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Expand chart
Data: Centers for Medicare & Medicaid Services; Chart: Andrew Witherspoon/Axios

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.

Go deeper:

Go deeper

Dave Lawler, author of World
2 hours ago - World

How Biden might tackle the Iran deal

Photo illustration: Aïda Amer/Axios. Photo: Drew Angerer/Getty Images

Four more years of President Trump would almost certainly kill the Iran nuclear deal — but the election of Joe Biden wouldn’t necessarily save it.

The big picture: Rescuing the 2015 Joint Comprehensive Plan of Action (JCPOA) is near the top of Biden's foreign policy priority list. He says he'd re-enter the deal once Iran returns to compliance, and use it as the basis on which to negotiate a broader and longer-lasting deal with Iran.

Kamala Harris, the new left's insider

Photo illustration: Eniola Odetunde/Axios. Photo: Joe Buglewicz/Getty Images     

Progressive leaders see Sen. Kamala Harris, if she's elected vice president, as their conduit to a post-Biden Democratic Party where the power will be in younger, more diverse and more liberal hands.

  • Why it matters: The party's rising left sees Harris as the best hope for penetrating Joe Biden's older, largely white inner circle.

If Biden wins, Harris will become the first woman, first Black American and first Indian American to serve as a U.S. vice president — and would instantly be seen as the first in line for the presidency should Biden decide against seeking a second term.

Updated 10 hours ago - Politics & Policy

Coronavirus dashboard

Illustration: Sarah Grillo/Axios

  1. Health: Large coronavirus outbreaks leading to high death rates — Coronavirus cases are at an all-time high ahead of Election Day — U.S. tops 88,000 COVID-19 cases, setting new single-day record.
  2. Politics: States beg for Warp Speed billions.
  3. World: Taiwan reaches a record 200 days with no local coronavirus cases.
  4. 🎧Podcast: The vaccine race turns toward nationalism.