Just before the 2018 mid-term elections, seen as a repudiation of Trump policies and a clear victory for the Democrats, the non-partisan AARP indicated that there were key items of concern for seniors. I’ve grouped them: healthcare (Medicaid, Medicare, insurance, caregivers) and financial (taxes, savings, pensions, fraud, Social Security). These will still be key to voting this November.


Trump has never backed away from his advocacy to repealing the Affordable Care Act (ACA). Repeal would harm seniors 50-64 by abolishing the preexisting conditions clause and cutting ACA funding enabling 20 million Americans (many 50-64) to receive coverage. Trump and the GOP have no clear replacement plan, instead focusing on reducing the number currently covered via regulation. 

Leading Democrats are all over the board with some advocating Medicare for all (Sanders)and others incremental Medicare expansion and/or expansion of the ACA (Biden). Democrats’ healthcare plans would positively impact seniors, but to differing degrees. 

Traditional Medicare is currently a national PPO with a very broad network… but not always. Medicare Advantage is a much stricter PPO, limiting choice of MDs and hospitals. Even in traditional Medicare, in certain medical specialties there’s an access problem (psychiatric services, for example). In many communities, it is also very difficult to find primary care MDs willing to take new Medicare patients. 

And, it’s not a sure thing for existing patients, either. Let’s say you are turning 65 and you already go to Dr. Smith. If he takes Medicare, fine. If not, you are suddenly forced to either pay the tab 100% yourself or find another doc. Voluntary “opting in” to Medicare ala Joe Biden does nothing to solve this problem.

On the other hand, under Medicare for All the Federal government would be the insurer for all Americans, guaranteeing broader political support for the program, leading to long-term financial stability (currently a major issue). If Medicare for All (per Sanders) were implemented with every physician compelled to join, it would also significantly expand the number of physicians available for seniors. 

 Expanding Medicaid, another Democratic priority, would have a major impact on younger seniors 50-64. These individuals are caught in the age discrimination gap whereby employers hire few new employees 50-64, looking instead for reasons to terminate existing older employees.

Per the Commonwealth Fund (2-7-19), people 50-64 have higher under-insured rates (26%) versus the general public (23%). In other words, over a fourth of this group is currently making a bet on not getting a major healthcare problem before they get on Medicare at 65.


Traditionally, the GOP has been the party of fiscal austerity and balanced budgets. However, with supply side economics and vastly increased military expenditures, this is no longer true. Plus, to keep Trump in rather than anything altruistic, the GOP endorses emergency pandemic spending.

The recent tax cuts are a good example of how the GOP is apparently unconcerned about deficits going up, creating a future burden for seniors and their children. According to the respected Committee for a Responsible Federal Budget, the Trump tax cut will “add $1.7 trillion to deficits over the next ten years.” 

The following chart illustrates how the deficit has risen since 2015 (and will continue to go up), proving both parties are addicted to deficit spending (even more so with the truly needed COVID-19 spending).

Trillion-Dollar Deficit Return This Year  (2020) created by @FixtheDebt
Chart does not include the trillions more expected to be spent related to COVID-19

Social Security is another major financial issue for seniors. What is being done to make sure that we have money to ensure that the trust fund will not be depleted?

Proposals to tax all income have been opposed by the GOP. Currently, high wage owners making over $132,900 in wages pay no additional tax. And items like capital gains, a major source of wealth for the rich, are not taxed at all for Social Security purposes. The main GOP alternative is to raise the retirement age yet again, as was done under Reagan. Or, to have benefits reduced in future years.

Seniors should do their own analysis of where their state and Federal representatives stand on healthcare, earned benefits, and financial matters. AARP recommends the following four web sites for non-partisan political fact checking and information:  Votesmart.org;  RealClearPolitics.com;  Ballotpedia.org; and Politifact.com.

We are now in 2020, an election year, facing a clear choice on the direction of our nation. Inform yourself and vote.


Image Credit: Feature image "Vote" by hjl (flickr/Creative Commons); Trillion-Dollar Deficit Return This Year chart by @FixtheDebt (fair use);.

Jack Bernard

Jack Bernard

Jack A Bernard is a retired SVP with a national healthcare corporation. He was Chair of the Jasper County, Ga Board of Commissioners and Republican Party. He was also on the Board of Health for Jasper County and is currently on the Fayette County BOH. Bernard has over 100 columns published annually, primarily in the South.