Possible Retirement Policy Changes in a Trump Administration

The electorate voted for change in the November election, and it could get it in spades when it comes to retirement policy.

It is far too early to predict the agenda President-elect Donald Trump will bring to the White House--or how closely it will align with the priorities of the Republican Congress, considering that many of his campaign positions didn't conform to GOP orthodoxy.

But let's try to read the tea leaves despite the uncertain environment. A big push for healthcare reform is most likely, including changes to Medicare and the Affordable Care Act. Policy affecting retirement saving is another area that could see early action. Other areas worth watching include Social Security and long-term care.

A big caveat: this is not a forecast of what will happen in Washington. Instead, it's a rundown of possible retirement policy changes that I think will bear close monitoring between now and the midterm elections in 2018--a time when the political apple cart could be upset again.

Healthcare
Healthcare reform is near the top of the priority list for both the new administration and Congress. That is due mainly to the GOP's promise to "repeal and replace" the ACA, President Barack Obama's signature legislative initiative. This will impact millions of older Americans not yet eligible for Medicare (which is available at age 65). The Commonwealth Fund estimates that the percentage of uninsured Americans ages 50-64 fell to 9.1% this year, compared with 14% in 2013. That translates to 3.1 million previously uninsured people who now have health insurance via the ACA's private exchanges and its expansion of Medicaid.

Will the Trump administration go for complete repeal of the ACA? How would Congress regard a move to end health insurance coverage for more than 20 million people? Or, will there be a move to replace the ACA with something different? Those will be key questions for pre-retirement folks who are counting on Obamacare to get them to Medicare. Some Republicans also have advocated raising the age of Medicare eligibility from 65 to 67. Absent ACA coverage, that could force even more older Americans to at least try to work longer to keep employer-based health insurance.

House Speaker Paul Ryan aims to package Obamacare reform with changes to Medicare. Ryan is a longtime supporter of something called "premium support"--a way of capping the government's liability for Medicare outlays. Ryan has advocated a move to premium support for years, so its basic features are well known.

Currently, when you sign up for Medicare the government pays 70% of your expenses, and you pick up the other 30%. With premium support, you'd get a fixed amount of money each year to buy insurance--probably choosing between original, fee-for-service Medicare or Medicare Advantage, the managed care alternative. The initial premium contribution could be tied to the current cost of the private policies where you live, and that figure would be adjusted annually.