Overview

The survey analyses described in this report are intended to help policymakers understand better the health insurance problems that confront Americans who are approaching age 65 and Medicare eligibility. A clear understanding of these problems is crucial to deciding whether or not to proceed with incremental coverage reforms for older, “pre-Medicare” adults. We had four specific research objectives:
1. To learn about the transitions in health insurance coverage experienced by older adults prior to age 65, especially as they relate to changes in employment and health;
2. To look at how well a policy allowing people to “buy in” to the Medicare program at age 62 (as proposed by former President Clinton and others) would compensate for the loss of employer-based insurance;
3. To see if there are compelling arguments, in addition to early retirement and the loss of employer coverage, to target older Americans in particular for coverage expansions;
4. To explore the empirical justification for targeting people age 62 and older, rather than setting eligibility for a buy-in at some other age.
More generally, we wanted to produce a compendium of relevant statistics that would be useful to policy analysts and others who are considering coverage reforms for older Americans.
To accomplish these objectives, we made detailed estimates of change over time using revised data from the first two waves of the Health and Retirement Study (HRS), a nationwide longitudinal data collection sponsored by the National Institute on Aging that has been providing a wealth of information about preretirement-age Americans since its inception in 1992. We looked specifically at transitions in health coverage among members of the over-55 and over-62 age groups that are targeted in Medicare buy-in proposals. We also analyzed Current Population Survey (CPS) data for a recent period (1998) in order to complement the HRS data, which are from the early 1990s and focus on changes over time.

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