is truly stupid. What it means is that they drive anyway, but may have almost no understanding of the rules of the road and are highly likely to be uninsured.
Even states that give out those licenses, such as my state of NM, we still have a lot of those who drive without license and, even if they have a license, are uninsured. It's why car insurance is relatively high here.
Heck, I think we should all have to pass a written exam every time we renew. When I lived in Kansas they did that. I hope they still do. They'd mail a test and a copy of the test booklet, so it was open book. I'd usually fill it out while standing in line at the DMV. Anything I wasn't 100% certain of I'd look up. I really liked being reminded of various basic things every few years.
In NM, after I think it's age 75 (I can't find it quickly on the DMV site) you have to renew every year, but they don't charge for the renewal. At least you have to present yourself in person and pass the little eye exam, which I think is a good idea. I'm 70 myself, and I'm frequently horrified at how absurdly easy it is to get a license in this country.