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Candidates in the 21st Congressional District race have distinctly different views about the future of Medicare, the federal health care insurance program for the elderly and disabled.

Republican and Conservative Party candidate Elise Stefanik said the eligibility age, at some point in the future, should be raised and the program should be “modernized.”

Green Party candidate Matt Funiciello said the program should be expanded to mandatory enrollment of everyone.

Democratic and Working Families Party candidate Aaron Woolf said the program should be kept as is.

The solvency of Medicare has long been a concern, as baby boomers reach 65 and increase the number of people covered.

Federal health care and treasury officials announced in late July that the Medicare Hospital Trust Fund will be solvent until 2030, four years longer than the latest estimate.

Woolf said efforts within the traditional Medicare program to reduce the growth in health care spending are working.

“It certainly is a further affirmation that we do not want to change or put our Medicare guarantee at risk,” he said Monday in a telephone interview.

Stefanik said the extension merely delays insolvency.

“It shows that Medicare will be insolvent within the next 20 years. That is not smart policy, especially when we’re talking about these programs in the long term,” she said Tuesday in a telephone interview.

Funiciello said the extension of the program’s solvency has little significance in the overall health care debate.

Some people, including U.S. Rep. Paul Ryan, R-Wisconsin, a key Stefanik supporter, have proposed establishing optional private Medicare coverage.

Recipients would be given a stipend to buy Medicare coverage on the private market, instead of being enrolled in the federal government program.

Woolf opposes Ryan’s proposal.

“I think we do not want to do anything to privatize Medicare or end the Medicare guarantee as we know it,” he said.

Woolf said, under a so-called voucher system, benefits of plans might be limited, and there is a danger the traditional Medicare system could be left with just the chronically ill to cover.

Stefanik, who was a debate adviser on Ryan’s 2012 vice presidential campaign, would not say whether she supports Ryan’s Medicare proposal.

“At least he’s putting forth solutions,” she said.

Stefanik said her campaign is based on her own ideas.

“I hope to put forth my own proposals about modernizing Medicare,” she said. ... “I think the ultimate goal is to make sure that any type of reform with Medicare — it doesn’t strip benefits, it doesn’t reduce options and it doesn’t raise prices.”

Stefanik said her plan would increase the eligibility age from 65, for people who are younger now.

“I think we should raise it in a small process so that it’s not immediately raised for everyone,” she said. “I think it should be raised to 67 or beyond. But I think there needs to be a discussion about that, and it needs be established by thinking about what the lifespan is for future generations.”

Stefanik said putting in place technology to track waste and fraud would be another aspect of her proposal.

Funiciello opposes private Medicare coverage.

“Privatizing always comes with a profit margin. And that profit margin always makes things less efficient,” he said in an interview at Glens Falls Farmers Market, where he was campaigning Saturday.

Funiciello said the Medicare program should be expanded to cover everyone, with mandatory coverage funded through increasing the Medicare tax.

“Literally, all it does is change the age of eligibility for Medicare from 65 to zero,” said Funiciello, a bread company owner and political activist from Glens Falls.

Medicare has lower administrative costs than private insurance and has no profit margin, he said.

In the past, some people, such as Sen. Kirsten Gillibrand, D-N.Y., advocated for an expansion of Medicare that would allow people younger than 65 to purchase Medicare coverage as an alternative to private insurance.

Woolf, a filmmaker from Elizabethtown, would not say whether he supports any expansion of Medicare.

“I think that’s something also that I’d like to get back to you on,” he said Monday morning.

In a prepared statement his campaign spokesman issued Tuesday afternoon, Woolf said, “My primary concern is to first protect Medicare and ensure than my opponent does not end the Medicare guarantee.”

Stefanik, a plywood company vice president and former White House policy adviser, said expansion of Medicare should be discussed.

“I think that’s an example of where I need to listen to feedback on what will work for future generations,” she said. “I don’t think there should be any changes to the program for those that are very near retirement.”

Medicare is an economic as well as a health care issue. It is the largest funding source for hospitals, which are major employers.

Medicare funding changes have caused many hospitals to lay off employees.

Woolf said he is not yet sure how to keep hospitals financially viable.

“My sister is a physician, and I would actually like to get back with you on that one,” he said. “We need to make the system work for all players.”

In a prepared statement his campaign spokesman released Tuesday afternoon, Woolf said Congress has “made strides in finally addressing physician reimbursement,” but has not done enough.

He said he would advocate for increased payments to physicians and measures to reduce waste and fraud.

Stefanik said health care reform has created more administrative tasks and paperwork for hospital management, which increases costs at the same time hospitals have less revenue.

The expense of medical malpractice insurance is a challenge for hospitals, too, she said.

“I think we need to have an immediate discussion about what our immediate fixes to Obamacare are,” she said.

Funiciello said hospitals would have fewer unpaid bills if everyone was covered by Medicare.

“We pick up that dime because public money ends up propping up the hospitals when those bills aren’t paid,” he said.

The two major party candidates have received campaign contributions from the health care industry.

Stefanik received $500 from AFLAC disability insurance; $2,500 from UNUM Group, a disability and health insurance company; and $2,500 from American Medical Association, according to the Federal Election Commission.

Woolf received $5,000 from the American Society of Anesthesiologts and $5,000 from Service Employees Internationa Union, a health care union.

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