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Before the Affordable Care Act, people older than 55 tended to have difficulty buying their own insurance, because insurance companies saw them as bigger risks. Since the health law passed, insurance plans have been banned from discriminating against people based on health history, but they can charge premiums that are three times as much as younger adults are charged.Moving more older adults into the Medicare program could have the effect of lowering insurance costs for younger people, as Mrs. Clinton suggested. But the exact dynamics would depend on how the program was structured.Mrs. Clinton did not say, for example, whether lower-income Americans choosing Medicare would receive help paying their premiums, as they do when they buy private plans on the new marketplaces in the Affordable Care Act. Without such subsidies, Medicare might be an affordable option only for wealthy or very sick customers. In 2008, the Congressional Budget Office estimated that a Medicare buy-in program for 62- to 64-year-olds would cost about $7,600 a person.
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