50 Years: What is the Future of Medicare and Medicaid?
Fifty years ago, Medicare and Medicaid became the latest and greatest entitlement signed into law. Lyndon B. Johnson did the honors July 30, 1965, with past Democrat president Harry S Truman sitting next to him.
The new law was part of Johnson’s “Great Society” plan, which was a continuation of Franklin Roosevelt’s “New Deal.” It was meant to be another safety net for seniors and other Americans who would need medical care later in life.
It is a significant milestone to have a government program remain operational 50 years later. But with such longevity, the question is then begged, as times have changed:
What will become of this program over the next 50 years?
That discussion has been a hot topic among conservatives and Republicans in regards to saving not only Medicare and Medicaid, but also to Social Security. While those programs were signed into law by Democrat presidents, Republicans have seemed to be the ones fighting to see that the government “upholds its promises to the nation’s seniors.”
With all the talk over the last several years, backed up by various studies and analyses about the programs, there have been suggestions that Medicare and Medicaid may be completely broke as early as 2025 if nothing is done to reform the structure of the system. But there are others who say that sustainability has already been addressed with the Affordable Care Act – though it reportedly took $700 billion from Medicare to pay for the bill.
In some ways, it is serendipitous that these programs have managed to be around for 50 years in the first place. But can the government continue to fulfill promises moving forward as the population ages and there are fewer workers paying into the system but more former workers taking out of the system?
What should be done, if anything has been a source of much debate? And the New York Times, in “celebrating” 50 years of Medicare, opened up its debate and opinion pages to several perspectives about Medicare and its future. While it seems there is general agreement that Medicare will look different in the next 50 years than it was in the last 50 years, there is strong debate as to how the program will change. From discussions about structural reform or developing a single-payer healthcare system (“Medicaid for all,” as it has been deemed), to cutting benefits, raising taxes and having benefits means-tested – there are plenty of options and plenty of areas of discussion and disagreement.
Whichever way you come down, there is one thing that is certain – you can’t be certain about it, so you need to be prepared for alternatives. Before you are near the age of being qualified for Medicare or Medicaid, it would be a good idea to include this topic in your discussion about estate planning with a local certified elder law attorney. He or she can sit down with you and discuss not only your general estate plan to get all your affairs in order, but can also help you understand Medicaid, its uncertain figure and how you can create some certainty for yourself and your family.
When you don’t know how much longer you’ll live, you can’t count on something unreliable. You need a rock to lean on, and your estate plan can be that rock – whether it includes Medicare or not.
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