Discussion of the House Republican budget has focused mostly on the privatization of Medicare, the block-granting of Medicaid, and the repeal of the Affordable Care Act. And that’s appropriate, given the magnitude of the changes and widespread impact they would have. But those proposals are obscuring some other proposed shifts that, in any other context, would be plenty troubling for their own sake. This week I'll highlight five of them. On Monday, I talked about radical changes to the Supplemental Nutritional Assistance Program (SNAP). Today I return to a health care issue:

By now, virtually everybody has heard about the Medicare voucher scheme that House Republicans want to implement starting in 2022. Instead of getting comprehensive, government-run insurance, seniors would have to enroll in private insurance, using a federal subsidy too skimpy to pay for adequate coverage. According to estimates from the Congressional Budget Office, seniors would become responsible for about two-thirds of their personal medical expenses. Many seniors would endure significant hardship as a result.

But that’s not the only Medicare change in the House Republican budget. Under current law, you become eligible for Medicare on the day you turn 65. If the Republicans get their way, you wouldn’t become eligible for the new Medicare voucher until the day you turn 67.

The change would happen gradually, with the eligibility age rising two months every year, starting in 2022. And, in the grand scheme of things, it's not like that many people are between the ages of 65 and 67 anyway. But think for a second about who those people are--and the insurance options they'd have available to them without Medicare.

Remember, the House Republican budget would also repeal the Affordable Care Act. That would leave insurance companies free to charge higher premiums, restrict benefits, or deny coverage altogether to individual applicants who have pre-existing conditions. Given the relatively high incidence of conditions like hypertension, arthritis, and vision problems among older Americans, it's safe to assume many seniors would have trouble finding affordable coverage--if, indeed, they could find coverage at all.