Medicare vouchers

As the oldest and most rural state in the nation, older Mainers and their families should be concerned with proposals taking shape in Washington to fundamentally change Medicare as we know it. Proposals to turn Medicare into a voucher program, often called “premium support,” would take health care in precisely the wrong direction — pushing up costs for current and future retirees, and eroding protections that Americans have earned through many years of paying into Medicare.
Yet, in a short-sighted attempt to save money, vouchers are being promoted on Capitol Hill as an answer to rising health care costs.
Unfortunately, they are the wrong answer. Vouchers pose troubling risks for 18,595 County residents who are currently in Medicare, not to mention the 16,796 age 50 and older who will enter the program in the next 15 years.
President Trump has promised to protect Medicare and Social Security, at one point telling older voters: “I am going to protect and save your Social Security and your Medicare. You made a deal a long time ago.”
Congress needs to follow the President’s lead. Vouchers would break a basic promise of Medicare, which is to provide a guaranteed benefit package to Americans who have paid in their entire working lives.
Under a voucher system, the basic promise could be tossed aside. Instead, consumers would get a fixed dollar amount to help pay for care in the private marketplace. On top of this you would still have to pay your Medicare premiums. And the guaranteed benefits you were promised could be scaled back.
Additionally, should that voucher amount turn out to be insufficient, tough luck. Seniors and future retirees could have to pay thousands of dollars out of their own pockets at a time when they can least afford it. In places like Aroostook and Piscataquis counties, the most rural counties in Maine, many of our seniors and older adults are already struggling to make ends meet and already pay more for health care due to our rural nature. Asking them to pay even more for their health care would simply not be acceptable or feasible.
Across Maine, 31 percent of Medicare beneficiaries have two or three chronic health conditions and rely on care they can afford. In our county, residents in poor health would quickly feel the pain of a voucher system. Many with limited resources could end up in health plans that limit their choice of doctors and demand high out-of-pocket spending to get needed care.

Nationally, one in four Medicare beneficiaries has incomes below $14,350, and one in two has incomes below $24,150. Raising their health care costs could be disastrous, forcing many to choose between going to the doctor and paying for other necessities.
The risks posed by a voucher proposal go against President Trump’s commitment to protect Medicare. Older voters helped decide the election and they’re counting on Congress to abandon this proposal.
The risks are widely recognized. For example, studies by the Congressional Budget Office and Medicare Payment Advisory Commission suggest that moving to vouchers could hit most Medicare beneficiaries in the pocketbook.
Yes, Medicare needs to be strengthened for future generations, but shifting costs to seniors and workers who’ve paid into the system their entire working lives is the wrong approach. We can put Medicare on stable ground with commonsense solutions, such as clamping down on drug companies’ high prices, improving coordination of care and use of technology, and cutting out over-testing, waste and fraud.
For example, the average cost for a year’s supply of a prescription drug more than doubled since 2006 to over $11,000 in 2013. That’s about three-fourths of the average Social Security retirement benefit, or almost half the median income of people on Medicare. Multiply this by the two to four drugs that many seniors take, and you see the magnitude of the problem.
AARP has already shown a commitment to working with elected officials of both parties to ensure that Medicare remains financially stable. But solutions must be responsible. Together, we must champion a Medicare system that delivers on the deal Americans have counted on and deserve.
During Congressional recess — the week of February 20th — both Senator Susan Collins and Congressman Bruce Poliquin will be home in Maine. If you are concerned about protecting Medicare, please contact their offices to make sure your voice is heard. You can also sign AARP’s petition to Congress, and get involved by going to www.aarp.org/protectmedicare.
Steve Farnham is executive director for the Aroostook Agency on Aging and Rich Livingston is AARP Maine’s volunteer state president.