How the Senate Better Care Reconciliation Act (BCRA) Could Affect Coverage and Premiums for Older Adults

Issue Brief
  1. The actual applicable percentages would be somewhat higher. The language in the BCRA amends the 2014 required contribution rates outlined in current law. Each year, these percentages have been increased by an inflation factor and would continue to be indexed in the future. By 2020, the actual percentage amounts would be more than the 2014 amounts.

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  2. Kaiser Family Foundation analysis of MSIS data, 2013.

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  3. A 2007 study published in the New England Journal of Medicine that looked at previously uninsured Medicare beneficiaries helps explain this dynamic. It showed a direct relationship between lack of insurance (pre-65) to higher service use and spending (post-65). Previously uninsured adults were more likely than those with insurance to report a decline in health, and a decline in health (pre-65) was associated with 23.4% more doctor visits and 37% more hospitalizations after age 65. Depending on the number of people who lose coverage and how long they remain uninsured, the impact for Medicare may initially be modest, but could compound with time.

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