AARP’s Policy on Healthcare

AARP supports measures to achieve access to affordable health care coverage for all individuals. More than 41 million people have no health care insurance. Nearly 39 million people–14 percent of the population– were without public or private health insurance throughout 2000. The likelihood that someone is uninsured is associated with age, race, income, education, and employment. Young adults, people with low incomes, the self-employed, individuals working less than full time or for small employers, individuals without a high school diploma, and women are more likely than others to be uninsured.

Other trends contribute to the ranks of the uninsured. Faced with steadily increasing premiums, employers increasingly ask workers and retirees to bear a greater share of the costs for themselves and/or their dependents. Some people may have to forgo coverage if they are unable to absorb these shifts. Recent employment trends show that workers are less likely to have employer-sponsored insurance. More people are becoming self-employed or are working part-time or on a temporary basis. Most new jobs are being created by small employers and in the service sector, both of which tend to pay lower wages and offer fewer benefits than other areas of employment.

Americans in many geographic areas also continue to lack access to basic health services. Residents of isolated rural and inner-city communities are especially likely to be medically underserved. These populations tend to be disproportionately low income, uninsured, and in the case of rural areas, older.

Mental illness can strike those of all ages and incomes and can be as debilitating as any other major medical illness. However, insurance policies typically place restrictions on coverage for mental health services that do not apply to other services.

For decades, federal, state, and local governments have sought to provide protection for those without health insurance in a variety of ways: providing health care services directly, subsidizing providers serving the uninsured and establishing public insurance programs. In more recent years the Medicaid program has been expanded to cover additional vulnerable populations, especially children.

In the absence of health care reform that provides universal coverage, and recognizing the size and complexity of the health care system, AARP can support incremental reforms that move the system closer to achieving universal coverage or significantly improve coverage for those who are either without public or private insurance or are at risk of losing coverage.

Strategies for improving access to health care include:

• Expanding public health insurance (e.g. Medicaid) programs to new categories of eligibility;
• Extending Medicare to the near-elderly;
• Developing health plans specifically for the uninsured;
• Creating high-risk pools for uninsurable people;
• Subsidizing the purchase of private coverage (e.g., through income tax relief) for those who are uninsured, underinsured, or at risk of losing health coverage, such as low-come children and adults, and people between jobs or approaching Medicare eligibility;
• Continuing group health coverage at group rates to people whose access to group coverage is ending;
• Establishing and supporting programs that improve delivery of services in medically underserved areas and increasing financial resources dedicated to community clinics and outreach activities;
• Requiring parity for mental health services, i.e., covering mental health service at levels equivalent to coverage for other health services

In evaluating tax incentives to support the purchase of private health coverage, AARP will consider whether such incentives:

• give priority to groups currently without coverage and those not benefiting from current tax incentives,
• recognize the high cost of coverage in private markets faced by those who re older and those who have problems or histories of poor health,
• incorporate assistance for those whose income may not require them to pay taxes and who may have insufficient resources to pay premiums out of pocket during the tax year,
• and guarantee access to healthcare policies offering adequate coverage in the private market.