More than 80 House Democrats on Monday urged the Biden administration to fulfill its "commitment to expand and improve Medicare" by including three provisions—broader eligibility, enhanced benefits, and strengthened drug-pricing powers—in its American Families Plan, a social spending and tax reform proposal set to be unveiled this week.
"As we emerge from the Covid-19 pandemic—the nation's most acute healthcare crisis in the last century—now more than ever, we must ensure that families and older adults are equipped with the health coverage they need."
—House Democrats' Letter
In their letter (pdf) to President Joe Biden and Vice President Kamala Harris, the lawmakers—led by Democratic Reps. Pramila Jayapal (Wash.), Jared Golden (Maine), Joe Neguse (Colo.), and Conor Lamb (Pa.)—wrote that "you have previously expressed commitments to expanding Medicare eligibility, improving its benefits package, and empowering Medicare to negotiate with pharmaceutical companies."
"As we emerge from the Covid-19 pandemic—the nation's most acute healthcare crisis in the last century—now more than ever, we must ensure that families and older adults are equipped with the health coverage they need," the House Democrats continued.
INBOX: 80 House Democrats, including moderates like Jared Golden and Conor Lamb, urge Biden to include Medicare expansion in his American Families Plan. pic.twitter.com/EqgQL7S0vS— Andrew Solender (@AndrewSolender) April 26, 2021
Referring to a recent study conducted by researchers at Stanford University, who identified "a sudden jump in the diagnosis of cancer among individuals who reach the age of 65 due to the fact that many older adults delay care for financial reasons until they have Medicare coverage," the lawmakers wrote that "lowering the Medicare age would provide immediate coverage for millions of older adults who are still uninsured or underinsured."
"Lowering the Medicare eligibility age to 60 could enable an additional 23 million people to access Medicare coverage," the lawmakers added. "Meanwhile lowering the Medicare eligibility to 55 could expand Medicare coverage to over 40 million people. Expanding Medicare to these age groups is critical for addressing inequities in health coverage and access, as communities of color and low-income individuals are disproportionately more likely to be uninsured."
The House Democrats noted that "there is also a critical need to improve the traditional Medicare benefit to include dental, vision, and hearing." The letter continues:
According to the Commonwealth Fund, among Medicare beneficiaries, "75% of people who needed a hearing aid did not have one; 70% of people who had trouble eating because of their teeth did not go to the dentist in the past year; and 43% of people who had trouble seeing did not have an eye exam in the past year." Poor oral health, vision loss, and hearing impairment have been independently linked to numerous negative health outcomes, such as diabetes, cardiovascular issues, depression, and dementia. Lastly, research shows that half of older adults who live alone don't have enough money to cover even their basic needs. Therefore, it's past time that we place an out-of-pocket spending cap to traditional Medicare, just as we have already for Medicare Advantage plans and other private insurance plans.
If the federal government were to fully utilize its immense bargaining power to reduce the costs of prescription medications, the lawmakers noted, the proposed Medicare expansion could be funded in part by the savings generated through drug price negotiations with pharmaceutical giants.
"The United States spends, by far, more on prescription drugs than any other country, despite Medicare Part D being the largest purchaser in the world," the House Democrats wrote. "The Congressional Budget Office estimated Medicare could save over $450 billion and increase revenue by $45 billion over the next decade by requiring Medicare to negotiate with pharmaceutical companies. Therefore, we request that the savings achieved by robust Medicare drug-price negotiations be used to make critical expansions and improvements to Medicare, alongside other bold investments in health coverage and affordability."
The House Democrats' letter came one day after Sen. Bernie Sanders (I-Vt.) and 16 Senate Democrats sent a similar letter to the White House in an attempt to influence the contents of Biden's soon-to-be-unveiled American Families Plan, the second key component—following the American Jobs Plan, a $2.3 trillion infrastructure proposal announced last month—of the president's "Build Back Better" agenda.
Biden's American Families Plan "calls for devoting hundreds of billions of dollars to national child care, prekindergarten, paid family leave, and tuition-free community college, among other domestic priorities," the Washington Post reported Saturday. "It will be at least partially funded by about a half-dozen tax hikes on high-income Americans and investors, proposed changes that are already provoking fierce opposition in Congress and on Wall Street."
With the roughly $1.8 trillion proposal set to be released ahead of the president's joint address to Congress on Wednesday, "White House officials spent much of the past week making refinements to the plan, showing the enormous pressure they are under to include or discard key items as they attempt to satisfy a range of competing voices," the Post noted.
According to the newspaper:
In a potential last-minute change, White House officials as of Friday were planning to include about $200 billion to extend an increase in health insurance subsidies through the Affordable Care Act exchanges, according to three people who spoke on the condition of anonymity to reveal internal discussions.
Despite pressure from Democratic leadership, White House officials are also prepared to table a measure they had included in earlier drafts aimed at reducing consumer and government spending on prescription drugs, a measure fiercely opposed by the pharmaceutical industry, the people said.
House Speaker Nancy Pelosi (D-Calif.) has been the key driver in Congress pushing for increased federal subsidies to private insurers under the Affordable Care Act in order to make the program created under the Obama administration more affordable and widely available, but Sanders and other progressive lawmakers have been leading the effort incorporate an expansion of Medicare in the American Families Plan.
Pelosi, however, is aligned with congressional progressives on the need to allow the federal government to rein in Big Pharma's price-gouging, having recently announced the reintroduction of the Elijah Cummings Lower Drug Costs Now Act.
According to the Post, Pelosi is urging the White House to include such a measure in the American Families Plan after it was revealed that the Biden administration is "set to scrap a plan included in earlier drafts of their proposal to include as much as $500 billion in savings from the prescription drug industry."
Monday's letter—which includes a wide range of House Democrats, from Jayapal, chair of the Congressional Progressive Caucus, and other progressive stalwarts, to moderates like Golden and Lamb—makes clear that "expanding and improving Medicare is not only good and critically needed policy, it also has support from overwhelming bipartisan majorities of the American people."
According to recent polls, nearly two-thirds of U.S. voters are in favor of lowering the Medicare eligibility age, while almost 80% support adding routine dental, vision, and hearing benefits to Medicare.
"Lowering the eligibility age and improving its benefits package would provide immediate and substantial relief for millions of individuals throughout the United States, as well as much-needed long-term security," the lawmakers wrote. "Now is a historic opportunity to also make an important expansion of Medicare that will guarantee healthcare for millions of older adults and people with disabilities struggling with the health and economic realities of the Covid-19 pandemic."
"We are asking for you to prioritize the expansion and improvement of Medicare in the American Families Plan," the House Democrats concluded. "We strongly support this investment and stand ready to help your administration make it a reality."