Reform Could Mean Lower Medicare Costs

Janice Simmons, for HealthLeaders Media , October 12, 2009

Among those adults with cardiovascular diseases or diabetes, previously uninsured adults were more likely to be hospitalized for complications such as myocardial infarction, heart failure, or even stroke. And for those with arthritis, those who were uninsured before enrolling in Medicare were more likely to be hospitalized for joint replacement than those with prior coverage.

Thus, extending insurance to uninsured adults may result in improved health for many older working age adults—and even increased life expectancy. Plus, subsequent reductions in Medicare spending after age 65 could partially offset increased spending from expanded coverage before age 65.

The researchers, putting their findings into dollars, calculated that providing coverage to adults ages 51 to 64 would increase healthcare spending by $197 billion annually. However, this increased coverage would decrease later Medicare spending (for adults ages 65 to 74) by about $98 billion—essentially offsetting nearly half of the original costs.

These benefits suggest that health insurance coverage for uninsured adults—especially over the age 50—would be a more "valuable investment for the United States than previously thought," the researchers said.

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Janice Simmons is a senior editor and Washington, DC, correspondent for HealthLeaders Media Online. She can be reached at

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