Health Insurers Lay Groundwork For Biden And Medicare Advantage At 60


Health insurance companies are expanding Medicare Advantage health plan offerings to seniors in hundreds of new counties for 2021 as new regulations allow for new benefits and the program becomes more popular.

But these health plans could also be establishing a beachhead for perhaps an even bigger draw of seniors if a Joe Biden White House successfully convinces Congress to lower the eligibility of Medicare to 60.

As the presidential campaign heats up in its final month, Biden is stepping up talk about his healthcare proposal that includes allowing Americans between the ages of 60 and 64 the option of buying into Medicare, the federal health insurance program for the elderly. The proposal is considered less costly than earlier versions proposed by Democrats in the U.S. Senate to lower Medicare eligibility to as young as 55 or even 50 and is expected to allow private insurers to offer Medicare Advantage at a younger age just as they do now for existing eligible Medicare beneficiaries.

Meanwhile, the Trump administration supports Medicare Advantage but doesn’t have a plan to lower the age of eligibility. Health insurers aren’t weighing in on a general election presidential endorsement, but advocates and lobbies to expand Medicare Advantage see potential to expand if eligibility widens to more Americans.

“With Medicare Advantage’s steady growth in enrollment and the increasing evidence of its value through better costs and better outcomes for beneficiaries, it would be our expectation that any proposal to extend Medicare to more beneficiaries would include a strong role for Medicare Advantage,” says Allyson Y. Schwartz, who is president and CEO of the Better Medicare Alliance, which includes an array of business, community, health groups and insurers like Humana, CVS Health, parent of Aetna, and UnitedHealth Group.

Insurers began last week announcing their expansions in new regions ahead of the annual open enrollment period when seniors eligible for Medicare can choose new benefits or stay with their existing plans. Such changes can be made during Medicare’s open enrollment, which runs Oct. 15 through Dec. 7.

Medicare Advantage plans contract with the federal government to provide extra benefits and services to seniors, such as disease management and nurse help hotlines with some also offering vision, dental care and wellness programs.

Every state in the U.S. offers Medicare Advantage and choices of plans are soaring with practically every major plan offering options that include “$0 Medicare Advantage 2021 premiums.” 

Among those that have already announced their Medicare Advantage expansions include Cigna, Humana, UnitedHealth Group and newer companies like Alignment Healthcare, which said last week it is offering 36 Medicare Advantage options in three states.

These established health plans and startups are looking to take advantage of new rules that allow Medicare Advantage plans to offer more benefits to seniors. Insurers are adding broader coverage of telehealth and ways to address social determinants of health that provide low cost and $0 coverage of several different benefits.

The expansion into Medicare Advantage comes as many of these same health plans look to expand in the individual health insurance market under the Affordable Care Act. Thus, healthcare analysts say it makes sense for health plans to expand in the individual market, also known as Obamacare, as a way to prepare for lowering the age of Medicare to 60 or even lower.

“(Medicare Advantage) plans that also participate in the individual market should be especially well positioned to take advantage of this opportunity if it were to present itself,” says Katherine Hempstead, senior policy adviser at the Robert Wood Johnson Foundation. 

“We talk a lot about the synergies between Medicaid and the marketplace, but the connection between M.A. and the marketplace is also important, since a lot of marketplace enrollees are older and on the verge of Medicare eligibility,” Hempstead says. “ I think M.A. plans increasingly view Marketplace participation as an opportunity to recruit members. This also raises interesting questions about how this age group will evaluate the potential benefits of Medicare versus Marketplace, in terms of both affordability as well as maybe networks and access to care issues.”

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