The New Republic

As somebody in the age 60 to age 65 category, I can attest that it's health insurance hell. Chait makes much of the fact that ACA will take care of people if the Medicare eligibility age is increased to age 65, which may be true for those at or near the bottom end of the income scale, but for the millions who actually pay for their own health insurance, it would extend the health insurance hell. And it's not only the cost of health insurance (at three times the premium paid by younger insureds even though age is a "preexisting condition"), but the complexity of the insurance that make it unreliable as people age - what's covered, what's excluded, what's deductible, etc. Chait might argue that the "essential health benefits" feature of ACA will protect older insureds who pay for their own health insurance, but I know I don't need birth control pills and seriously doubt other seniors do either even if couples are having babies at older ages. I won't apologize for the sarcasm, since Obama has now officially deferred to the states to come up with the list of "essential health benefits" (other than birth control pills, of course). It's easy for Chait and others who are young and covered by group health insurance to suggest increasing the eligibility age for Medicare, but for an increasing number of Americans who must rely on individual insurance policies, it increases the time in health insurance hell.

- rayward

December 10, 2012 at 11:36am

Good reporting. I listen to Republican legislators explain we should not raise top rates because, "raising taxes does not solve our problem." I think we should get rid of the investigative powers of Congress. Skip the hearings and all the testimony. It's not solving our problems. It has to go.

- Nusholtz

December 10, 2012 at 11:55am

For writers and readers at TNR who might suffer amnesia, I will remind them that the 3:1 premium difference according to the age of the insured was included in ACA because it lowered, and lowered significantly, the cost of the universal coverage provisions (i.e., the new entitlement). I might have expected a thank you note from the beneficiaries and the policy experts who put universal coverage at the top of health care reform, but instead they want to impose even more of the cost on me and others my age by extending the age of Medicare eligibility. Bitter? No. But a little more honesty would be nice. And a thank you note.

- rayward

December 10, 2012 at 12:17pm

But what is the time frame? For someone like me, my retirement age is fixed at 68 as they raised the retirement age back under Reagan. I could take early retirement at 62 but the pay is much less. If the retirement age for Medicare is 67 and my working retirement is 68, in the end so what? Yes, I suppose for 3 years I could save myself and my employer the insurance premium costs but I am already getting nailed on the retirement age. Rayward, what the hell are you talking about? they are not going to raise the retirement age for people in your age bracket. Republicans would never be that stupid, they spent the entire campaign promising not to touch it for people 55 and older. I am the one who is getting the shaft.

- blackton

December 10, 2012 at 1:27pm

Rayward -- I know exactly the hell you are talking about. My husband and I run a small business, much too small for access to any kind of group plan, and have long paid individual insurance rates for ourselves and two long term employees. When I became eligible for Medicare this year and was able to give up my expensive, high deductible coverage, the savings were so significant that we were able to provide individual coverage for TWO young, less than full-time employees, plus, purchase premium Medicare supplement coverage for myself -- and still realize some minor savings.

- esmense

December 10, 2012 at 1:33pm

esmense, the retirement age is not being raised for people over 55 so why is rayward claiming that additional costs are going to be imposed on that age group? My generation is the one getting the shaft and it has always gotten the shaft, my payroll taxes shot up just as I started working, my retirement age was pushed back 3 years, and likely my medicare age will be pushed back two. It is the older baby boomers who got all the benefits in the world with few of the sacrifices (besides those who got drafted to Vietnam) And I am not complaining, while I think pushing the age back 2 years is idiotic from a fiscal standpoint for the economy as a whole there is little that can be done when one party is fundamentally idiotic so my complaining or expecting a thank you note would be silly.

- blackton

December 10, 2012 at 2:29pm

Some people are more robust than others of course - but past 60 even the strongest and most vital of us starts feeling it. And, it is harder to find work. Many of us fall into poverty. Plus it has yet to be seen if ACA will actually work. Many states refuse to help implement the law let alone expand Medicaid benefits. Giving in on Medicare/Medicaid, which are life-savers for tens of millions of Americans, most of whom have indeed paid into the system for decades, in exchange for pocket change from the rich - that is not only stupid economically as Mr. Cohn points out, it's immoral. At some point we need to address the fact that a tiny percentage of Americans and their captive political party are holding America hostage.

