Why millennials should care about Medicare right now

Medicare provides basic health care to one out of six Americans, most of them 65 and older. Even people decades away from retirement, though, should be concerned about Congress meddling with the program.

Lawmakers understand that cutting current retirees' benefits is a political nonstarter. Older people vote, and they have one of the most powerful lobbyists, AARP, advocating on their behalf.

Younger people?

Not so much. Politicians will be tempted to foist the biggest cuts on people farther away from retirement (who are presumably paying less attention).

Millennials - born between 1982 and 2000 - are now the largest generation, representing one-quarter of the U.S. population, according to the Census Bureau. Deep cuts to their future benefits could rack up big savings - and potentially doom their retirements.

Without a sturdy Medicare system, health care for older Americans could quickly become unaffordable. People would be afraid to quit work, lest they lose their employer provided coverage. Those forced to stop working could find their savings wiped out in a medical crisis. Retirement as we know it could all but disappear for everyone except the wealthiest.

Yet some politicians support big Medicare cuts. In his proposed budget, President Trump suggests cutting about $500 billion from the program over the next 10 years.

But let's back up. Why are some politicians so keen to cut Medicare?

Three reasons:

THE RECENT $1.5 TRILLION TAX CUT

The tax bill Congress approved in December is expected to widen the U.S. deficit, and that has led to calls to cut other programs. And Medicare is a big program, representing 15 percent of the federal budget.

MEDICARE'S FINANCIAL TROUBLES

Like Social Security, Medicare isn't adequately funded. Neither system is "going broke" or headed for bankruptcy - that's political rhetoric. If nothing changes, however, the portion of Medicare that covers hospital stays and skilled nursing care, known as Part A, will start paying out more in benefits than it collects in payroll taxes from workers' paychecks.

Previous years' surpluses, stowed away in a trust fund, will cover the gap until 2029. After that, Medicare Part A will be able to cover 88 percent of promised benefits, rather than 100 percent.

RISING HEALTH CARE SPENDING

The rest of Medicare, which pays for doctor's visits and prescription drugs, is not projected to run short of money. As health care costs continue to rise faster than inflation, though, Medicare spending is projected to become a larger share of government spending and of the economy.

AARP and others say the system needs tweaks, rather than drastic changes. But some lawmakers want to change the fundamental nature of Medicare.

Republicans have floated a variety of voucher or "premium support" systems that would move Medicare away from guaranteed benefits to a system where people get a chunk of money to spend on a health insurance plan.

Rather than try to rein in health care costs directly, such vouchers are designed to spur competition among private insurers and make people more cost-conscious in selecting their plan.