Which States Could See the Greatest Impact of Medicare at 60?

Published Jan. 8, 2020

One of Joe Biden’s proposed initiatives as president is to lower the Medicare eligibility age from its current age of 65 down to 60.

More than 20 million Americans (more than 6% of the population) would become newly eligible for Medicare under Biden’s plan. But which state populations would such legislation impact the most? 

Based on our analysis of U.S. Census Bureau data, lowering the Medicare eligibility age would have the greatest impact on people in Montana, Maine and West Virginia. At least 7% of the total population of each state are aged 60 to 64, and at least 14% of the 55-64 year-olds in each state are currently uninsured.

We also surveyed 456 adults aged 59-64 from across the U.S. about their current insurance coverage and whether they would switch to Medicare if the eligibility age was lowered. We found more than 3 out of 5 people who would be impacted by the change would enroll in Medicare before age 65 if they had the option.

How Medicare at 60 Would Affect Each State

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Who Would Switch to Medicare?

According to our survey, 61% of adults ages 59 to 64 would leave their current health insurance and enroll in Medicare if afforded the opportunity.

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A respondent’s willingness to leave their current coverage in favor of Medicare largely depended on the type of insurance they currently have.

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ACA Marketplace Coverage

Of those enrolled in Health Insurance Marketplace coverage (plans provided through the Affordable Care Act, or “Obamacare”), 90% said they would leave their current coverage and enroll in Medicare if they could.

Around 11 million Americans were insured by Marketplace plans at the time of the study, with average monthly premiums of $328 for the lowest tier of plans and $482 for plans in the highest tier during this time.

Most people do not pay a monthly premium for Medicare Part A, which provides coverage for hospital and other inpatient care. Medicare Part B – which is optional and includes coverage for outpatient care, medical equipment and other services – had a standard premium of $148.50 per month in 2021 ($174.70 in 2024). 

Employer-based Insurance

More than half of people under the age of 65 receive health insurance through an employer. Though health insurance is largely regarded as the most coveted employee benefit, 44% of our respondents said they would leave their employer’s coverage to enroll in Medicare if they could. 

Nationwide in 2019, employees contributed an annual average of $1,489 for their employer-provided insurance premiums ($124.08 per month). In Massachusetts, the average premium was $149.42 per month, the highest in the nation. The average monthly premium in Hawaii was the lowest in the nation, at $59.83.

Medicaid

Of those on Medicaid, 57% said they would leave it in favor of Medicare coverage if given the opportunity. However, many wouldn’t have to. More than 12 million Americans are enrolled in both Medicaid and Medicare and receive coverage from both programs as “dual eligible beneficiaries.” 

Other Insurance

Among those on other types of insurance such as federal benefits or military health insurance, 54% said they would make the switch to Medicare if they became eligible due to a lowered eligibility age.

As with Medicaid, many beneficiaries wouldn’t necessarily have to disenroll in their current coverage to join Medicare, as Medicare can be used in conjunction with both the Federal Employee Health Benefits Program as well as with military insurance like TRICARE and VA benefits.

Uninsured

82% of adults ages 59-64 who do not currently have health insurance said they would enroll in Medicare if they were eligible.

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Montana’s 17.5% rate of uninsured residents aged 55 to 64 is the highest in the nation, followed by Maine (16.8%) and South Carolina (14.8%).

Conclusion

Around 20 million Americans would become eligible for Medicare if the eligibility age were lowered to 60 from its current requirement of 65, and more than 3 in 5 adults ages 59-64 say they would enroll in the program if given the opportunity. 

The people most likely to enroll in Medicare at 60 are the uninsured and those currently enrolled in ACA Marketplace health insurance plans. 

States with a higher percentage of residents ages 60-64, such as Maine, Vermont and New Hampshire, would see the largest impact of Biden’s proposed Medicare expansion, if enacted.

Methodology

The data analyzed for this piece came from the U.S. Census Bureau, exploring the distribution of adults aged 60-64 in each state and the percentage of uninsured adults aged 55 to 64 in each state.

We also conducted a survey of 456 people aged 59 to 64 using an audience pool gathered using MTurk, a survey platform tool. Participants were filtered based on completion time and failure to follow written instructions within the survey. Those who are already enrolled in Medicare were also excluded.

Margin of error: +/- 4% (95% confidence interval)

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