Celebrating 35 years of making Medicare more accessible, affordable, and equitable!

Why People with Medicare Need Access to More Universal Benefits

As Congress works toward a potential deal that might expand access to benefits within Medicare, it is important to step back and see why such benefits matter.

In many ways, Medicare’s approach to health coverage is a remnant of its 1965 origins. At that time, many benefits we now consider key were overlooked or deliberately excluded. This means many people with Medicare are left having to pay out of pocket for much of their mental health care, oral health care, hearing aids, substance use disorder care, and other services and items they need to keep them safe, healthy, and engaged. In addition, drug prices keep climbing and millions of people have hit “catastrophic” levels of spending in Part D.

Most Americans simply cannot afford to pay more out of pocket. Half of all people with Medicare live on $29,650 or less per year, while one-quarter have less than $8,500 in savings. And health care costs take up a disproportionate share of their limited budgets. In 2016, nearly 30% of Medicare households spent 20% or more of their income on health care, while only 6% of non-Medicare households did so.

And needed help has not always materialized. Assistance programs for people with lower incomes have not kept up with need and may include draconian income and asset limits or complicated enrollment processes.

Health-related expenses are projected to grow with time and policymakers must act swiftly to improve the program and its affordability for all beneficiaries. The forthcoming reconciliation bill in Congress presents lawmakers with an historic opportunity to do just that. Prioritizing commonsense reforms—like lowering prescription drug prices and costs, filling gaps in coverage, and easing access to low-income assistance programs—would strengthen Medicare as well as the health and financial security of all who rely on its promise.

Medicare must continue to keep pace with the needs of its beneficiaries, now and in the future. We urge you to weigh in today to tell Congress to prioritize people with Medicare.

Policy Issues: Coverage and Benefits
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