What Does the 2020 Election Mean for Seniors on Medicare?

Table of Contents:

  1. The New “Third Rail”
  2. Medicare for All vs. Today’s Medicare
  3. Common Ground

The New “Third Rail”

Conventional wisdom holds that Social Security is the “third rail” of American politics. So many Americans (1 in 6) depend on the system that so much as threatening to touch it could derail a campaign, even a political career. More recently, however, another long-standing social program has taken on the moniker. Medicare, its funds, and its future have emerged as the subjects of the 2020 election cycle.

Across the aisle and across generations, Americans agree that healthcare is their primary concern ahead of November. What’s more, they agree that even beloved systems like Medicare need updates. A May 2019 Real Clear Politics poll discovered that just 4% of Americans believe our nation’s healthcare system functions effectively. More than a quarter would prefer a new system altogether.

It’s unsurprising, then, that a number of prospective candidates have made healthcare their signature policy issue and offered bold plans to expand and evolve Medicare. From Senator Bernie Sanders’ Medicare for All proposal to Former Vice President Joe Biden’s less transformative expansions to the Affordable Care Act, seniors will face a host of hypothetical options long before they go to the polls.

The Future of Medicare in the Hands of the Democratic Candidates
The Future of Medicare in the Hands of the Democratic Candidates

Medicare for All vs. Today’s Medicare

A majority of Medicare recipients are satisfied with their current benefits. The program’s broad popularity is part of why so many candidates in the crowded Democratic field have borrowed the term Medicare for their own healthcare proposals. In reality, very few are talking about Medicare as we’ve come to understand it.

When Senator Sanders says, “Medicare for All,” he’s actually referring to an entirely new program. The self-described Democratic Socialist aims to transform Medicare rather than simply extending its benefits to all age and income groups. Under Medicare for All, the government would enroll every American in a single, comprehensive plan. Providing access to a vast network of doctors, this plan would also eliminate premiums, deductibles, and out-of-pocket expenses. It would effectively replace the private health insurance industry and, depending on income, mean higher taxes for some Americans.


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Sanders and other Medicare for All proponents hope to close what they consider gaps in Medicare’s current coverage.

  • Long-Term Care: Though around half of Americans who reach age 65 will require some long-term care, Medicare does not currently cover a majority of these services. Seniors who need support for everyday tasks are left paying exorbitant prices or securing long-term care insurance to cover some of these costs. Medicare for All would eliminate these concerns by covering the full spectrum of long-term services.
  • Hearing, Dental, and Vision: Traditional Medicare does not cover dental care, routine eye care, or hearing aids. Though there are exceptions, most seniors cover these costs out-of-pocket or through a combination of Medicare and private insurance, including Medicare Advantage plans. Medicare for All would reduce or eliminate these costs.

More moderate candidates have warned seniors against such radical change. Speaking at an AARP forum, Biden painted a dismal picture of a nation under Medicare for All. If Sanders gets his way, Biden remarked, “Medicare goes away as you know it.” Though it might sound alarmist, the statement is technically true. It also ignores a crucial fact: No matter who wins the Democratic nomination and the 2020 election, it’s almost certain Medicare is changing.

Common Ground

All eight of the candidates still vying for the Democratic nomination have expressed interest in providing Medicare-like coverage to every American and expanding benefits to current beneficiaries. They merely disagree on whether or not “Medicare for All” should mean eliminating private health insurance altogether. Pete Buttigieg is the only candidate to attach a name to his proposal, but he and his fellow moderates are offering what amounts to “Medicare for All (Who Want It).”

Each candidate agrees, for example, that drug prices have gotten out of control. Progressives and moderates alike have a similar plan for addressing the issue. They’ve called for the federal government to have more leverage at the negotiating table. While the government currently works with hospitals and other providers to ensure manageable drug prices, the law prohibits similar conversations with drug manufacturers. As such, these organizations face no competition and little incentive to keep drug costs low. Even Biden has called this law an “outrageous exception” that only enables “profiteering” throughout the pharmaceutical industry.

The candidates are also united in their opposition to Donald Trump. In 2016, the President won 53% of the senior vote due in part to campaign promises that Medicare funding would remain untouched. His recent budget proposal for Fiscal Year 2021 has called these promises into question. The budget is unlikely to pass — after all, the Democrats control the House — but it should make the conversation around healthcare all the more intense.

Americans over 65 will make up nearly a quarter of the electorate in 2020. If historical trends are any indication, they’ll also turn up to the poll in greater numbers than any other demographic group. 71% of seniors voted in 2016. All 100% can expect to hear pleas from both sides of the aisle between now and Election Day.