- Sophia

December 10, 2012 at 3:04pm

blackton: you and people of your age should be organizing and fighting changes to SS and Medicare that affect your generation. The safety nets are paltry as it is. They should be expanded, not made even more austere. And, we should be pushing for ACA Part II: expansion of Medicare to include everybody. The health insurance game is greatly increasing health care costs for everybody. And what about dental care? At the rate we're going teeth are going to be a luxury. The fact is, what we can't afford is our plutocracy.

- Sophia

December 10, 2012 at 3:07pm

As for limousine liberals who think President Obama should compromise other people's health and security: get a grip you guys. Better yet I challenge you to do what Cory Booker has been doing: try eating on the food stamp allowance for, say, a few months. Give up your health insurance and secure jobs too, just for a year and get a job paying Walmart wages or even, say, up to $30K per year. If it involves physical labor and/or powerlessness, so much the better. If you could arrange to be a female with children depending on you too you'd definitely be changing your song and dance.

- Sophia

December 10, 2012 at 3:11pm

PS: if you have inherited money and are writing for funsies, give your money to charity. I dare you. Life looks very different when you have nothing but what you came into the world with: your skin, your brains, your talents, such as they may be. And yes liberals come in the Mitt Romney mold too. Excuse rant but this class warfare stuff is ruining our country and to have it coming from the so-called left is adding insult to injury. Rich people have, by definition, enough money. For them to pay a few more percentage points on their marginal income isn't going to hurt them. Forcing working people to work longer and go without Medicare longer is going to hurt people and it will also harm the economy. OK, the end. For now.

- Sophia

December 10, 2012 at 3:15pm

sophia, while I support UHC lets give the PPACA a shot. And my generation is living longer, 2 of my grandparents never lived long enough to collect Social Security, one did for a few years, and my one grandmother lived to her 90's. I have seen pictures of my grandparents at my own age and the world beat them down so much more. I see no problem with people working a few more years before they collect. However I also favor people owning their own social security accounts (with additional taxes for women and orphans) so my grandfather would have, at least, left something more for my grandmother than he did.

- blackton

December 10, 2012 at 3:36pm

Chait's post (and Cohn's response) was about raising the eligibility age for Medicare to age 67 from age 65, not the retirement age for SS.

- rayward

December 10, 2012 at 4:02pm

At this point my retirement plans pretty much all count on the Mayans being right.

- Tristan

December 10, 2012 at 4:36pm

I mostly post comments that are asides, but here's a rant: I've tried, many times, to get Cohn or Scheiber to explain how, during the 2008 campaign, Obama could both support health care reform and oppose the mandate (his opposition to the mandate was the big issue between him and Clinton); after all, the mandate is the sina qua non for covering pre-existing conditions. Neither took the bait, Scheiber one time explaining that Obama "changed his mind". Changed his mind! Either Obama was stupid before he was elected and suddenly became smart afterwards, or his idea of "health care reform" was much different from mine. We know Obama isn't stupid, so the only answer is that his idea of "health care reform" was much different from mine. And so it was. His idea of "health care reform" was the creation of a new entitlement, to insure the millions of uninsured who couldn't afford insurance. Of course, the mandate had nothing to do with that. Once he became president, however, "health care reform", to have any chance of being adopted, became much broader, to include pre-existing conditions as well as reforming an industry, the health insurance industry, that was as rapacious as the banks, selling "health insurance" designed not to pay for health care expenses people actually incur. And, so, Obama, once elected, supported the mandate. But Obama's focus didn't changed. How do I know? One of the best parts of ACA is the provision for minimum federal standards for health insurance policies, so that insureds can be confident that the policies they buy actually cover health care they are likely to need. And so, with much fanfare, Obama announced that policies must include birth control pills as an "essential health benefit", which caused a big ruckus and re-invigorated Obama's base. So what are the other "essential health benefits"? The Administration released its rule regarding "essential health benefits" during Thanksgiving week, and, as a result, it has mostly passed under the radar. I'm sure it was just a coincidence that it was Thanksgiving week. What's in the rule? The administration, courageously, . . . . punted to the states. Yes, the states will come up with a list of essential health benefits. Except for birth control pills. We know that's covered from the political stunt the Obama administration pulled off earlier this year.

