Bethany Cole, Research Assistant

Democratic presidential candidate Joe Biden has called for lowering Medicare’s eligibility age to 60. What are the potential impacts and policy design issues to consider?


In the years before reaching Medicare’s current eligibility age of 65, individuals face risks that may leave them without access to employer-sponsored health insurance, such as job loss or early retirement for health or family reasons. Older Americans are particularly vulnerable to losing their jobs during this COVID-19 crisis and may face difficulty in finding employment after the pandemic ends.

The Academy’s March 2020 report on Medicare eligibility provides an overview of the policy design issues and potential impacts of lowering the age of Medicare eligibility. Key findings:

  • Lowering the Medicare eligibility age to 60 could extend eligibility to about 18 million Americans.
  • Extending the program to a younger population creates specific challenges that policymakers need to consider, such as altering the automatic enrollment processes, delayed enrollment penalties requirements, secondary-payer provisions, and ensuring access to Medigap supplemental insurance policies.
  • Lowering the age could provide significant cost relief to many older Americans, particularly: middle-income persons who devote a relatively high share of their income to coverage, especially individuals who purchase policies on the individual market and are ineligible for subsidies.
  • Moving older adults to Medicare could increase premiums in the ACA individual market, which might actually increase uninsurance among the young and middle aged.
  • Employers and states could see savings, because the costs of coverage for an expanded beneficiary population would be shifted from private insurance and Medicaid to the Medicare program.

View the full report for information about implications for employers, the role of Medicare Advantage, and more.


An Executive Summary and additional resources are available here. 

Posted on: April 17, 2020

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