Hillary Clinton's Health Care Reform and Plans to Expand Medicare

Is 'Medicare for More' the Answer?

Hilllary Clinton Medicare for More
Hillary Clinton proposes offering Medicare to more Americans. VIEWpress / Corbis News / Getty Images

Health care reform is here to stay. Regardless of how the political tides turn with the 2016 presidential election, Medicare is about to undergo major changes.

Impact of the Affordable Care Act 

Health care reform began with the introduction of the Affordable Care Act (Obamacare) in 2010. Since that time, the United States has increased access to health care for millions of Americans. Some of the strengths of the law have included:

  • Continued health coverage for children up to 26 years of age on their parents' health plans
  • Decreased cost of Medicare drugs during the coverage gap, aka the "donut hole"
  • Exclusion of pre-existing conditions from insurance company pricing policies
  • Health Insurance Marketplace plans for people earning incomes up to 400 percent of the federal poverty level
  • Medicaid expansion in many states

That is not to say that everything has run smoothly with Obamacare. Costs have been on the rise. There have been increases in deductibles, premiums, and controversy over employer and individual tax mandates. The Affordable Care Act has even been brought to the U.S. Supreme Court with concerns that parts of the legislation may have been unconstitutional.

The question to ask is whether or not the Affordable Care Act is enough. Are more changes to our health care system needed? Should Obamacare be scrapped altogether as many Republicans propose or should it be expanded or replaced with another plan?

Hillary Clinton's Health Care Reform

Hillary Clinton has championed universal health care for years. In that regard, it should be no surprise that the Affordable Care Act would remain in effect if she were to be elected President. In fact, she wants to make even more care options available to Americans, options that add coverage for undocumented immigrants and that protect women's reproductive rights.

The former Secretary of State has emphasized cost containment as part of her health care agenda. She aims to decrease the cost of prescription drugs by increasing market competition between pharmaceutical companies, letting Medicare bargain with drug companies for better deals, and allowing Americans to access medications from overseas, as long as the medications are proven safe and effective. In terms of consumers, she also hopes to put a cap on out-of-pocket spending for medications.

These reforms would impact on Medicare beneficiaries but she has even bigger plans for Medicare. On the campaign trail, Hillary Clinton has introduced the idea of "Medicare for More". This would make Medicare available to people as young as 50 years old. What effect would this have on our health care system?

How "Medicare for More" Could Save Money

The current eligibility age for Medicare is 65 years old. People in this age group tend to have a number of medical conditions and more medical conditions mean more health care spending.

At least 87 percent of Americans aged 65-74 years old have at least one chronic medical problem. The number increases to 92 percent for those 75 years and older. Taking a closer look, more than 50 percent of seniors over 65 years old have at least two to four chronic conditions while 20 percent of seniors 75 and older have five or more.

The numbers decrease significantly when we look at the younger 50 to 64-year-old population, not currently covered by Medicare. Nearly 72 percent of Americans in this age group have one or more chronic medical problems, 40 percent have two to four conditions and 5 percent have five or more. 

Once someone meets eligibility criteria for Medicare by age or disability, they begin to pay monthly premiums for medical coverage. This money is put into a pool and used to pay for services for all beneficiaries. If younger, relatively healthier Americans were added to that pool, then an interesting thing would happen to Medicare. There would be more money to share. Though there would be more patients in the pool too, there would be a smaller average number of medical conditions to address. This could potentially add years of savings to the Medicare Trust Fund.

The Difference Between "Medicare for All" and "Medicare for More"

Hillary Clinton and Bernie Sanders may both be Democrats but their vision for American health care differs on many levels. Senator Sanders's plan, "Medicare for All", wants a single payer system where everyone gets care access through Medicare. Hillary Clinton prefers expanding Medicare coverage to younger Americans but not to all of them.

In either case, would younger Americans want Medicare over other care options? After all, Medicare coverage is not all-inclusive. A private insurance plan may cover things that Medicare does not, things like contact lenses, eyeglasses, and hearing aids. In many cases, other plans may be less expensive in terms of deductibles and premiums. This is often the case for people on Medicaid and, in some cases, Health Insurance Marketplace plans.

The appeal of "Medicare for More" is that it could save money for Medicare in the long-run. Unfortunately, this could cost younger beneficiaries more from their own pockets. Medicare expansion will be one of the issues that Americans will need to consider when they vote in the coming election. The specifics of Hillary Clinton's Medicare plan have yet to be announced.


AARP. Chronic Conditions Among Older Americans. http://assets.aarp.org/rgcenter/health/beyond_50_hcr_conditions.pdf. Accessed July 6, 2016.

Hillary Clinton. Health care: Affordable health care is a basic human right. https://www.hillaryclinton.com/issues/health-care/. Accessed July 6, 2016.

Obamacare Facts. ObamaCare Enrollment Numbers. http://obamacarefacts.com/sign-ups/obamacare-enrollment-numbers/. Accessed July 6, 2016.

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