- rayward

December 10, 2012 at 4:48pm

The thing that is driving me crazy about this topic, whether it be on Chait's site, here, or anywhere else, is everyone keeps going on about what a terrible policy change it would be. Almost everyone on the left, though, already agrees on that point, so there is no point in trying to one-up each other on sounding the alarm. The interesting question, as Chait tried to convey, is whether this concession is better than most of the alternatives that can be anticipated in these negotiations. In other words, the question isn't whether raising the retirement age is a good idea, but whether it is a good idea as opposed to, for example, no deal being made at all. I'm not even arguing that it is a good idea in ANY context, but I'm surprised and frustrated by how little this aspect of the issue is being engaged.

- Fishpeddler

December 10, 2012 at 5:00pm

OK fishpeddler I will bite. I think this is blackmail. Giving into it is probably worse than the alternative.

- Sophia

December 10, 2012 at 5:58pm

On that score, Krugman has a good piece (as usual) about "Robber Barons and Robots," and the very long and rich comment thread reiterates the perception that private and/or corporate parties pretty much own outright at least one of our major political parties as well as almost all of our wealth. When some unelected guy named Grover is de facto King of the Republicans, preventing national progress and enabling strong-arm tactics that have contributed to widespread economic malaise, it's time to stop enabling them and giving in to their threats and tantrums. It's outright abuse of the social contract that makes us a country. And, it's a threat to the entire democratic system.

- Sophia

December 10, 2012 at 6:03pm

No deal made at all is actually the best result-- especially if BHO ever bothers to read the 14th Amendment to give him power to ignore the debt ceiling. But all that takes real political guts on domestic issues that we haven't yet seen in four years--- as opposed to foreign policy issues required to sending in a Seals team to off Bin Laden. That's one-off gutsy, but requires much less continuous fortitude than is now required for domestic issues.

- drofnats1

December 10, 2012 at 8:17pm

ray, I know that, I said Republicans ran a whole campaign about not changing medicare for those 55 and older. As to essential health benefits that all states must cover, read this: http://ebn.benefitnews.com/news/hhs-defines-essential-health-benefits-ppaca-2729494-1.html Essential Health Benefits. The PPACA defines “essential health benefits” by specifying 10 categories of benefits that must be covered by all health insurance plans offered through an exchange. These categories are: Ambulatory patient services Emergency services Hospitalization Maternity and newborn care Mental health and substance abuse disorder services Prescription drugs Rehabilitative and habilitative services and devices Laboratory services Preventive and wellness services and chronic disease management Pediatric services, including oral and vision care The new regulations extend the rules to all non-grandfathered plans offered in the individual and small group (generally less than 100 employees) markets and define the expenses that must be covered within the 10 categories. In line with proposals that have been published previously, the regulations establish a list of permissible benchmark plans. Each state is required to designate an EHB benchmark plan from that list to serve as the standard for benefits in those categories. If the state does not select a benchmark plan, the benchmark plan will be determined in accordance with default rules established by HHS. The regulations include an appendix that identifies a proposed benchmark plan for each state.

- blackton

December 10, 2012 at 9:10pm

Sophia, your remark would be more persuasive if you would make an argument why "the" alternative (whatever that means giving the innumerable possibilities) is better. Thanks for biting, but built into my point was that no one is bothering to do it unless criticized for not doing it by jerks like me -- they just want to bitch about the apostasy of floating the idea. I wish I was in a position to evaluate drof's comment, but I still haven't come fully to grips with what would result from 'no deal'. (I'm not entirely convinced most other people have either.) Some of the ramifications of no deal that I AM aware of, like expiration of unemployment benefits, don't exactly have me jumping for joy.

