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Abstract

This Article examines the use of minimum age cutoffs to define eligibility for social insurance, public benefits, and other governmental programs. These cutoffs are frequently used but rarely examined in detail. In Part I, I examine and catalogue policies that employ minimum age cutoffs. These include not only Medicare and Social Security but also other policies such as access to pensions and retirement benefits, eligibility for favorable tax treatment, and eligibility for discounts on governmentally provided goods and services. In Part II, I examine different rationales underlying eligibility and discuss the imperfect fit between these rationales and the use of age cutoffs, as well as the likelihood that cutoffs will exacerbate disparities and disadvantage those with atypical life plans. In Part III, I consider different ways that age cutoffs might be reformed. One, the most realistic, is the option proposed for Medicare: extending eligibility downward to people earlier in life. But other options exist as well. One option, often advanced by those further to the political left, would completely eliminate age-based eligibility cutoffs in favor of universal programs such as Medicare for All. Another option would adjust age cutoffs upward or downward based on factors like geography or occupation, rather than basing eligibility on a one-size-fits-all cutoff. Yet another would replace age-based eligibility cutoffs with eligibility time periods, which are limited but can be started and ended flexibly: people could give up some eligibility time later in life in order to receive access during earlier periods.

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