By Nora OBrien-Suric, PhD
July 30 marks the 56th anniversary of President Lyndon B. Johnson signing into law the amendment that created Medicare, the federal health insurance program for Americans 65 years and older. In the decades since, Medicare has made a difference in the lives of millions of older adults. Now, as we attempt to ‘build back better’ based on the lessons learned from a devastating pandemic, our elected officials have a clear imperative to improve Medicare coverage so it makes an even greater impact.
As we approach the program’s anniversary, there are promising legislative efforts underway in Congress to help strengthen Medicare. These coverage improvements would have many long-term beneficial effects, including bolstering efforts to address a serious issue facing our country: social isolation in older adults.
Comprehensive Health Coverage and the Social Isolation Crisis
Vision, hearing and oral health are core components of overall well-being, but for many older adults, limited coverage of these services puts important preventative care out of reach. For example, just 53 percent of older adults said they have dental coverage, according to a poll led by the University of Michigan Institute for Healthcare Policy and Innovation.
That’s why we are pleased to learn that some U.S. senators are championing an expansion of Medicare benefits to include coverage of dental, vision and hearing care.
The traditional Medicare program offers very limited coverage of these critically important health care services. As a result, many older adults are forced to choose between paying high out-of-pocket costs, enrolling in privately-run Medicare Advantage programs, or forgoing this type of care altogether.
No one should have to choose between affording food, rent or medical care, but for many older adults, the cost of purchasing a life-changing hearing aid or visiting a dentist is simply too great an expense.
While the immediate benefits of this coverage expansion are clear, it could also help improve the lives of older adults in other, less obvious ways. Poor vision, hearing or dental health are often associated with a greater risk of social isolation and loneliness—an ongoing problem for older adult populations that has reached crisis levels during the pandemic.
Older adults with these types of health issues may find it harder to visit with friends and loved ones in their community, putting them at greater risk for social isolation. For example, if someone has hearing loss but is unable to afford a hearing aid, it may be unsafe or uncomfortable for them to leave their home. Painful or embarrassing dental problems may discourage people from seeking social connections and support.
Simply put, improved health coverage in these areas can help older adults stay healthier and more connected to their communities.
Lowering the Age of Eligibility May Be Next
Although it is not currently part of active legislation, lowering the age of eligibility for Medicare to 60 has also been proposed by some lawmakers, and President Joe Biden raised the possibility during his candidacy. While most in this age group have either employer-sponsored insurance or coverage through the Affordable Care Act, there are millions who remain uninsured or underinsured, including many who live in states that chose not to expand Medicaid programs under the ACA.
Lowering the age of eligibility could help more people access preventative care that is so important as we grow older. In fact, a recent study in the journal Cancer from the American Cancer Society demonstrates that rates of cancer diagnoses increase at 65, but outcomes are better in this age group compared to those age 61-64 without insurance. This is because many people find themselves in a ‘coverage limbo’ after age 60 due to retirement or other loss of employment. Those without coverage are less likely to seek preventative care or diagnostic screenings that can catch cancer in an earlier, more treatable stage. The report concluded that the expansion of Medicare would improve cancer outcomes in the 60-65 age group.
Better Health Coverage Means Better Outcomes
We applaud these efforts to expand Medicare coverage for more Americans, and we are eager to see how they progress. The data is clear: having comprehensive health coverage leads to better access, care and health outcomes, and can help address health disparities. Health care is a human right, and we will continue to work toward our goal of achieving universal health care for all New Yorkers. Improvements to existing programs, like the efforts outlined here, get us closer to that goal and to an overall healthier community.