The progressive think tank People's Policy Project offered a proposal to presumptive Democratic presidential nominee Joe Biden's campaign Tuesday after the former vice president amended his healthcare agenda in a bid to reach out to former rival Sen. Bernie Sanders' supporters.
Lowering the Medicare eligibility age to 60 from 65, as Biden proposed last Thursday after Sanders exited the primary election, will do little to appeal to the Vermont independent senator's supporters, who are overwhelmingly under the age of 45—a group Biden has consistently struggled to win over. Instead, People's Policy Project founder Matt Bruenig wrote, Biden should propose opening Medicare to Americans from birth to age 25.
"Biden already won near-seniors, and that group is much more likely to vote Republican in November in any case. Throwing them and only them on Medicare risks simply expanding the group of people who want to pull up the ladder behind them, but putting kids on it automatically creates a constituency for further expansion."
—Ryan Cooper, The Week
Many proposals for expanding Medicare to a greater share of Americans include incrementally extending eligibility to more "chunks" of the population, Bruenig said. The Biden campaign must be strategic in how it uses Medicare expansion to appeal to progressives who want the program to cover all Americans as soon as possible, he added.
"The precise chunk you use matters a lot... Bernie voters are overwhelmingly young adults," Bruenig wrote. "His support among ages 60 through 64 is vanishingly low. To give a crumb to Bernie voters, you need to do something that includes the youth."
Biden's plan to include people between the ages of 60 and 64 in Medicare does not promote further expansion of the program—a top priority for many Sanders backers—and is not supported by the "logic of the prevailing Medicare system," Bruenig explained:
You can't, for instance, bring everyone over the age of 50 onto the Medicare rolls because that creates a wild asymmetry between old working-age adults whose only contribution to the healthcare system would be payroll taxes and young working-age adults who would be contributing the same payroll taxes and paying full freight for their own private plan. [...] Nondisabled people between the ages of 60 and 64 can work, do work, and are expected to work within our current public understanding of when retirement should occur. Bringing them in breaks the logic of the program and, as noted already, creates hard-to-justify asymmetries between workers.
By contrast, Bruenig said, "Medicare for Kids" is likely to appeal to young Sanders supporters and parents who are now required to pay premiums and copays for their children's healthcare.
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"Medicare for Kids also creates conditions that should push further Medicare expansion as individuals who age out of Medicare will be an obvious constituency for finishing the job and bringing in the remaining 26 to 64 age group," Bruenig wrote. "Indeed, the logic of including kids in Medicare is so obvious that it was part of some of the initial proposals for the program under the name Kiddiecare."
The proposal drew support from Josh Bivens, research director for the Economic Policy Institute.
Totally agree that medicare-for-kids should be a no-brainer for everybody to embrace. https://t.co/RrxC0dyCdM
— Josh Bivens (@joshbivens_DC) April 13, 2020
Bruenig released his proposal a day after Rep. Alexandria Ocasio-Cortez (D-N.Y.), who endorsed Sanders in the primary, said Biden must offer concrete proposals to help working Americans, young voters, and people of color in order to earn their votes in the general election.
Biden's offer to lower the Medicare eligibility age to 60 was "almost insulting," according to Ocasio-Cortez.
Medicare for Kids, wrote columnist Ryan Cooper at The Week on Monday, is part of what Biden "could realistically do to win over the left."
"It would actually give something to the population of people Biden is supposedly trying to win over—young people and younger parents," Cooper wrote. "Biden already won near-seniors, and that group is much more likely to vote Republican in November in any case. Throwing them and only them on Medicare risks simply expanding the group of people who want to pull up the ladder behind them, but putting kids on it automatically creates a constituency for further expansion."