In April 2020, then-presidential-candidate Joe Biden proposed lowering the Medicare eligibility age from 65 to 60. Surprisingly, Medicare at 60 and its likely consequences—from how many people it would cover to its fiscal costs—have not been explored in much depth. The current proposal comes with several unanswered policy questions. Would coverage be mandatory or voluntary? Would new recipients be subject to the same rules as traditional Medicare enrollees or have their own rules? Would late-enrollment penalties apply to individuals who wait until 65 to enroll?

This brief explores how certain answers to these questions could prove costly and disruptive to the current program. Preliminary estimates find that if traditional Medicare rules were applied to the Medicare at 60 population:

  • In 2018, as many as 16.9 million of 18.2 million 60- to 64-year-olds who weren’t enrolled in Medicare would have enrolled in Medicare at 60.
  • Medicare would serve as the primary payer for as many as 11.1 million of this group.
  • Among this population, average Medicare-related expenditures were $8,400 in 2018. Assuming no change in average expenditures, Medicare could pay as much as $5,700 per new enrollee.
  • With Medicare at 60 implemented in 2022, the HI Trust Fund would likely be depleted in 2024 unless policymakers adopt alternative financing methods for the new Part A expenditures.

Read the paper released by the Partnership for America's Health Care FutureMedicare at 60: A Preliminary Overview

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