Poverty and InequalitySexual and Reproductive HealthFamily, Maternal & Child HealthMethodology

Modernizing Medicare's Benefit Design and Low-Income Subsidies to Ensure Access and Affordability

TitleModernizing Medicare's Benefit Design and Low-Income Subsidies to Ensure Access and Affordability
Publication TypeJournal Article
Year of Publication2015
AuthorsSchoen, C, Davis, K, Buttorff, C, Andersen, M
JournalIssue Brief (Commonw Fund)
Date PublishedJul
ISBN Number1558-6847 (Electronic)1558-6847 (Linking)
Accession Number26219116
KeywordsFinancing, Government/*economics, Forecasting, Health Care Costs/*statistics & numerical data, Health Services Accessibility/*economics, Humans, Insurance Benefits/*trends, Insurance Coverage, Insurance, Medigap, medicaid, Medicare/*economics, Poverty, United States

Insurance coverage through the traditional Medicare program is complex, fragmented, and incomplete. Beneficiaries must purchase supplemental private insurance to fill in the gaps. While impoverished beneficiaries may receive supplemental coverage through Medicaid and subsidies for prescription drugs, help is limited for people with incomes above the poverty level. This patchwork quilt leads to confusion for beneficiaries and high administrative costs, while also undermining coverage and care coordination. Most important, Medicare's benefits fail to limit out-of-pocket costs or ensure adequate financial protection, especially for beneficiaries with low incomes and serious health problems. This brief, part of a series about Medicare's past, present, and future, presents options for an integrated benefit for enrollees in traditional Medicare. The new benefit would not only reduce cost burdens but also could potentially strengthen the Medicare program and enhance its role in stimulating and supporting innovations throughout the health care delivery system.