Where Spending More Means a Lot Less

You probably know by now that I turned 65 in April, and I’m now a Medicare beneficiary. I’m enrolled in traditional Medicare and pay separately for my Medicare Part D drug plan and a Medicare supplemental policy from my state’s Blues plan. My total monthly premium for everything is $355.59, or $4,267.08 per year at the moment. I’m not sure yet how that will change for 2026.

That’s why I was personally interested in The Commonwealth Fund’s new State Scorecard on Medicare Performance. The scorecard ranks states and the District of Columbia on how well they’re taking care of people like me. The Commonwealth Fund researchers did it by using 31 publicly available performance measures in four domains:

• Access to care
• Quality of care
• Costs and affordability
• Population health

My home state of Illinois ranked 37^th, sandwiched in between Montana at 36^th and Wyoming at 38^th. Not a comfortable place to be. The top five were: Vermont (1), Utah (2), Minnesota (3), Rhode Island (4) and Colorado (5). In last place were the usual suspects of: Louisiana (51), Mississippi (50), Kentucky (49), Oklahoma (48) and Arkansas (47).

Beyond the overall rankings, the researchers did a few interesting cross tabulations and put their results on some scatter charts. The most interesting to me was the scatter chart on life expectancy after age 65 and Medicare spending. As is always the case with our paradoxical healthcare system, states that spent the most on their Medicare beneficiaries had the lowest life expectancy for their seniors.

For example, Oklahoma spent $13,538 per Medicare beneficiary in 2023, but its beneficiaries only had an average life expectancy of 81.4 years in 2022. By comparison, Hawaii spent $7,976 per beneficiary in 2023, and its beneficiaries had an average life expectancy of 85.6 years in 2022.

Illinois was one of only five states in which you spent more than the average and lived longer than the average, according to the analysis. Here, we spent $12,258 per Medicare beneficiary in 2023, and we lived an average of 83.6 years.

So, six months have passed since I turned 65. That gives me 18 more years. But if I’m only spending about one third of the state’s average, does that give me only six more years? We’ll see.

Thanks for reading, at least for now!