Medicare guarantees access to health care for older adults and people with disabilities. Together with Medicare and Medicaid, the Affordable Care Act (ACA) builds health security for Americans of all ages. The House of Representatives passed the American Health Care Act (AHCA), which repeals essential policies in the ACA, ends Medicaid as we know it, and undermines Medicare—forcing older adults and people with disabilities to pay more for less.
The AHCA harms people not yet on Medicare.
23 million Americans would lose health coverage if Congress rushes to pass AHCA.
Medicare eligibility begins at age 65 for most. People ages 55-64 often find it hard to stay in the full-time job market or to find new employment after a job loss, making access to health coverage critically important.
The AHCA would shift drastically higher costs to people in their 50s and 60s by allowing insurers to charge an “age tax” on health insurance premiums.
The ACA limits the premiums people 60-64 pay to three times what younger people pay, but the AHCA lets insurers charge older adults five times (or more if state law allows) what a younger person pays for the same health plan.
The AHCA would make less assistance available to people with low incomes, to help pay for insurance premiums and cost-sharing. Combined with the “age tax,” older adults would be among those hardest hit by the law’s changes.
The AHCA would effectively end the Medicaid expansion, leading to coverage losses for low-income people in their 50s and 60s and for people with Social Security Disability Insurance who are in the required two-year waiting period for Medicare.
People Who Need the ACA: Annie
Several years ago, Annie was diagnosed with cancer and was uninsured. She worked hard and long hours earning a modest middle-class income, but health insurance was not offered through her employer. Her cancer might have been detected much earlier through routine physician visits if she had coverage.
Once she was diagnosed, Annie scrambled for coverage. Fortunately, under new ACA rules she qualified to enroll in a health plan that would cover her treatments. She had multiple surgeries at a major cancer hospital. Although these treatments were successful, the illness resulted in disability.
Annie remained fully insured post-surgery during the two-year waiting period for Medicare, after which she was able to enroll. Together, the ACA and Medicare saved Annie’s life.
Nearly 3.3 million people between ages 55 and 64 have coverage through the Marketplaces, representing the largest share of enrollees nationwide—26%.
People with disabilities also have coverage through the ACA, especially those who have Social Security Disability Insurance but are in the required two-year Medicare waiting period.
Over 750,000 people receive formal disability determinations per year, which means over 1.5 million people are in the two-year waiting period at any time and frequently turn to the ACA for coverage before their Medicare takes effect.
In 2017, most people who are eligible for both Medicare and Medicaid have incomes below $12,060/year—the federal poverty level.
In 2010, 56% of people with both Medicare and Medicaid had a cognitive or mental impairment, and 55% lived with one or more functional impairments in activities of daily living like bathing or dressing. Both were higher than for people with Medicare alone.
The AHCA harms people with Medicare, today and in the future.
By capping federal funding—through what’s known as a per-capita cap—the AHCA cuts $834 billion from Medicaid over 10 years.
These Medicaid cuts will harm the 11 million people with Medicare who also have Medicaid by leading states to reduce important Medicaid benefits, like long-term home care and nursing home services.
In 2011, Medicaid spent $146.9 billion for people with Medicare, mostly for long-term care.
The AHCA rolls back improvements to the long-term financial outlook for Medicare by cutting taxes for wealthy taxpayers and corporations.
The repeal of one tax would reduce the Medicare Hospital Insurance (Part A) trust fund, which pays for hospital care for people with Medicare, by $58 billion and benefit mostly millionaires.
The AHCA would also repeal a tax on pharmaceutical companies that helps fund Medicare Part B, which pays for doctors’ visits and outpatient care, likely increasing Part B premiums over the long term.
Tell Your Senators to Abandon the American Health Care Act Once and for All
The American Health Care Act would yank coverage out from under 23 million Americans, impose an unaffordable “age tax” on older Americans, end Medicaid as we know it, and undermine the Medicare guarantee. Not only that, the bill leaves people with pre-existing conditions out in the cold.
Write to your Senators and tell them to abandon this bill once and for all, and to engage in a transparent, bipartisan dialogue on needed reforms to enhance health care access and affordability.
Visit our one-stop resource for facts and information on the Medicare program and on proposals under consideration by Congress and the Administration to change it. Check back for ongoing updates and opportunities to get involved.