At 55 and 53, couple split by Romney Medicare plan

So far, most of the debate about the Romney-Ryan proposal has focused on financial risk for future retirees, the chances that health care inflation would outrun the fixed insurance payments they would receive. If so, an older spouse on original Medicare might have to cross-subsidize the younger spouse on the new plan.

Bonnie Burns, who has spent more than 25 years counseling Medicare recipients about their benefits, says it could give rise to a new sort of family dynamic: health care envy.


“I think it would be part and parcel of whatever other family tension is going on,” said Burns, who works with the nonprofit California Health Advocates and is based near Santa Cruz.

But complexity is the biggest potential problem that Burns sees.

The guaranteed benefits the new plans would have to offer haven’t been spelled out, or the rules to prevent marketing abuses, or consumers’ rights in disputes with insurers.

“This would split everything wide open,” said Burns, “None of the components would be the same.”

The private plans currently available through Medicare are closely regulated by the government, so “there hasn’t been a big dispute about what is and is not covered,” said Burns. It’s not clear whether Romney-Ryan would tighten the rules, loosen them or keep them the same.

And she does worry about the financing.

“What do we do if we end up with a whole bunch of old people who can’t afford their premiums?” asked Burns.

Mike O’Malley said he brought this up to his oldest son, who is an Obama supporter. They discussed the Ryan-now Romney Medicare plan over a recent dinner.

He says he told his son he was getting the bad end of the deal “because I’m going to die and you’re going to have to take care of your mother. He goes, ‘I hope you leave us a lot of money.”’