Karen Davis, Kristof Stremikis, Michelle M. Doty, Mark A. Zezza
Medicare beneficiaries age 65 and older are more satisfied with their health insurance, have better access to care, and are less likely to have problems paying medical bills than working-age adults who get insurance through employers or purchase coverage on their own.
The aging of the U.S. population is posing challenges to the Medicare program. Policymakers have proposed a variety of measures to reduce spending, including shifting beneficiaries to a defined contribution plan. Commonwealth Fund researchers argue that when exploring options for sustaining coverage for the 65-and-older population—as well as for expanding coverage for those under age 65—policymakers need to consider the experiences of people covered by Medicare, employer-based health plans, and individual market plans. In this study, the researchers used data from the Commonwealth Fund 2010 Health Insurance Survey to compare individuals’ experiences.
Given the positive experiences reported by Medicare beneficiaries, policymakers should consider extending traditional Medicare coverage to the nonelderly population through the state insurance exchanges, the authors say. On the other hand, policy proposals that would replace Medicare with cash vouchers for purchasing private insurance should be considered warily: Commonwealth Fund survey results suggest shifting more beneficiaries to private plans could leave them less satisfied with their coverage and at increased risk for problems accessing needed care.
The authors analyzed data from the Commonwealth Fund 2010 Health Insurance Survey, which asked U.S. adults age 19 and older about their access to and experiences with health care, out-of-pocket costs, benefits, income, health status, insurance status, age, and other demographic characteristics.
Medicare beneficiaries are more satisfied with their health coverage—and have fewer health care access and medical bill problems—than adults with private insurance. Policymakers should proceed with caution when considering options to move beneficiaries to private plans.