will support the 55+ initiative and beyond that it will be like "If you feed a mouse a cookie...".

 

[DangerousNachos]

TO BE CLEAR... I didn't frame it as Medicare for all. I framed it as a first step towards Medicare for all.

While I understand the reasons for choosing 55+ and all, we can agree to disagree beyond that. I think that the proponents of Medicare for all will support the 55+ initiative and beyond that it will be like "If you feed a mouse a cookie...".

@pb4uski That’s a fair clarification, and I understand the concern.

My pushback would be that expanding eligibility doesn’t inherently create a pathway to universalization. Medicare at 65 has operated that way for decades. Eligibility exists, but individual circumstances like employer coverage, VA benefits, or other options still shape participation.

Not everyone 65+ uses Medicare the same way, and eligibility has remained optional in structure. It hasn’t meaningfully expanded beyond that defined group over time.

The Bridge follows that same logic. Targeted, voluntary, and tied to a specific population with a defined constraint.

A more practical way to look at it is how people already treat Medicare at 65. It becomes part of a broader transition decision: retirement timing, Social Security, and health coverage, not because it’s mandated, but because that’s how people plan.

And on the age point, I know you understand why I chose it. It's specific. It aligns with existing retirement provisions such as the Rule of 55 and 72(t), which already recognize it as a transition threshold under current law. If the threshold were defined elsewhere in the tax code, say age 57, that’s where the policy would anchor. The point is that 55 already has a foundation in existing law. That gives it a foundation that proposals at younger ages don’t have.

I understand the ‘mouse and cookie’ concern — but this is a very specific cookie for a very specific group with a defined constraint.

 

[JustOneMoreYear]

Medicare will never be lowered to before 65. Perhaps a whole new system will be introduced for the coming AI-apocalypse though.

 

[Time2]

As I understand, you want an additional 1%, I don't care how you split it, it is still more tax on the tax payers. This will allow people between 55 and 65 to collect Medicare. So an additional tax on those 18 yrs old to 54 yrs old to support the older generation, when the younger generation is already looking at a failing SS system that they don't expect to collect on, right or wrong, that's what they think, even some people on here don't put it in their planning. The fix, pay more tax or get less benefit. Now you want to tax them more to support a segment that have had 35 yrs to create their nest egg? I'm sorry but adding government money (previously taxpayer money) into anything increases cost. If you look at the slope of healthcare cost, it is higher after 2012 when the ACA regs started. I personally received a 71% increase in my health insurance in the first 3 yrs after the ACA regulations started. What happened to college costs when the government came in and made it easy for everyone to get a student loan? The cost of college increased faster. I think a better plan, if government needs to be involved, in reducing the high cost, (probably do) rather than throwing taxpayer money at the problem, put in regulations to slow the growth of health care. They can start with, everyone having a cost for every visit, to slow down those who use healthcare in a wasteful way. There is another problem, many doctors already don't accept Medicare Advantage plans and a few don't accept Medicare, that may expand if Medicare cuts their payments anymore. I'm aware that the program makes doctors find creative ways to get paid more by the program, not including the out right theft problem. Oh, back to SS, it is a life saver for many people and an efficiently run program, but most of us here would have had doubled the return of what we get from SS, if we had self invested it.

 

[FD1000]

HC in US isn't affordable and will never be. The gov can't subsided it because it's too expensive.
Obama care had good intentions but the execution was terrible. Premiums for small business owners or people without HC tripled within several years.
Before Obama care my wife and I could get insurance for both of us for $400 per month + $4K deductibles.
It is now over $2K for premiums and at least a $17K deductible.
HC in the US will never be solved. Every part of HC is making a lot of money with a strong lobby and will never give it up.
You need to change the whole thing from the root.
Education is much more expensive.
The doctors are making a lot more than other countries. Add PBM, the pharma and insurance companies and you have a complicated system on purpose.
HC is a global problem but capitalism makes it worse in the US.
If you look at the whole thing from far maybe it's not bad if you consider the fact that total taxes (forget about NY and CA) are lower in the US but graduating from University and HC are more expensive.
Bottom line there is no solution in the foreseeable future.

 

[TripleLindy]

HC in the US will never be solved. Every part of HC is making a lot of money with a strong lobby and will never give it up.

I’m slightly more optimistic on the first point (not much, though), and 100% agree on your 2nd point. As long as healthcare remains a business, costs will continue to climb. If we could just eliminate the business of healthcare insurance, that would reduce expenses by trillions. Maybe we could then afford to allow the “business” of healthcare to continue. But lobbyists would fight it hard.

 

[DangerousNachos]

As I understand, you want an additional 1%, I don't care how you split it, it is still more tax on the tax payers. This will allow people between 55 and 65 to collect Medicare. So an additional tax on those 18 yrs old to 54 yrs old to support the older generation, when the younger generation is already looking at a failing SS system that they don't expect to collect on, right or wrong, that's what they think, even some people on here don't put it in their planning. The fix, pay more tax or get less benefit. Now you want to tax them more to support a segment that have had 35 yrs to create their nest egg? I'm sorry but adding government money (previously taxpayer money) into anything increases cost. If you look at the slope of healthcare cost, it is higher after 2012 when the ACA regs started. I personally received a 71% increase in my health insurance in the first 3 yrs after the ACA regulations started. What happened to college costs when the government came in and made it easy for everyone to get a student loan? The cost of college increased faster. I think a better plan, if government needs to be involved, in reducing the high cost, (probably do) rather than throwing taxpayer money at the problem, put in regulations to slow the growth of health care. They can start with, everyone having a cost for every visit, to slow down those who use healthcare in a wasteful way. There is another problem, many doctors already don't accept Medicare Advantage plans and a few don't accept Medicare, that may expand if Medicare cuts their payments anymore. I'm aware that the program makes doctors find creative ways to get paid more by the program, not including the out right theft problem. Oh, back to SS, it is a life saver for many people and an efficiently run program, but most of us here would have had doubled the return of what we get from SS, if we had self invested it.

