Coverage and Benefits

What the Affordable Care Act Means for Older Adults

The Affordable Care Act (ACA) strengthened Medicare and Medicaid and created important coverage avenues and consumer protections for people of all ages. Despite these successes, the health law continues to face opposition from some policy corners in Congress, the states, some presidential administrations, and the courts.

What Medicare Premium Support Means for Older Adults and People With Disabilities

Some policymakers support turning Medicare into a premium support system, also called a defined contribution system or a voucher program. These programs would give people with Medicare a voucher or coupon to purchase health coverage. If the voucher did not cover the full cost—a certainty, given the aim of such programs is to save Medicare dollars—the person would presumably have to pay the rest or go without coverage. Though touted as a cost saver, a hallmark of these policies is to instead shift significant expenses onto consumers.

What Raising the Medicare Eligibility Age Means for Older Adults and People With Disabilities

Medicare is a nearly universal program for people 65 and over, guaranteeing health care for older adults who have paid into the system during their working lives. This ensures that older adults do not have to continue to rely on employer health insurance and can retire at 65 without risking coverage loss. Some policymakers want to delay access to Medicare by raising the eligibility age from 65 to 67 or even 70. This would disproportionately harm people who can least afford it, including people who work in physically demanding jobs and older adults of color.

What Medicaid Cuts Mean for Older Adults and People With Disabilities

With the passage of HR 1, Congress is cutting around $1 trillion from Medicaid over the course of the next 10 years. The cuts will affect Medicaid at every level, restricting eligibility and enrollment, driving up the cost of covered services for beneficiaries and states, and damaging the health care system nationwide. These cuts harm the people who rely on the program, including millions of older adults and people with disabilities who are dually eligible for Medicare and Medicaid, as well as people nearing Medicare eligibility who have coverage through expansion Medicaid.

What Medicaid Waivers Mean for Older Adults and People With Disabilities

Many states have expanded Medicaid coverage and care through Medicaid “Section 1115” waivers, but some states are inclined to move in the opposite direction, to limit eligibility or restrict coverage.

What Medicare Private Contracting Means for Older Adults and People With Disabilities

Some policymakers endorse proposals to give Medicare providers the right to charge beneficiaries more for care than is currently allowed, either through balance billing or private contracting. Under these reforms, providers could require their Medicare patients to negotiate a contract for the cost of their care, or simply charge more for Medicare-covered services, leaving those beneficiaries with additional costs on top of their premiums, copayments, and coinsurance.

What Medicare Means Testing Means for Older Adults and People With Disabilities

A core component of Medicare is its universality. Some policy ideas would undermine that promise by limiting benefits to people with lower incomes or requiring higher income enrollees to pay more for their care or coverage.

Comments on HHS Notice of Benefit and Payment Parameters for 2027

Comments on 2026 Outpatient Prospective Payment System (OPPS)

Our comments are informed by our work helping callers to our National Helpline navigate and afford their care. These experiences drive us to support efforts within this rule to bring more sustainability and rationality to Medicare payment, including by establishing greater site neutrality.

Comments on the Proposed 2026 Physician Fee Schedule

Our comments are informed by our work helping beneficiaries, including callers to our National Helpline, navigate, understand, access, and afford their care. Based on this experience, we know many people with Medicare want and need to maintain deep and trusting relationships with their providers. Finding the right provider fit, spending time with that provider, and staying with that provider over the years is a priority for many people across Original Medicare and Medicare Advantage.