Financial advisors may want to keep a close watch on how the next Congress and president deal with Social Security, Medicare and Medicaid. According to a new survey from Nationwide Retirement Institute of adults 50 and older, Social Security and Medicare top the list of sources they expect to use  to pay for health care in retirement. More than 60% of respondents expect to tap both sources to pay for health care, well above the 47% who expect to use savings.

“Older Americans are increasingly reliant on these programs to pay for their health care,” says John Carter, president and COO of Nationwide’s retirement plans business.

That’s probably because less than half have set aside savings to cover health care expenses and one-third said they currently don’t have enough money on hand to cover health care expenses above $500, according to the Nationwide survey. Twelve percent said they couldn’t cover any amount of health care costs.

And those costs can be exorbitant. According to a new report from HealthView Services, the average expected future retirement health care premiums for Medicare Parts B, D and supplemental insurance for a healthy 65-year-old woman living to 89 are projected to run just over $235,500; for her male counterpart living to age 87, projected costs are just under $200,000. If all out-of-pocket medical expenditures and costs for hearing, vision and dental services are included, the total jumps about $80,000 for women and about $70,000 for men.

During the primary and presidential campaigns, President-elect Trump pledged not to cut Social Security or Medicare, but his pick to head Health and Human Services, Rep. Tom Price, R-Georgia, who chairs the House Budget Committee, has called for major changes to Medicare and Medicaid and repeal of the Affordable Care Act, which expands Medicaid in many states.

House Speaker Paul Ryan, R-Wis., has called for transforming Medicare from a government insurance plan to a voucher system whereby the government provides subsidies to retirees to buy their own insurance. He also favors broad reform of Social Security and has proposed raising the retirement age.

Despite their differences on Social Security and Medicare, both Ryan and Trump favor repeal of the Affordable Care Act, which guarantees acceptance for anyone not qualifying for Medicare, such as certain early retirees.

The Nationwide survey, conducted in September before this year’s election, found that 71% of respondents approaching retirement are “terrified” about the potential impact of health care costs on their retirement. But despite those fears, many have not discussed this challenge with their children (51% ) or spouses (47%) or even their financial advisors (48% of those who have an advisor, which was 38% of respondents). Altogether 1,316 adults 50 or older were surveyed.

Many didn’t want to burden their children or spouse with such discussion or feel their spouses as well as financial advisors didn’t know enough about health care to discuss the topic with them.

There was some good news in the Nationwide survey related to financial advisors.

Three-quarters of non-retirees who have discussed retirement with an advisor believe it is important  to discuss health care costs with them – up from just 53% a year ago – and 65% have a plan to do just that. Sixty-nine percent have plans to discuss long-term care costs.

And of those adults who have discussed retirement with a financial advisor, 81% felt the advisor was well equipped to talk about retirement health care costs, up from 65% in 2015, and even more – 89% – thought the advisor was more than competent to discuss long-term care costs – 89%, up from 72% last year.

Such discussions are especially important for women, who tend to live longer than men but earn less, which crimps Social Security payments. Married women face the additional risk that their spouse may require long-term care at the end of life, which often depletes household assets, leaving the surviving spouse insufficient funds to meet her own needs in the last years of her life, according to the HealthView Services report.

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