The Washington PostDemocracy Dies in Darkness

Electing an older candidate carries risks. Just ask the life insurance industry.

How much should age matter to Democratic primary voters?

Democratic presidential candidates Mike Bloomberg, right, and Joe Biden greet supporters at the end of a debate in Charleston, S.C., on Tuesday. (Patrick Semansky/AP)

The Democratic presidential candidates have been sparring over whether Sen. Bernie Sanders (I-Vt.) has been adequately forthcoming about his medical records. At a debate in Las Vegas this month, former South Bend, Ind., mayor Pete Buttigieg said Sanders needs to disclose “full medical records, do a physical, and release the readout.” The Sanders campaign says demanding greater detail on Sanders’s health resembles “the kind of smear” that demands for Barack Obama’s birth certificate represented.

It’s easy to understand why Sanders is not eager to release more of his health history. He’s a 78-year-old who weighs 179 pounds and recently had a heart attack. And he’s not the only one. Of the major Democratic candidates, only Sen. Elizabeth Warren (Mass.), former vice president Joe Biden and Sen. Amy Klobuchar (Minn.) have released comprehensive medical reports. Of course, President Trump as a candidate famously released — in lieu of his physical — a letter from a doctor declaring that “if elected, Mr. Trump, I can state unequivocally, will be the healthiest individual ever elected to the presidency” — a letter it later emerged that Trump had dictated himself.

But how big is the risk associated with electing older guys?

For those voters who are concerned about the longevity of our more elderly candidates, the good news is that there is an industry devoted to assessing how likely a person is to survive for a certain number of years. Actuaries study the risk that a person, given both demographics and personal circumstances, will die in a given period; insurance companies use that data to price the cost of insuring that person. The price of a life insurance policy over the eight years a president would be eligible to serve is, thus, a good way of assessing the likelihood of survival — and whether other candidates might be likelier to live out a full two terms.

So we priced life insurance for the leading Democrats. We examined the monthly cost of a term life insurance policy for 10 years — enough to cover the entirety of a two-term presidency — that would pay out the president’s annual salary of $400,000.

The price differences between the candidates were illuminating. The annual monthly fees for the Democratic candidates varied immensely — with Buttigieg and Rep. Tulsi Gabbard (Hawaii) costing less than $20 per month to insure and Biden, former New York mayor Mike Bloomberg and Sanders costing thousands per month. It’s not all about age: Warren, who is 70 but remarkably healthy, would cost dramatically less than her septuagenarian male counterparts.

Can a president be too old?

A few caveats before we dive into the details. First, we do not have the kind of medical or family-history details an insurance company would collect about these candidates before writing a policy, so what follows are broad estimates that should be understood to have a relatively wide margin of error. Second, presidents have access to superb health care and constant vigilance of a highly attentive staff, so the life expectancy of a President Sanders or Warren may well be longer than the life expectancy of a similarly situated non-president. Third, insurance companies are generally not eager to announce life insurance prices based on hypothetical people; they like real clients with actual lives that can be assessed against the actuarial tables. So we had to piece together these costs using a few different approaches.

To determine insurance costs, we used three different but complementary methods. To get a rough sense based on relatively crude demographics, we used Policygenius’s online life insurance calculator to establish a baseline estimate of what each candidate, given age and gender, might expect to pay monthly in life insurance. If candidates had no known prior health problems, we selected the estimate applicable for a “healthy” person. If they did have known prior medical issues, we characterized them as “healthy-ish.”

At first blush, the range is pretty remarkable. On the lower end of the spectrum were Buttigieg and Gabbard, both 38-year-olds whose estimated rates for $400,000 of coverage for 10 years were $18 and $16 monthly — roughly what you’d expect to pay for a matinee movie with a big Diet Coke. Costing slightly more were 59-year-old Sen. Amy Klobuchar, 70-year-old Warren and 62-year-old billionaire Tom Steyer, whose monthly rates ranged from $71 to $131 to $201 — what some might expect to spend on a nice dinner and a movie.

But once you get into men in their later 70s with prior health issues, the costs skyrocket. The expected monthly payments for Biden, 77, Bloomberg, 78, and Sanders ranged from $1,060 to $1,269, more than 65 times the rate that Buttigieg and Gabbard would pay. The price of a policy for Trump when he was 69 in 2016 — when he, too, would have needed a 10-year policy to cover eight potential years in office — would have run $283 per month, somewhat higher than the comparably aged Warren but significantly less than the older Democratic men.

Yet these figures surely understate the cost differential between the candidates. Insurance is complicated, after all. And underwriting a life insurance policy figures in individualized data far more granular than just age and gender. So in addition to consulting Policygenius’s crude calculations, we did more granular calculations using AIG Direct, which asks more questions regarding height, weight and health.

For most of the candidates, the results were broadly consistent with the figures that Policygenius generated. AIG Direct cited the following monthly estimates for the cheaper candidates: $17.31 for Buttigieg, $17.56 for Gabbard, $66.82 for Klobuchar, $135.55 for Steyer and $211.78 for Warren.

I'm a geriatrician. There's no clear age that is 'too old' to be president.

But the online calculator could not give us estimates for the more complicated cases — the older men with complicated health histories. So we contacted a licensed insurance expert at SelectQuote Insurance Services, which uses an algorithm that is similar to AIG Direct’s, to get concrete numbers for them on the basis of the information they have made public. Sanders and Bloomberg have not released comprehensive medical reports — unlike Warren, who has. But letters from their doctors combined with public reporting suggests that both have heart stents replaced — Bloomberg in 2000 and Sanders last year after his heart attack.

When we shared this information with Brian Barrett, a licensed agent with SelectQuote, he told us that Sanders and Bloomberg would probably not qualify for life insurance at all. But if they could get an insurer to sell them a policy, they should expect to pay a whopping $2,766 per month — almost 13 times as much as AIG Direct suggested Warren would pay and more than 160 times what Gabbard and Buttigieg would need to pay.

Biden fared even worse. Having suffered both an aneurysm and an intracranial hemorrhage in the late 1980s, a person like Biden could expect to pay an estimated $3,978 per month if he was insurable at all, according to Barrett.

In other words, the three oldest men running for the Democratic nomination cost more than two orders of magnitude more than the youngest candidates to insure.

Mark Twain famously said, “Age is an issue of mind over matter. If you don’t mind, it doesn’t matter.” Supporters of Biden, Bloomberg and Sanders may not mind the risk and may decide that it doesn’t matter. But an insurance company would very much mind the risk associated with betting that any of these men will live another 10 years — let alone that they will remain mentally and physically capable over that time. (And our estimates don’t take into account the effects of the stress of being the president.) The estimated costs of insurance offer a window into how that risk escalates with age. To wit, it creeps up slowly as candidates age — until suddenly, the cost growth becomes exponential.

It turns out that electing a 78-year-old man with prior health complications is not just a little bit riskier than electing a healthy 70-year-old woman. It is dramatically more so.