The Effects of Raising the Age of Medicare Eligibility in a Post ACA Environment
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1 The Effects of Raising the Age of Eligibility in a Post ACA Environment Juliette Cubanski, Ph.D. Associate Director, Program on Policy Kaiser Family Foundation jcubanski@kff.org Alliance for Health Reform Washington, D.C. December 17, 2012 EXHIBIT 1 Kaiser Family Foundation Study Overview Raising the Age of Eligibility: A Fresh Look Following Implementation of Health Reform (July 2011) Kaiser Family Foundation and Actuarial Research Corporation collaborated on an analysis modeling the effects of increasing the eligibility age from 65 to 67 Analysis assumes full implementation in 2014 of both the proposal (no phase in) and the coverage provisions of the 2010 health reform law (including all states expanding ) Analysis assesses the effect of increasing eligibility age in a post ACA environment on: and state spending ( and ) Out of pocket costs for those ages 65 and 66 who shift out of Costs for employers Part B premiums premiums for younger Total health care spending effects 1
2 Projected Distribution of Beneficiaries Affected By Raising Eligibility Age to 67 in 2014 By Source of Health Insurance Coverage Active workers in employer sponsored plans (n=1.0 million) (n=860,000) EXHIBIT 2 Current (dual eligibles) (n=130,000) 17% 3% 38% (n=1.9 million) 20% 22% Retirees in employersponsored plans (n=1.1 million) Total Number of Full Year Equivalent Beneficiaries Affected = 5.0 million SOURCE: Actuarial Research Corporation analysis for the Kaiser Family Foundation, July NOTES: Estimates reflect annualized number of people ages 65 and 66 affected in 2014 by raising eligibility age to 67. EXHIBIT 3 Projected Distribution of 65 and 66 Year Olds by Change in Out of Pocket Spending If the Eligibility Age is 67 66% would pay MORE out of pocket Average increase = $2,200 Total Number of Full Year Equivalent Beneficiaries Affected = 5.0 million SOURCE: Actuarial Research Corporation analysis for the Kaiser Family Foundation, July NOTES: Estimates reflect annualized number of people ages 65 and 66 affected in 2014 by raising eligibility age to 67. Estimates do not reflect individual changes in out of pocket spending, but rather the average change for each group of individuals, based on new source of health insurance. 2
3 EXHIBIT 3 Projected Distribution of 65 and 66 Year Olds by Change in Out of Pocket Spending If the Eligibility Age is 67 No change in out of pocket spending 3% Average reduction = $2,300 31% would pay LESS out of pocket 66% would pay MORE out of pocket Average increase = $2,200 Total Number of Full Year Equivalent Beneficiaries Affected = 5.0 million SOURCE: Actuarial Research Corporation analysis for the Kaiser Family Foundation, July NOTES: Estimates reflect annualized number of people ages 65 and 66 affected in 2014 by raising eligibility age to 67. Estimates do not reflect individual changes in out of pocket spending, but rather the average change for each group of individuals, based on new source of health insurance. Net Change in Average Out of Pocket Spending in 2014 Among 65 and 66 Year Olds If the Eligibility Age is 67 Based Weighted on average Source change of Health in out of pocket Insurance spending, and Subsidy 2014 = Level + $700in 2014 $5,000 $4,000 $3,000 $2,000 $1,000 Net spending $0 Net savings $1,000 $2,000 $3,000 $4,000 Lower spending for lower income groups and <150% FPL $3,200 $3, % FPL $2,200 EXHIBIT % FPL $200 + $500 + $1,200 Active workers with employer coverage % FPL + $2,200 Retirees with employer coverage Higher spending for higher income and employer coverage groups + $4,300 >400% FPL SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health 3
4 If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: saves $23.5 SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health 4
5 If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: savings: $5.7 SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: Out of pocket spending increases by $6.2 SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health 5
6 If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: Employer costs increase by SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: State costs increase by $0.7 SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health 6
7 If the eligibility age is 67 and the ACA is fully implemented in 2014, spends less, others spend more In s: NET INCREASE IN TOTAL HEALTH CARE COSTS: $5.7 BILLION SOURCE: Kaiser Family Foundation, Raising the Age of Eligibility: A Fresh Look Following Implementation of Health 7
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