@Time2 There's a lot to unpack there. I acknowledge your frustration with the current Social Security system and your concerns about its funding and availability of benefits when needed. I would respectfully set that aside and focus only on the Medicare Bridge proposal.

The combined Medicare payroll tax rate of 2.9% has been unchanged since 1986. Over that same period, healthcare costs have risen more than twice as fast as wages; insurance premiums alone have grown 740% since 1984, while wages grew roughly 26% over the last decade. The Medicare HI Trust Fund is projected to face insolvency by 2033.

The proposed 0.5% employee contribution, applied to all workers, not just the 18–54 age group, combined with the matching 0.5% employer contribution, is designed to fund the Medicare Bridge and help address existing deficiencies in the system.

You're correct that controlling actual healthcare costs is the central challenge. That's exactly what PPOs, HMOs, and Medicare attempt to do by limiting what providers can charge for services. I'm not promoting any of those as the right model, only pointing out that controlling what can be charged is the most effective lever we have for controlling premiums.

The college loan comparison doesn't hold here. The ease of student loans didn't limit what universities could charge. It gave universities a funding source but set no ceiling on the cost of education. Medicare does the opposite. It sets what providers can be paid. That's not the government inflating costs. That's the government controlling them.

Regarding out-of-pocket costs and doctor acceptance, both are legitimate concerns for the existing Medicare population. The 1% combined payroll tax increase is specifically designed to address that. The proposal isn't meant to strain an already underfunded system. It's meant to bring additional revenue that strengthens it. Properly funded, the Medicare Bridge doesn't accelerate the reimbursement cuts that push doctors away from Medicare; it helps prevent them.

Being in the insurance business for over thirty years and watching the ACA develop and be implemented was painful. The irony was that a policy affecting individual and small group markets was being designed by people who had never been on those plans and likely never would be. They had their employer-provided coverage. That experience is exactly why I'm not promoting a new type of coverage, but tweaking one that already exists. Thank you for your response.

 

[Onda]

High-quality affordable healthcare is not a mystery — virtually every advanced economy already showed that it works best when basic coverage is universal, portable, and negotiated at scale rather than fragmented through employers and insurers. The real U.S. problem is not lack of models, but reluctance to apply what others already proved can deliver better outcomes at lower administrative cost.

 

[DangerousNachos]

@FD1000 You won't get much argument from me on the broader diagnosis. The system is complicated by design; the lobbying is real; and the ACA's execution left many people, including small business owners, in a worse position than before. I lived that firsthand. My greater frustration was that there was no subsidy for the small employer trying to offer benefits to employees to stay competitive with larger companies. That's where most of my small employers said they never wanted to be in the insurance business anyway. Whatever they provided was too expensive and didn't cover enough. Most opted to give their employees a modest raise and drop group coverage altogether.

The Medicare Bridge doesn't attempt to solve all of that. It addresses one specific gap for one specific group. Sometimes a targeted fix is more achievable than a comprehensive overhaul, and more durable.

@TripleLindy The lobbying point is exactly why the proposal is designed the way it is. It's working within existing infrastructure rather than threatening the broader industry.

 

[DangerousNachos]

High-quality healthcare is not a mystery — virtually every advanced economy already showed that it works best when basic coverage is universal, portable, and negotiated at scale rather than fragmented through employers and insurers. The real U.S. problem is not lack of models, but reluctance to apply what others already proved can deliver better outcomes at lower administrative cost.

@Onda I'm not promoting universal anything. But I will say this: when private companies compete for the same dollar, you're going to have inefficiencies and overlap. Three companies employ three times as many people to administer the same benefit, and all three answer to shareholders. That's not a political statement. That's just how the math works.

The Medicare Bridge doesn't resolve that. It simply moves one defined group into a system that already negotiates at scale. And at this point in the thread, I want to reiterate: this is not making anyone take Medicare at 55. It is to give a group of individuals who might want to retire early, maybe need to care for an elderly family member, want to start their own new adventure, or are displaced because of a change in employer goals, a more affordable option than they currently have available.

 

[Onda]

I am simply stating how functioning high-quality healthcare works: there is no secret to it, because every advanced country that consistently delivers good outcomes follows the same basic principles — broad risk pooling, negotiated pricing, and low administrative duplication.

US Private healthcare dos not work.

 

[FD1000]

Because ACA insured all for all/ most procedures, all the insurance components had to increase by a lot.
Before about 70% had great cheap insurance, 20% had to pay higher premiums and the rest didn't have insurance.
Now most pay a lot. This is how insurance works. If you want a guarantee for everyone for everything, you will pay a lot and HC services will go down for everyone.
Taxing the rich and subsiding a lot of people never works.

Universal will never work either because many Doctors will quit and go to other STEM.
We have doctors shortages already.

 

[GenXguy]

The ACA (Obamacare) has been great, despite enhanced subsidies not being extended as they should have been. It allowed many people including myself to retire earlier than otherwise could have afforded to. My personal cost is about $100 premiums and $500 deductible thanks to the ACA. Medicare is going to be more costly for me when I become eligible, assuming the ACA holds on as it is.

Medicare taxes probably do need increased some due to soaring costs, but the reason is to make Medicare more affordable to people 65+, not to bring on a younger contingent.

There are retirement plans that you do not need to be 55+.

There's no magic wand to make healthcare lower cost. It's actually going to keep going up in cost.