ABSTRACT
This chapter addresses the issues related to possible expansion of the Medicare system. The Qualified Medicare Beneficiary program was established as part of the Medicaid program in the Medicare Catastrophic Coverage Act and was one of the few elements retained after repeal. Its goal was to extend protection for low-income Medicare enrolees against the costs of Medicare’s cost-sharing and premium liabilities. One of the areas of greatest concern to health policy professionals in assessing the quality of health insurance is whether it offers good stop-loss protection—that is, the guarantee that above a certain threshold, the individual should not have to continue to pay out of pocket for covered services. This is one of Medicare’s greatest weaknesses. The two groups most closely related to existing Medicare beneficiaries are early retirees between the ages of 62 and 65 and newly disabled individuals who have qualified for Social Security but then must wait an additional 24 months to receive Medicare.
