Trustees for the actual Medicare trust fund say it will be insolvent by 2029, a year later than predicted by the Obama administration last year. The year before that, the Congressional Budget Office foresaw the program running dry in 2026. This means the infamous Independent Payment Advisory Board—devised by the designers of the Affordable Care Act (ACA, or “Obamacare”) to put the brakes on Medicare spending if costs grew faster than a predetermined rate—will not take effect. The date by which Medicare would go out of business, so to speak, has been a moving target for years. With efforts to replace the ACA with a plan presumed to be more sustainable ongoing, it’s likely to continue to be in flux. In addition, the growing influence of relatively cost-effective modes of treating patients of all ages—including the urgent care model—is likely to exert some influence on Medicare’s lifespan.