Policy Options to Improve Older Adults’ Health Insurance Affordability

Health insurance is a critical component of access to health care. People who are insured are more likely than those who are uninsured to have a regular source of care, receive preventive care, and benefit from early detection of medical problems. Older adults are more likely to have chronic health conditions that may require regular monitoring, making health insurance especially important for this age group.

The Affordable Care Act (ACA) of 2010 led to significant improvements in access to affordable health insurance coverage, including through health insurance Marketplaces where individuals can shop for and enroll in health insurance.  

Yet despite gains in health coverage and affordability under the ACA, a significant number of Americans remain uninsured, including millions of adults ages 50 to 64, and affordability and access barriers remain. As of 2021, 5.6 million adults ages 50 to 64 remained uninsured, and racial and ethnic disparities persist. Compounding the issue is the unwinding of COVID-19–era Medicaid continuous enrollment protections, putting more older adults at risk of losing health coverage. 

A variety of federal and state policy options exist that could increase access to health insurance, improve affordability, and reduce health disparities among individuals ages 50 to 64. 

This series consists of four reports: 

• Policy Options to Improve Older Adults’ Health Insurance Affordability
• Improving Affordability of Coverage
• Expanding Access to Coverage
• Facilitating Enrollment and Outreach

The first report provides background on health coverage for adults ages 50 to 64 and presents the policy categories and solutions included in the rest of the series. The additional three briefs highlight a range of potential policy approaches to improve affordability of health coverage, expand access to coverage, and facilitate outreach and enrollment.