Why you should care about Medicare

By 2080, nearly a quarter of Americans will be old enough for Medicare, the federal health insurance program for people age 65 and older. Because Medicare is popular and fiddling with it is not, little has been done to curb costs since its creation in 1965. President Obama and his challengers, Mitt Romney and Paul Ryan, have markedly different ideas for dealing with the looming issue.

It's a big part of the budget

First, it is not the same as Medicaid. Both government-funded programs provide health insurance, but the two cover different people, with little overlap:


is a federal program based on age, although it also covers some younger people with disabilities. In general, if FICA was deducted from your paycheck or your spouse’s for at least 10 years, you are entitled to Medicare when you retire.

48 million


is a state-and-federal program for low-income residents of any age. Each state’s version is a bit different, but all must meet federal guidelines. Some low-income seniors are covered by both Medicare and Medicaid.

60 million

People progam insures

Medicare as part of total federal spending

The program makes up 15 percent of total federal spending. That amount is expected to increase to 18 percent by 2021.

  • Interest
  • Discretionary (Defense and nondefense)
  • Medicaid
  • Medicare

Fifteen percent of Americans are covered by it

The typical Medicare recipient is a white female in her late 60s to early 70s who lives independently in an urban area. She has one chronic medical condition, most likely high blood pressure, and lives on a modest income. The demographic breakdown from 2010:

A breakdown of who is covered by Medicare, by race, age, residence, chronic medical conditions and annual income

*They are disabled or have end-stage kidney disease or amyotrophic lateral sclerosis.

**Most common chronic medical conditions are high blood pressure, arthritis, diabetes, mental disorder, osteoporosis or broken hip.

It could change radically in your lifetime

If you are already in Medicare, both candidates say your coverage would change little, other than that Romney would like to overturn Obama’s Affordable Care Act, which provides free preventative care and closes the “doughnut hole” gap in prescription drug coverage. For younger people, however, the candidates’ plans differ dramatically. How the plans would affect you depends on your current age.

GRAPHIC: Projected U.S. population age 65 and older who are eligible for Medicare, in millions

Projected U.S. population age 65 and older who are eligible for Medicare, in millions

If you are 56 to 64, you will reach 65 by 2022 »

If you are 30 to 55, you will reach 65 between 2022 and 2047 »

If you are 29 or younger, you will reach age 65 between 2047 and beyond »

In 2020, Obama’s health-care act would close the “doughnut hole;” Romney would keep it.

SOURCE: U.S. Department of Health and Human Services; Congressional Budget Office; MittRomney.com.; Board of Trustees of the Federal Hospital Insurance and Federal Supplementary Medical Insurance Trust Funds; 2010 Medicare Current Beneficiary Summary by the Centers for Medicare and Medicaid Services; Kaiser Family Foundation; U.S. Census Bureau; Medicare.gov; Medicaid.gov; National Center for Policy Analysis; U.S. Social Security Administration. GRAPHIC: Bonnie Berkowitz, Cristina Rivero and Emily Chow - The Washington Post. Published August 26, 2012.