BRUNSWICK — For more than 50 years, Medicare has provided recipients with a guaranteed set of health care benefits in retirement. Right now, 55 million Americans rely on this crucial program. Here in Maine, more than 288,000 individuals – or 22 percent of our population – are covered by Medicare. Another 315,000 between the ages of 50 and 64 will enter the program in the next 15 years.

The voucher system for Medicare being proposed in Congress would hurt hardworking Americans who have paid into the program their entire working lives, but the system would hit those near retirement the hardest.

A voucher system (or “premium support,” as some in Washington call it) would replace Medicare’s current guaranteed benefits with a risky alternative. Under a voucher system, the federal government would substitute the guaranteed benefits package with a fixed dollar amount or “defined contribution” that beneficiaries would apply toward their health coverage.

Each Medicare beneficiary’s premium would be the difference between the government’s defined contribution (voucher value) and the cost of the insurance plan he or she chose. If the fixed dollar amount turned out to be insufficient to cover necessary health care costs, the beneficiary would have nowhere to turn. They would either have to dip into their own savings or go without medical care.

For many older Americans, Medicare provides important protection against economic insecurity. Without the guarantee of health care coverage, especially for older adults, the consequences are alarming. As it is, many Medicare beneficiaries in Maine are in poor health and struggling to cover Medicare out-of-pocket costs. They could face increased financial distress under a voucher model.

The fact is that the burden of chronic disease is high in our state. In 2014, 31 percent of Medicare beneficiaries had two or three chronic health conditions. Nineteen percent had four or five conditions, and 12 percent had six or more. Why should our most at-risk residents be subjected to a system that would make it even more difficult for them to access necessary health care?

We know that many residents in Maine are already struggling. The median personal income among Mainers 65 and older is about $21,000. In 2015, 7 percent of Mainers age 65 and older lived below the federal poverty level.

Many current Medicare beneficiaries have low incomes and would be at risk of catastrophic out-of-pocket costs under the voucher system. For example, people with limited financial resources could be forced to enroll in less expensive health care plans under the new system. Such lower-priced plans might come with higher deductibles to make up for a lower monthly rate. The plan might include other cost-sharing requirements, and this would increase the risk of these lower-income individuals going without necessary care because they simply couldn’t afford it.

The bottom line is that a voucher system is a step in the wrong direction. Yes, Medicare needs to be strengthened, and solutions should be considered for the long term. However, rather than shift higher costs of care to those who can least afford it, we should look at ways to strengthen the program. For example, we should be clamping down on drug companies’ high prices, improving the coordination of care and taking steps to stop Medicare fraud. We should work on advancing improvements in the use of technology and cut out overtesting.

President Trump emphatically said during his campaign that he will protect and save Social Security and Medicare. Now we need Congress to support this position and oppose a voucher system.

During the congressional recess – the week of Feb. 20 – our U.S. senators and representatives will be home in Maine. If you are concerned about protecting Medicare, please contact their local offices. You can also sign AARP’s petition to Congress, and get involved by going to

This is the time to make your voice heard on this important issue. Our elected leaders need to hear from us in Maine so they will fight for us in Washington.

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