Excerpts from an article ln the Palm Springs Desert Sun. 8.5.19
Bill Youngblood considers himself an expert on the struggle many people in their 50s and early 60s face: how to find affordable health insurance before they turn 65 and qualify for Medicare. Youngblood’s expertise is professional: He’s an insurance agent in the Coachella Valley, a popular retirement destination and home to a growing baby boomer population.
And it’s personal too: He’s 63 — just two years shy of qualifying for Medicare, the federal health insurance plan for seniors. Right now, he’s paying $2,000 a month for health insurance through Covered California for himself and his wife, 62. Once they both turn 65, they will pay a combined $580 with no deductible or copay for a Medicare Part B plan, plus supplemental coverage and Part D prescription coverage.
“What choice do I have but to pay that?” Youngblood said. “I certainly don’t want to roll the dice with my health insurance at this point in my life. Some people say they never get sick and they opt out, but you never know.”
Medicare covers nearly all seniors in California – only 1.4% of those 65 and older in the state lack health insurance, according to a study conducted by UC Berkeley looking at the years 2015 to 2017. But nearly 9% of Californians ages 50 to 64 are uninsured.
While new state subsidies aim to make individual premiums more affordable for middle-income individuals, officials still fear that won’t be enough for the pre-Medicare age group seeking insurance through Covered California. The problem is exacerbated for people who are 55 to 64 years old because they tend to pay the highest premiums and have more frequent, dire and expensive medical needs.
In the Golden State, new Covered California subsidies will be available starting Jan. 1 for individuals who earn between $50,000 and $75,000 a year and families of four who take in $103,000 to $155,000. Covered California is the state’s insurance marketplace created under the ACA, where people can buy policies if they do not have employer-provided health insurance. The expanded subsidies will benefit Californians who get insurance on the state’s exchange, including the pre-Medicare demographic.
Currently, a 55-year-old couple in Northern California earning $74,000 would pay $1,362 per month – 22% of their income – for the lowest level of coverage available under the state marketplace, with a $6,300 deductible per person, Lucia said. With the new subsidies, they will pay $863 per month, with a $2,500 deductible per person.
Many of these early retirees have too much income to qualify for subsidized coverage on the exchange or Medi-Cal, the state health program for low-income individuals.
“There’s been a lot of discussion about letting people buy into Medicare at age 50,” Gilbert noted. “That wouldn’t be cheap, but it would at least be a guaranteed option. ... Those discussions haven’t gone much of anywhere with this current administration, though.” Even if people under 65 were able to buy into Medicare, Youngblood said, he’s not sure it would be a panacea.
“I don’t think bringing these people into Medicare earlier is going to solve the problem. That doesn’t address the underlying issue,” Youngblood said. “It is the high cost of medication and the lack of transparency in provider services by the hospitals that drive the costs.” Consumers in their 50s and early 60s need more choices, he said.
“There aren’t many health insurance options available that are affordable, and Covered California really isn’t an option unless you qualify for subsidies, and those who are struggling are the ones who don’t qualify,” Youngblood said. Lucia, at the UC Berkeley Labor Center, agreed that expanding subsidies to middle-class
Californians are a positive step but not a long-term fix, as health care costs are rising rapidly. “The rising cost of health care also impacts how much the state spends on Medi-Cal and how much the federal government spends on Medicare,” she said. “Ultimately, we really need to address the underlying growth in health care costs in our system.”