More older Americans rely on Medicare and Medicaid

Retirement in America is growing less secure, physically and financially, given the omnipresent threat and cost of serious illness or disease.

Why it matters: Qualifying for Medicare does not guarantee that older adults will skirt potentially ruinous medical bills. Millions of seniors have also come to rely on the taxpayer-funded program for lower income people — Medicaid — and there's no indication that will slow down.

• "I can't tell you how many times people talk about how unaffordable the costs are, how it wipes away life savings in short order," said Tricia Neuman, a Medicare policy expert at the Kaiser Family Foundation.

By the numbers: More than 12 million Americans — most of them over 65 — have both Medicare and Medicaid coverage.

• That represents about one-fifth of all Medicare enrollees, a percentage that has stayed stable over time even as more baby boomers enter the program.
• This low-income population has some of the most expensive health care conditions and disabilities — averaging roughly $30,000 in annual spending per person, or double the average Medicare enrollee.

Between the lines: Some people who age into Medicare have very few assets and income, and therefore automatically qualify for Medicaid. But retirees who consider themselves middle-class increasingly have to resort to Medicaid because the costs of things like dementia or nursing home care consume their entire nest egg.

• "The real challenges are for people who are just above the Medicaid eligibility level," Neuman said. "They're really left to fend for themselves."

What to watch: The federal government has been experimenting with ways to coordinate care better for this population, but that's a reaction to seniors falling into poverty due to health care costs.

• Unless policymakers address the high and rising costs of care, more retirees and their families will have to depend on both Medicare and Medicaid.

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