Medical Migration; Federal Mandate: In simple terms, Medicare is health insurance for solvent retirees, and Medicaid is for the indigent.

Medicare is paid by federal funds; Medicaid is matched with state funds. For many solvent retirees, private Medigap insurance pays most or all of the cost-sharing of Medicare. The Debt Commission Report recommends that Medigap policies no longer pay all of the cost-sharing. A retired husband- wife household must pay up to $5,000 annually. The purpose seems noble: ‘to lower Medicare cost’ by discouraging use, through higher cost to beneficiaries.

The result will certainly be less than noble to solvent retirees, especially those with expensive chronic illness, who depend entirely on Social Security income, with some savings for emergencies. The additional, unavoidable medical expense may deplete savings, coercing them into insolvency, where property assets must be liquidated to pay medical expenses.

Eventually, no longer independent but totally indigent and dependent, it will be ‘beneficiary migration from Medicare to Medicaid’ and ‘cost migration from federal to states.’

Chet Barber

Vicksburg