While its positive effects are certainly noteworthy for elderly women, Medicare just doesn’t seem to have the horsepower to accommodate their longer life spans and higher rates of poverty to anywhere near the point of gender equality. The list of services that Medicare does not currently provide––dental care, hearing aids, non-medically necessary foot care, home health services, long-term supports, nursing homes––may sound like unnecessary and costly miscellanea when compared with many private insurance plans. But the oldest segments of the Medicare population suffer from issues like chronic diseases, disabilities, and dementia that make these services indispensable. And given that women make up 67 percent of those over 85, that they are more likely to suffer from these issues than same-aged men, and that they suffer worse effects from diseases like dementia, they are by far the most likely to be left in the cold.

Essentially, for aging women, the pie of health-care costs grows on a steep curve, while the slice of the pie that Medicare pays for diminishes. On average, Medicare only pays for half of medical costs, even though there are a few ways to fill in the gaps. Many turn to Medicare Advantage plans and other private insurance providers for necessary services.

However, this setup can be extraordinarily expensive, as most Medicare services require copayments or co-insurance in addition to the premiums for supplemental insurance. High drug prices and the infamous-but-shrinking “donut hole,” all impact seniors’ pockets as well. While poor and low-income people who also qualify for Medicaid are eligible for dual coverage that takes care of most issues, poverty versus unaffordable care seems like a fairly hellish dilemma.

Might this disparity in elderly women’s health be affecting the primary elections? Given the aforementioned demographic skew in aging and the granularity limits of polls, it is hard to entirely extract gender from age and health. But in the Democratic field, where health-care polls as one of the four most important issues to voters, Hillary Clinton’s strongest footholds have been elderly people, women, minorities, and people in the sickest states. Clinton scores consistently as the candidate voters trust most on health care over her rival, Senator Bernie Sanders.

While both candidates are rather thin on concrete proposals to solve the specific health problems of elderly women, Sanders’s health-care plan may actually hurt him in relation to Clinton. “Medicare for all” does not actually entail Medicare for all; rather, it would replace all insurance with a more comprehensive single-payer option that would beat Medicare’s cost issues with a healthy mixture of risk-pool expansion, taxes, and unobtanium. But the name does help Sanders sell it to the general public, as it polls far better than any relevant synonyms.