The health reform legislation before Congress contains a little noticed provision that allows an increase in health insurance premiums for those under 65.The idea is that as we age we cost the health care system more, but as the National Committee to Preserve Social Security and Medicare notes “age is far from an entirely reliable predictor of health care costs, accounting for less than 20% of the variation in costs across age groups. A healthy 55-year-old may well consume fewer health care dollars than a 35-year-old who is obese or has diabetes. ‘’ As the Committee goes on to note:
The current House bill would allow someone 55 or older to pay premiums that are twice as high as a young enrollee (a 2:1 age rating). The Senate agreed to a 3:1 age rating, which would allow premiums to be three times higher for older people. In a recent briefing, Karen Ignagni, head of the American Health Insurance Plans that represents private health insurers, called for a 5:1 age rating.
All this raises a new question for the Congress: Will this age based rating system coupled with a lack of serious public option, end up forcing older Americans to forego expensive insurance altogether.
This is not just a numbers game. There is both a human and financial toll to be paid. A recent Harvard study published in the American Journal of Public Health found that American adults under 65 who lack health insurance have a 40 percent higher risk of death than those who have coverage. Ailing and uninsured people in their 50s and 60s will likely add to the strain on Medicare’s budget as they seek care for neglected health problems as soon as they become eligible for this entitlement.