## Aaron Carroll: Raising the Medicare Eligibility Age Is Really, Really, Really, Really Bad Policy

Whenever a debate begins on how to cut Medicare spending, someone "sensibly" suggests raising the eligibility age to 67 from 65….

It's a bad idea because it's a regressive way to cut Medicare. Life expectancy at age 65 has gone up over the past four decades, but it hasn't gone up equally. A 2007 study showed that while earners in the top half of incomes saw life expectancy at 65 increase more than five years since 1977, earners in the bottom half saw an increase of barely more than a year. So raising the eligibility age likely will result in a significant number of people receiving less years of Medicare overall than people did when the program was enacted. We're punishing the poor, not correcting for improved health and longevity.

It's a bad idea because it will raise the number of uninsured dramatically…. [S]ome who qualify for Medicaid will fail to enroll. Some won't be able to buy health insurance, even with government subsidies. According to estimates from the Kaiser Family Foundation, half of the affected seniors would have incomes too high to qualify for exchange subsidies, and since insurance companies can charge the elderly more under the ACA, their premiums could reach up to $12,000 annually for an individual. Many won't be able to afford that…. It's a bad idea because it will be bad for health. Studies have shown that uninsured adults nearly eligible for Medicare often forgo care until they get Medicare and then use more care once they get in…. Delaying eligibility means delaying these improvements. It's a bad idea because it will cost America money, not save it…. The Kaiser Family Foundation examined what would happen in 2014…. Washington would see$24 billion in Medicare savings. But it also would see a rise of about $9 billion in Medicaid spending and another$9 billion in subsidy spending, which would reduce the overall savings to about $5.7 billion. But all those 65- and 66-year-olds need insurance. Those who get it through their jobs would cost employers another$4.5 billion. Others would go to the exchanges. But, ironically, removing these people from the Medicare risk pool and adding them to the exchanges makes both groups less healthy, so everyone's premiums would go up. This would cost all Americans another $2.5 billion. States have to cover a portion of the new Medicaid spending. That's$700 million. Finally, there are the out-of-pocket costs to seniors, which may rise by $3.7 billion. So to save the federal government$5.7 billion, the rest of America has to cough up \$11.4 billion. That makes no sense.