The situation is dire. Millions of people in the United States are months away from losing their health care. On January 1, dramatic changes to Medicaid outlined in the One Big Beautiful Bill Act, or OBBA, will take effect, impacting who is eligible for Medicaid. The new law excludes some groups completely (like most immigrants), introduces “community engagement” requirements (defined as 80 hours a month of work, volunteering, or school) for most people (apart from the elderly, children, and pregnant women), and requires renewals twice a year (as opposed to yearly). Some people have been impacted already (Nebraska implemented its changes on May 1 and began disenrolling people this month), and some will be kicked off their health care in October, when some previously qualified immigrants are made ineligible for Medicaid.
Though 92 percent of people should remain eligible for Medicaid coverage (through either a qualifying exemption or meeting the community engagement requirements), millions will still end up losing care.
Discovering what Medicare really means is depressing as fuck. We need single payer, insurance must die.
Medicare for all would be America’s single-payer. Thinking that a bill that’ll fundamentally change how Medicare works, but won’t change how Medicare works is kinda crazy thinking.
Why?
It costs hundreds of dollars per month, 20% per visit. Unless you want to roll the dice with no out of pocket max, you’ll still have to deal with networks and a 17% denial rate. It’s still insurance and, as such, does nothing to prevent the vicious cycle of exorbitant overcharging in the healthcare industry.
Health insurance in America is designed to extract as much wealth as possible, actual care is an afterthought. We need single payer, or at least a HEAVILY regulated multi-payer system. We need to simply take care of people when they are sick and to stop the artificially inflated prices. Medicare doesn’t go far enough.
You are right, Medicare does suck compared to single payer coverage other countries have, but it is far better than anything else in the U.S. I’ve done more than my share of reading and researching for friends and relatives. Maybe too much info follows…
What you’ve heard isn’t really accurate. There are 3 flavors of Medicare, 2 of them decent and 1 that can be OK or an absolute nightmare.
Standard Medicare - you owe about $260/month + 20% of allowable charges for everything, but that’s a smaller amount that it appears. A $550 specialist visit might only have Medicare allowable charges of $150, and the 20% deductible is $30, NOT 20% of $550. You and your doctor make the care decisions and there is no insurance company denying coverage. Standard Medicare denial rates are very low. Almost every medical provider accepts this and if you want to fly to Mayo Clinic for care you just get on a plane.
Medicare + Medigap - An additional policy that pays most all of that 20% deductible. It runs around $200 per month in many locations, but can vary quite a bit. Like standard Medicare, there is no insurance company making decisions about care. No matter what care is needed, costs out of pocket are predictable. Almost every provider accepts both of these too.
Medicare Advantage - This is NOT Medicare at all and it’s what you hear the horror stories about. Medicare Advantage is the same horrible insurance UHC, Cigna, Aetna, etc. offer but is paid for by the government. THIS is the one with the 17% denial rates and the people dying from lack of care. What’s worse, Medicare Advantage and those denial rates are such money makers for the insurance industry that the companies trick people into signing up by charging very low or zero dollar premiums per month. Medicare insurance salesmen are also paid far more to sell MA plans so they push it and lie about how great it is. Providers must be in network AND within a geographical area for coverage with limited exceptions. No Mayo Clinic for you!
The worst part is that the Medigap rules make it damn near impossible to move to Medicare + Medigap once on Medicare Advantage. I’ve spoken to people with dying parents that can’t get care from local cancer centers because of they can’t get off Medicare Advantage.
Of course it’s far more complicated than this, Medicare A & B for instance, but everyone I know that’s gone from standard insurance to Medicare + Medigap love it, and a few that are on MA with coverage at decent local medical center have good experiences too.