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This Insight on the Issues summarizes the key findings from a new Urban Institute research report examining a proposed Medicare reform that would significantly change the program for people with Medicare. The Urban report offers important insights into how transforming Medicare to a “premium support” system would work in practice—and how it would adversely affect people with Medicare. The report—Restructuring Medicare: The False Promise of Premium Support by Robert A. Berenson, Laura Skopec, and Stephen Zuckerman—was funded by the AARP Public Policy Institute.

The Urban Institute report shows that premium support would put numerous people with Medicare at risk for high out-of-pocket expenses. Many people would be forced for affordability reasons to enroll in a plan they would not otherwise choose.  With premium support, individuals would also have fewer options for their health insurance coverage, compared to what is available now through private Medicare Advantage plans and traditional Medicare. In some locations, traditional Medicare would likely be affordable only for people with higher incomes.  In other locations, private plans would likely no longer be available.