This week 59 years ago, President Lyndon B. Johnson signed Medicare and Medicaid into law, improving access to care and advancing health and financial security for millions of Americans. As we celebrate this milestone, we pause to recognize the critical role of Medicare in the nation’s health care system and in the lives of its nearly 70 million enrollees, and the importance of ensuring the program is best positioned to meet current and future needs.

Medicare has long been a powerful tool to reduce injustice and inequality, and it continues to promise coverage to all who qualify. But inequities remain. Medicare Rights supports addressing disparities in ways that advance equity, justice, and access to care. This includes strengthening core health care programs—Medicare, Medicaid, and the Affordable Care Act—and improving the entire health care and social services landscape, including federal, state, and community-based initiatives that support these enrollees, their families, unpaid caregivers, and the health care workforce.

Within this framework, we call on policymakers to reduce barriers to care. On our helpline, we frequently hear from people with Medicare who are struggling to access and afford their earned benefits. These financial challenges, along with confusing Medicare rules and requirements, can make it difficult for people to get the care they need when they need it.

Easing eligibility for Medicare’s low-income assistance programs; reducing costs and Medicare Advantage (MA) overpayments; limiting beneficiary cost exposure; streamlining Medicare’s appeals processes; filling gaps in the Medicare benefit; and enforcing current coverage rules could make Medicare easier to navigate and afford. Stronger rules, plan oversight, and consumer protections are needed to address MA-specific barriers like inadequate provider networks; aggressive marketing; abusive utilization management; inappropriate coverage denials; and the lack of integration in Dual Eligible Special Needs Plans. To best support people with Medicare and the program, we ultimately recommend equalizing payment and coverage between MA and OM, with strong coverage rules and cost protections.

Reforms are also needed to simplify initial and annual Medicare enrollment processes, so that beneficiaries can truly make active, informed, and meaningful choices. Shifting demographic and employment patterns put a growing number of individuals on a collision course with Medicare’s overly complex enrollment rules, coverage options, and timelines. Commonsense modernizations could simplify the system and help enrollees, such as by notifying people approaching Medicare eligibility about their responsibilities; adequately funding State Health Insurance Assistance Programs and enrollment outreach to low-income individuals; enhancing Medicare Plan Finder; and rationalizing the MA choice landscape to ensure plans are high-quality, limited in number, and easy to compare. We also support making enrollment errors and coverage decisions easier to remedy, including through expanded access to equitable relief and to affordable, non-discriminatory Medigap plans.

For 35 years, Medicare Rights has advocated for a strong and sustainable Medicare program. We look forward to continuing to build an ever-brighter future.