How Health Care Overhaul Affects Baby Boomers

fromKQED

Javier Hiriart, Francis Arguello

Dr. Javier Hiriart examines Francis Arguello during a medical checkup at the Camillus Health Concern clinic in Miami last year. A report by the  Commonwealth Fund lays out the new benefits that the 18 million baby boomers in the U.S. would gain under the federal health law. Lynne Sladky/AP hide caption

itoggle caption Lynne Sladky/AP

A federal judge in Virginia has declared part of the health care law unconstitutional. Monday's ruling applies to the requirement that everyone have insurance — a provision not scheduled to kick in until 2014.

But many parts of the law were left untouched by the ruling — including the expansion in government help for millions of uninsured Americans who want insurance but can't afford it.

A report released Tuesday looks at a big segment of that population: baby boomers.          

Boomers seemed to be blessed: happy-go-lucky, healthy and wealthy. Everything seemed to tilt in their favor, but then they slammed head-on into the Great Recession.

"One of the harsh realities for boomers, especially brought on by this recession, is their optimistic view of the world has been shattered," says Matt Thornhill, president of The Boomer Project, a market research company.

He says many older adults have suffered huge investment losses, and nearly one in four doesn't have enough money for even a modest retirement.

"Those boomers today in their late 50s, early 60s who've been unemployed for a handful of years now, can't find a job, find themselves up against health crises and unexpected expenses — they're just ill-equipped to deal with it," Thornhill says.

And while those boomers have always seemed comfortably comfortable, the reality is that those ages 50 to 64 have been unemployed longer than other adults, and some 8.5 million have no health coverage.

Bruce Bellingham, 59, of San Francisco had a heart attack in June. He says this is where someone can get into trouble quickly.

Bellingham has written a book, appeared in several movies and trained as a chef. But for the past five years, he has been unemployed and uninsured. The heart attack left him with $94,000 in medical debt.

"I don't want to owe anybody anything," Bellingham says. "It's the way of the world these days. And as you get older, they never tell you this stuff in school. Things do not get easier."

The report by the nonpartisan health research foundation The Commonwealth Fund found that boomers like Bellingham and some 18 million others would gain new benefits under the federal health law — everything from direct government health coverage to new protections from high out-of-pocket costs. But it may take awhile.

"Starting in 2014, things really do change," says Sara Collins, who co-authored the report.

"If you lose coverage through your employer, you will have access to comprehensive benefits, either through the Medicaid program or through this insurance exchange, where you'll also be eligible, depending on your income, for premium subsidies," Collins adds.

The report found that more than 3 million baby boomers could get coverage under Medicaid, the government's insurance program for the poor. The federal law greatly expands Medicaid to include nearly all low-income adults. As of now, recipients must have dependent children or be disabled to qualify.

And some 3.5 million more boomers, the report estimates, will qualify for government subsidies to buy private health insurance. Monday's court ruling left all of that intact.

Baby boomers, more active and diet-conscious than their meat-and-potato predecessors, are expected to live longer than past generations. But that depends in part on their ability to access medical care.

"What's important about age 50 to 64 is that's the age at which you start seeing chronic conditions start to appear," says Steven Wallace, a public health professor at UCLA. "When you look at heart attacks among men, that's really when you first start to see an uptick."

Getting chronic conditions under control before the Big Chill set hits Medicare could, in the end, save money. Studies have found that uninsured adults — with their pent-up medical needs — end up costing the federal government dearly.

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