Medicare Buy-In for Older Adults Could Cut Health Costs, Increase Coverage Value: Urban Institute

There remain major healthcare coverage gaps for older Americans, according to Healthcare Dive . A Medicare buy-in program offers an incremental solution, allowing eligible people who currently do not qualify for Medicare to buy a Medicare-like insurance plan. Two recent Medicare proposals would set up a rival insurance for adults aged 50 to 64, leveraging lower Medicare payment rates for providers in an attempt to cut costs without limiting provider networks. A December study by Urban Institute researchers determined that a Medicare buy-in option would only modestly impact health coverage and spending, given existing Affordable Care Act (ACA) subsidies. The policy would enroll approximately 2.1 million Americans, mostly transferred from the ACA marketplaces or nongroup coverage. Of the roughly 5.6 million uninsured older adults, just 176,000 would opt into the buy-in, suggesting the policies have limited appeal. Still, a Medicare buy-in could significantly reduce national health spending, and could boast out-of-pocket maximums to limit cost-sharing obligations to further protect enrollees. The Urban Institute researchers also estimated that out-of-pocket spending among adults moving from marketplace coverage to the buy-in plan would fall from $3,414 to $1,528, and premiums would dip from $6,430 to $6,230.