If Obamacare Exits, Some May Need to Rethink Early Retirement

By Austin Frakt
The New York Times, February 27, 2017

Here’s another possible consequence of repealing the Affordable Care Act: It would be harder for many people to retire early.

Americans reaching 65 become eligible for Medicare. Before reaching that age, some can get retiree coverage from their former employers. But not very many companies, especially small ones, offer medical insurance to retirees. If early retirees are poor enough, they could turn to Medicaid. To retire early, everybody else would need to turn to the individual health insurance market. Without the subsidies and protections the A.C.A. put in place, health care coverage would be more difficult to obtain, cost consumers more where available, and provide fewer benefits than it does today.

But it is clear that with A.C.A. repeal on the table, people contemplating early retirement may need to reconsider.

It seems that our goal should be to remove financial barriers to health care for all of us so we can get the health care we need when we need it.

So why do we make it difficult by establishing such arbitrary qualifications for health coverage: employment status (employer-sponsored plans), older age (65 for Medicare), younger age (CHIP), income (Medicaid), prior military service (VA), ethnic heritage (Indian Health Service), temporary unemployment (COBRA), or whatever?

This complexity contributes greatly to the profound administrative waste in our system – now over a half a trillion dollars a year that could be recovered, according to a report this month in the Annals of Internal Medicine. It also increases instability in our health care with ever-changing provider networks, creating a degree of fragmentation that is unique in the U.S. health care system.

It would be so much simpler and efficient to improve Medicare so that it is appropriate for all ages, and then automatically include everyone, using an equitable method of funding that would be affordable for all.

With the difficulty that Congress is having with decisions on how to improve health care financing, why don’t they finally take a serious look at a proven model that has worked well in other nations – a single payer national health program – in the form of an improved Medicare for all?