Medicare at 60: A Popular Program Facing Challenges

In this article in the Journal of Health Politics, Policy and Law, KFF’s Tricia Neuman, Jeannie Fuglesten Biniek and Juliette Cubanski examine three isssues facing Medicare’s future: privatization, affordability and spending/financing.

They write that as Medicare approaches its 60th anniversary, it almost goes without saying that the program is both popular and successful. Medicare provides health insurance coverage to 67 million older adults and people with disabilities. Medicare is viewed favorably by Democrats, Republicans, and independents. Medicare has also helped to extend life expectancy and, in conjunction with the Civil Rights Act of 1964, narrow disparities in care. It is a vital source of revenue for hospitals, physicians and other health care providers, and health insurers, and it is an essential component of health and retirement security in the United States. These are among the reasons why Medicare is often considered a third rail in politics.

The authors also note that Medicare also faces challenges stemming from the growing role of private plans, demographic shifts, and rising health care costs. They examine these challenges by focusing on three fundamental questions: What are the implications of the transformation taking place such that private insurers are playing a more dominant role in providing Medicare benefits? What changes may be important for addressing the gaps in covered benefits and related affordability challenges? And how can Medicare be sustained to finance care for current and future generations?