- Fishpeddler

December 10, 2012 at 9:21pm

I think, Fishpeddler, that the conversation about low wages, poor working conditions, offshoring, outsourcing, and attempts to evade taxation by the rich and the corporations have been turned on the victims, who are now "moochers." This represents a truly evil turn in American social history. The unproductive management class rewards itself enormous salaries, makes bad and/or outright pernicious business decisions then blames the victims, ie the workers. This was a common theme throughout the election, thanks in part to that all-too-honest 47% tape but also manifest in Paul Ryan's speeches and in his awful budget. Even more importantly we have Walmart scions "earning" hundreds of thousands of dollars a day whilst their worker struggle on low wages, short hours, no benefits. This imbalance must be confronted not reinforced by the Democrats. Instead of addressing our crumbling infrastructure, poverty and environmental damage we have the rich holding a gun to the heads of people who can't fight back. We have threats to undo regulations that are at least attempting to hold Wall Street back from complete irresponsibility and attempt to protect the environment. At some point, the essential moral and economic bankruptcy of the GOP position, which has become that of a political party apparently willing to trash our economy and damage our citizenry and our natural resources rather than compromise on tax rates has to be challenged. The need to shift revenue from war-making to infrastructure, green energy and energy has to be addressed. The immorality of the plutocracy has to be addressed. The fact that a tiny percentage of Americans has most of wealth has to be addressed. The fact that national treasures like orcas, mustangs and wolves can be sacrificed for the financial benefit of a few businesspeople must be addressed. Our lousy national health care "system" must be confronted and fixed not made worse. None of these problems can be addressed let alone fixed by reinforcing this ghastly behavior. Top down class warfare, which began to really harm the American middle class under Reagan, has got to be confronted. The attempts to further abuse and disenfranchise the majority of Americans by union-busting, shredding much needed social safety nets, and further enriching the already obscenely rich and more importantly, powerful few which we now see in these absurd "fiscal cliff" and debt ceiling non-negotiations will not be meaningfully stemmed by giving in to their demands. We need to accept this: the right wing is serious about undoing Great Society and New Deal social compacts and they are serious about never ever allowing Americans to have decent medical care and they are serious about stripping unions of any remaining power they still possess. They are serious about quashing green energy initiatives because they compete with existing extraction energy corporations and their profits. They are serious about tossing the environment out the door for the sake of their profits. They are serious about breaking the backs of American workers because that we will have zero control over wages and working conditions. So, this is as good a time as any to show some resolve in the face of a very real threat to America's status as a fair and democratic state. It's also fiscal common sense not to allow the mighty and powerful few to make matters even worse. The economics of taking relatively young and healthy people out of the Medicare system will not make it stronger. By the same token, forcing older workers who are getting sick or may not even be working, who may be poor and unemployable, and sick, to seek out private insurance is asking for more medical bankruptcies, more personal tragedy and shorter lives. I'll go a step further. I think the malign influence of Grover Norquist needs to be investigated and stopped. He is not an elected leader. ALEC is not an elected body. The Heritage Foundation and its ilk are not elected. The Koch Brothers and their kind are not elected. Karl Rove and Fox "News" are not elected but they are imposing their point of view on Americans none the less, and in spite of the fact that Democratic congressional candidates received many more votes than Republicans their gerrymandering has given them more seats. Their right wing Supreme Court has done immense damage to our democracy already. It's enough. It's time to stand up and fight for American decency and stop trying to compare rich people's pocket change to working, poor and middle class people's lives and health.

- Sophia

December 10, 2012 at 10:08pm

Finally, the Republicans need to realize that they lost the election and they lost on these issues: the rich need to pay more taxes and the rest of us need robust social safety nets because it is the decent and fiscally sound thing to do. The end.

- Sophia

December 10, 2012 at 10:13pm

I understand politically why there's a cap on social security taxes, but damn if it doesn't blow a big hole in the budget. And with the gutting of the middle class that has happened under bush, I am not sure raising the cap is such a political lose as it used to be.

- miceelf

December 10, 2012 at 10:31pm

I think raising the cap is necessary and it's an obvious way to raise revenue but also start eliminating some of the regressive burdens on the middle and working class. In this case doing what's necessary is also logical and right.

- Sophia

December 11, 2012 at 3:00am

Sophia, it appears that you think that liberals can't entirely dictate the outcome of this fiasco despite the fact that they don't control the House of Reps. Am I misreading you?

- Fishpeddler

December 11, 2012 at 9:31am

I should add that I am not against fighting for liberal principles, but we at least need to be willing and able to discuss issues in terms of what is possible, not merely in terms of what is desirable.

- Fishpeddler

December 11, 2012 at 10:24am