Over 60% of adults ages 50 to 64 who are working (or have a working spouse) have been diagnosed with at least one chronic health condition, such as arthritis, cancer, diabetes, heart disease, high cholesterol, or high blood pressure, according to a report from The Commonwealth Fund.
The report also says that one-fifth of older workers and their spouses -- 7 million Americans -- either have no healthcare insurance or have been uninsured at some time since age 50.
Trouble Ahead for U.S. Healthcare
The report raises alarms about the ability of the U.S. healthcare system to cope with the future healthcare needs of aging low and middle income baby boomers, who face:
- Increasing healthcare issues
- Unstable healthcare insurance coverage
- High medical costs
- Debt problems
Many Older Adults have Inadequate Healthcare Insurance Coverage
The authors found that many insured older adults have healthcare plans that do not provide adequate protection from medical costs.
"Numerous studies show that while the U.S. healthcare system spends far more than other countries on healthcare, we do not get commensurate value for our health care dollar," said Commonwealth Fund President Karen Davis in a news release.
"As millions of aging baby boomers demand more from our already strained health system, it is imperative that we move toward a high performance system of healthcare that is affordable, equitable, safe, efficient, and patient-centered."
What Worries Older Workers about the Current Healthcare System?
There is a lack of confidence in healthcare coverage among older workers and their spouses, and a lack of support for policy options that would improve access to healthcare.
- Older workers and their spouses with low and moderate incomes are worried about the affordability of healthcare insurance coverage: over half of old workers with incomes below $40,000 and two of five (42%) with incomes between $40,000 and $60,000 said they were very worried about being able to afford healthcare insurance.
- A large majority (72%) said they would be interested in receiving Medicare before age 65. Even among higher-income households ($60,000 and over) of older workers, two-thirds said they would be "very or somewhat interested" in early enrollment in Medicare.
- While older workers with low incomes were most at risk for being uninsured and having gaps in healthcare coverage, even those with moderate incomes face high rates of unstable healthcare coverage. More than one-half (54%) of older adults in working households with incomes under $25,000 and one-third (33%) of those with incomes between $25,000 and $40,000 said they experienced a time with no healthcare insurance coverage at all.
- Out-of-pocket costs for healthcare and healthcare insurance premiums take a large bite out of the household incomes of older workers. 50 to 55% of older adults in households with incomes under $40,000 spent 5% or more of their income on out-of-pocket healthcare costs and premiums, and more than one-third spent 10% or more.
- More than two in five with family incomes under $25,000 and about 30% of those with moderate incomes (between $25,000 and $60,000) reported not getting needed healthcare because of cost, compared to 11% with household incomes over $60,000.
Self-employed Older Workers Face the Biggest Healthcare Burden
- Over half (55%) of workers 50 to 64 with individual coverage spent more than $3,600 on annual healthcare insurance premiums, compared to 16% of workers with employer coverage.
- Three-quarters of older working adults and spouses with individual healthcare insurance coverage spent 5% or more of their annual income on premiums and out-of-pocket medical expenses; nearly one-half (48%) spent 10 % or more on premiums and out-of-pocket costs. Warnings for the Future
- Add special Medicare health accounts for expenses not covered by Medicare
- Eliminate the two-year waiting period for disabled individuals to be covered by Medicare
The authors caution that providing tax credits to people with low incomes to buy coverage on the individual market are unlikely to substantially increase access to meaningful and affordable coverage in this age group."
They suggest that the following options might do a better job of addressing the healthcare problems that aging baby boomers face as they approach retirement:
Allow people to get into Medicare early, helped by tax credits for people with low incomes