Margot Sanger-Katz, a correspondent for The New York Times, wrote that Democratic presidential candidate Hillary Clinton's proposal to expand Medicare to Americans 50 years old and up will likely not work because it is at odds with the Affordable Care Act.
"A Medicare buy-in could well work, but it wouldn't easily coexist in post-Obamacare times the way it might have in the 1990s," Ms. Sanger-Katz wrote.
She reasons that if Medicare — which has no limit on out-of-pocket costs to patients — were offered on the ACA exchanges, it would undermine the requirement for those plans to include catastrophic coverage. Catastrophic coverage means there is a limit to out-of-pocket coverage. For the ACA exchanges, this limit is $6,850 a year. So if Medicare were offered on the exchanges as is, younger people would actually be receiving better coverage than older Americans, according to Ms. Sanger-Katz.
If the government were to offer a "public option," or extend Medicare-like plans to younger Americans on the exchanges, it would have to set its prices lower than commercial payers to sell any plans. However, as Ms. Sanger-Katz notes, this could drive even more payers off the exchanges or would dilute the already small number of enrollees.
Without further details of how Ms. Clinton's Medicare plan would work, it appears to be incongruent with the ACA, according to the analysis.
Read the full report here.
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