Insurance subsidies, guaranteed issue, and personal mandate)

Insurance coverage which is affordable and sufficient is the main issue for elderly Americans since this age bracket is at higher risk for severe health issues and greater health care expenses than other age groups. Additionally, due to age status and greater risk to diseases, the elderly lacking coverage from their employers always experience problems getting affordable and sufficient coverage in the private insurance market.

Along with policy options to enhance elderly coverage and affordability for this group, all-inclusive reform of the personal insurance market along with a Medicaid development for persons with minimal incomes, would be most useful and comprehensive strategy.

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Together with policies intended for elderly persons, the policy makers can as well select to concentrate on projects targeted at sustaining employer-sponsored retiree insurance coverage. Even though the population of elderly retirees obtaining health benefits from their previous employer is modest, this number stands for major expenses load to several employers and unions in particular companies, comprising the communications, oil, and utilities industries (Harrington & Crawford, 2004, p.305).

For elderly persons getting higher income, paying for insurance coverage in the individual market is barely the alternative in case they didn’t obtain the public or employer coverage. The individual market changes greatly through out states, where some states are enforcing lower regulation whereas some have attempted to enhance the accessibility through ordering community ranking and guaranteed issue, in which health condition of a person is not used when establishing premiums.

If there is need of improvement in insurance coverage and expansion in health care affordability for the elderly persons, definitely the main efficient and effective strategy is comprehensive health policy, surrounding not merely individual market policy (comprising customized community ranking, income-based subsidies, guaranteed issue, and personal mandate) (Brux, 2011, p.208), but also a Medicaid improvement to offer coverage for the elderly persons with lower income.

They also offer dental coverage in some states. The most important thing is that the elderly persons can be eligible for benefits at Medicaid and Medicare.

The core disadvantage to reinsurance is that it decreases motivations for insurer or self-insured employer to practice care management and valuable utilization. It can raise population of uninsured, result in extensive fraud, and remove major Americans protections. Hence, if presenting financial aid to employers with huge retiree population is a strategy objective, a direct credit to employers would be a highly useful method for attaining that objective.

And, the possible advantage to the exchange, maintaining certain number of high-costs persons in individual market and out of the private market, would be relevant to a direct employer credit in addition to reinsurance plan. The greatest benefit for this policy is that it expands Medicaid to cover every person, comprising low income elderly people beneath 150 % of the poverty line (Seabrook, 2002, p.12).

Suggestions for some policy options have been done but are in highly incremental state, hence limited in their anticipated effect, and always do not aim the elderly who greatly requires assistance.

Strategies intended at enhancing affordability of personal insurance, through use of methods like reinsurance and tax credits, would posses less effect in comprehensive reforms to the individual insurance market and are highly probable to offer financial aid to persons who already posses health coverage in this market, comprising elderly persons with higher income, than to increase coverage to the uninsured.


Brux, J. M. (2011). Economic Issues and Policy. New York: Cengage Learning.

Harrington, C., & Crawford, C. (2004). Health policy: crisis and reform in the U.S. health care delivery system. Burlington, MA : Jones & Bartlett Learning.

Seabrook, M. (2002). Elderly Americans: issues and programs. New York: Nova Science Publishers.