Candidate Donald Trump didn’t say much about Medicare, and President Elect Donald Trump hasn’t said much, either. But the Republican Speaker of the House, Paul Ryan, has plenty to say about it, and what he’s said has got a lot of older Americans worried.
Paul Ryan has made it known for quite some time that he would like to privatize Medicare, and now that the Senate and Congress are dominated by Republicans, and there’s a Republican president, he might just get his way. But what will this mean to current Medicare recipients? The answer is a bit murky, just like a lot of other things right now.
Ironically, while Ryan has called for the repeal of Obamacare, his plan of privatizing Medicare looks remarkably similar to the Affordable Care Act (affectionately known as “Obamacare”). The plan involves setting up Medicare exchanges, where insurance companies would compete with each other and sell policies to former Medicare recipients. In those exchanges, people would use their own funds, in addition to “subsidies” for lower income people, to purchase health coverage. And the subsidies would be tied to the price of the second-lowest cost plan offered.
Sounds a bit familiar, doesn’t it?
Insurance companies wouldn’t be able to reject people based on health status, so everyone would qualify to be covered. Ryan’s plan sounds very much like putting all older Americans into Medicare Advantage plans, which are administered by private insurance companies. Instead of covering an individual under Medicare, the government pays an insurance company to cover an individual. Current estimates say that about 50% of Americans who are newly turning 65 are choosing these plans over traditional Medicare.
Any changes to Medicare won’t take effect until 2024, so we’ve got a bit of time to sort things out. The changes proposed by Ryan are intriguing, since they will likely increase competition in the marketplace, which should bring down coverage costs. What do you think?

Wiley Long is founder and president of Medigap Advisors, and is passionate about helping people navigate the confusing waters of Medicare. He is the author of The Medicare Playbook: Designing Your Successful Health Coverage Strategy, a clear and simple explanation so you can make the most of your Medicare coverage. For more information visit