Topping the health-care agenda of the Trump administration and Congress is the repeal and replacement of the Affordable Care Act. Still, it would be a mistake to ignore Medicare, the nation’s single largest health-care entitlement. While the program is well liked by senior citizens, Medicare’s growing share of the federal budget, growing reliance on general rather than dedicated revenue streams, and outdated benefits and cost-sharing structure make it ripe for changes that can deliver better value for beneficiaries and taxpayers.

While Medicare reform has traditionally been politically challenging, Republicans and Democrats have converged significantly in their support for market-oriented Medicare Part D (drug coverage) and Medicare Advantage plans. Understanding and leveraging lessons learned from these programs might enable Congress to shore up Medicare’s overall finances while continuing to offer senior citizens coverage that best suits their needs and financial situation.

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