It looks likely that lawmakers will reach a deal on the "fiscal cliff" that includes a hike in the Medicare eligibility age — a concession to those on the right who seem determined to achieve very deep entitlement cuts, even if they take benefits away from seniors. One argument for raising the age is that seniors can get insurance through Medicaid or the Obamacare exchanges.
But a Center for American Progress report released Tuesday undercuts that argument: It found that more than 400,000 seniors could lose insurance if the eligibility age is raised.
The report points out that seniors who lose Medicare could be compromised by the Supreme Court decision allowing states to opt out of the Medicaid expansion. The number of seniors who could be left without insurance would be inflated because many would fall into the category of lower-income seniors who would be expected to gain access to Medicaid through its expansion — and wouldn't be able to in states that opt out.
CAP noted that the Congressional Budget Office recently concluded that a rise in the eligibility age could mean as many as 270,000 seniors are left uninsured in 2021. But that's assuming Obamacare is fully implemented in all states. The CAP report points out that 10 states have publicly declared that they will opt out of the Medicaid expansion, and more are undecided.
CAP then found that more than 164,000 seniors live below the poverty line in states that may opt out of the expansion, using 2011 data.
It means 434,000 seniors could be left without insurance by 2021. It's a conservative estimate.
Many of these states may implement the Medicare expansion. But Republican state lawmakers are stalling in setting up the exchanges. With Obamacare implementation up in the air, it is risky to raise the eligibility age and hope Obamacare can pick up the slack.
The CAP report also found that raising the eligibility age could undermine a key goal of Obamacare by inflating health care costs.
I think speculation that Democrats will agree to raise the eligibility age is overheated.
Some on the right seem determined not to accept any entitlement reform as "real" unless beneficiaries are harmed, and President Obama and many Democrats prefer a deal to going over the cliff. Anyone who doesn't want to see this happen should make noise. There ways to cut Medicare spending without harming beneficiaries.
Greg Sargent writes for The Washington Post.