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Hillary Clinton’s Medicare Expansion Plan Could Cover 13 Million People

May 20, 2016, 7:49 PM UTC
Hillary Clinton Holds A Get Out The Caucus Event In Las Vegas
LAS VEGAS, NV - FEBRUARY 18: Democratic presidential candidate former Secretary of State Hillary Clinton greets supporters during a "Get Out The Caucus" event on February 18, 2016 in Las Vegas, Nevada. With two days to go before the democratic caucuses in Nevada, Hillary Clinton is campaigning in Las Vegas. (Photo by Justin Sullivan/Getty Images)
Justin Sullivan Getty Images

A new analysis finds that Democratic presidential candidate Hillary Clinton’s plan to expand Medicare to some younger beneficiaries could extend an additional health coverage option to 13 million Americans.

Clinton shuffled leftward on health policy earlier this month when she endorsed the idea of allowing older adults (who are younger than the current Medicare eligibility threshold of 65) to buy in to the federal health program for seniors. While she didn’t specify what the age cutoff might be, the implication was that the expansion would be available for those who are at least 50 or 55 years old.

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The idea doesn’t quite have the revolutionary veneer of Clinton challenger Sen. Bernie Sanders’ single payer plan, which he’s dubbed “Medicare for all.” But according to the new report from health care analytics firm Avalere Health, making Medicare available to Americans above 50 would give millions of older adults who are either uninsured or on individual market health plans a government-sponsored coverage alternative.

Avalere points out that there are nearly 63 million Americans who could be affected by the expansion. The lion’s share of these people are covered through employer-sponsored health plans and are thereby unlikely to switch out into Medicare given the robust benefits provided by many large firms.

avalere clinton medicare
Avalere Health
Avalere Health


But 7 million people aged 50 and older remain uninsured. Another 5.9 million own individual market health plans, either through Obamacare’s statewide marketplaces or directly from insurers outside of the marketplaces. That adds up to 12.9 million who could opt for Medicare under Clinton’s proposal. (The rest are already covered through public health programs.)

The bigger question posed by Avalere’s analysts is whether or not many of these individuals would benefit from actually switching to Medicare. For the uninsured, the option may be appealing. But individual plan holders may wind up preferring their existing plans, since some of these have more prescription drug options and harder caps on out-of-pocket medical spending.

The report also points out that a disproportionate share (47%) of Obamacare beneficiaries are 45 or older while 26% are 55 or older. Given those demographics, another possible result of Clinton’s plan is that it could create more sustainable risk pools in both Medicare and the Obamacare exchanges (i.e., the overall Medicare and Obamacare risk pools could both become younger and thus likely less expensive to cover).