Nov 5, 2019

Seniors struggle to afford health care

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Reproduced from Kaiser Family Foundation; Note: Costs do not include premiums; Chart: Axios Visuals

More than half of Medicare beneficiaries with a serious illness have struggled to afford a medical bill, and some beneficiaries with chronic conditions pay an astronomical amount out of pocket for their care, two new studies find.

Why it matters: Medicare is supposed to be a safety net for America's seniors, but its lack of a cap on what beneficiaries pay out-of-pocket — and the fact that it doesn't cover some benefits — leads to many seniors falling through the cracks.

Driving the news: A new survey published yesterday in Health Affairs found that 53% of seriously ill Medicare beneficiaries said they'd experienced financial hardships while trying to get care.

  • Respondents reported having problems paying prescription drug bills most often, followed by hospital bills.

A second brief published by the Kaiser Family Foundation broke down Medicare beneficiaries' out-of-pocket spending, which averaged $5,460 in in 2016, including their premiums.

  • The most expensive service for seniors, by far, was long-term care, which isn't covered by Medicare.
  • Beneficiaries with diseases likely to require long-term care — like Alzheimer's, other kinds of dementia, or Parkinson’s — had the highest spending.
  • Older beneficiaries, women and those in poor health faced higher-than-average costs.

The bottom line: Democrats across the ideological spectrum are leaning into expanding Medicare, but the existing program has plenty of holes.

Go deeper: The looming crisis in long-term care

Go deeper

More older Americans rely on Medicare and Medicaid

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.

Go deeperArrowNov 16, 2019

We all pay for the bloated U.S. health care system

Data: OECD; Chart: Andrew Witherspoon/Axios

Americans pay higher out-of-pocket costs than most other wealthy countries, a byproduct of having the most expensive health care system in the world, according to the OECD.

Why it matters: Health care costs are at the heart of today's most explosive health care debates, including Medicare for All, prescription drug prices and surprise medical bills.

Go deeperArrowNov 13, 2019

Buttigieg's new plan for long-term care

Photo: Mario Tama/Getty Images

South Bend, Indiana, Mayor Pete Buttigieg is out this morning with a new plan to shore up long-term care, along with other retirement-related priorities.

Why it matters: Older people caucus, and long-term care is an enormous strain on millions of families.

Go deeperArrowNov 25, 2019