Medicare Q&A

Q: I’m already on Medicare. Could I really lose my coverage or see it radically altered?

For people currently on Medicare, there is no immediate threat to your coverage. The most widely discussed plan proposed by House Republicans would not go into effect until 2024. But at this point, the debate is just beginning, and there are other proposals that could reduce coverage and raise costs for today’s seniors. Current beneficiaries could also be affected if the Affordable Care Act, known as Obamacare, is repealed, and the additional benefits that the law provided to Medicare recipients disappear.

Q: Reforming Obamacare seems to be an important early goal of the Trump administration. How could that affect my Medicare coverage?

The ACA made a number of improvements to Medicare—including closing the gap in drug coverage (the “doughnut hole”), adding free preventive benefits and cutting excess provider payments—that improved the financial stability of the program. Obamacare also took some steps to improve care coordination and reduce hospital readmissions. If the entire health care law is repealed, these improvements would be lost.

Q: Isn’t Medicare at risk of going broke within a few decades? For the sake of grandkids, don’t we have to make some changes?

Medicare is not going broke: The program can pay full hospital benefits through 2028. Beyond that, there are challenges, largely caused by a growing older population and skyrocketing health costs.

A number of proposals on the table could keep Medicare on a strong financial footing. Some would make older Americans shoulder more of the costs. Others would focus on lowering health care costs by tackling high drug prices, improving care coordination and cutting back on waste and inefficiencies in our health system.

Q: I’ve heard about the voucher-type plan that House Republicans hope to implement soon. How would this plan change Medicare?

The “premium support” plan put forward by House Republicans represents a dramatic change: It would move away from guaranteed benefits and instead provide older adults with a set amount of money (similar to what has been called a voucher) to buy health insurance from private companies. Supporters say this would stimulate greater price competition among insurers and ultimately cut down on costs.

But opponents — including AARP — say the amount of the voucher may not be enough to keep up with health care inflation, so older adults could end up paying more for care and for insurance that has fewer choices of doctors and other providers.

Q: I’ve been paying payroll taxes for Medicare for many years and thought I was guaranteed coverage. Can the rules be changed now before I’m old enough for Medicare?

Current benefits are set in law for today’s beneficiaries. But Congress can revise the law at any time to change the benefit guarantee, raise the age of eligibility and require higher cost sharing.
AARP is fighting to protect that benefit guarantee. We are also working to improve the care and coverage in Medicare, and to make sure that health costs stay as low as possible for those using the program.

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