Could Medicare Buy-In Replace the Public Option?

A provision to allow 55-65 year-olds to purchase Medicare entices liberals

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The public health insurance option passed the House, but reform legislation is still inching through the Senate. Because votes are so tight, Democratic leaders are considering alternatives to the public option that might fare better at attracting the last handful of votes needed to pass. The chief proposal being considered is a lowering of the minimum age for Medicare from 65 to 55. This would allow Americans in that age bracket to buy into the incredibly popular government-run insurance plan.

The death of the public option has been forecast many times and never come true. But this provision is enjoying a surprising warm reception among liberals. Could it be a substantive and politically viable alternative to the public option?

  • Alternative Worth Considering  The New Republic's Jonathan Cohn likes it. "It's a very good idea that really would offer at least some workers--those over 55 [...] (Two key questions: Would workers be eligible for subsidies to offset the cost; if so, when?)" Cohn elaborates that the public option currently being considered in the Senate isn't especially strong, but Medicare is. "People between the ages of 55 and 64 have a notoriously hard time buying coverage on their own, since their age and higher incidence of disease makes them the sorts of high medical risks insurers don't want to cover." And it "would seem like a smart move, as policy (by helping people who genuinely need the assistance) and politics (by giving a particularly skeptical age group more reason to value reform)."
  • Not Necessarily Replacement  Huffington Post's Sam Stein reports that Democrats don't currently see this as complementing, not replacing, the public option. "A Medicare buy-in program, one of several compromises being considered, would not be a full replacement for a government-run insurance plan open to people of all ages, a high-ranking Democrat stressed. But it would serve as a complement to an option that has been watered down beyond what progressive senators are willing to accept."
  • Good For Troubled Age Group  Digby thinks this would be better for 55-65 year-olds than the public option. "The huge group of baby boomers in my age group (the second wave) are facing an unbelievable squeeze and the latest versions of the public option aren't going to help us much, especially in high cost states, unless we are really doing badly financially," she writes. "I do worry about the political ramifications with respect to this huge demographic between 50 and 65 that's likely to have very mixed results in this health care reform."
  • Appealing to Progressives  The Washington Monthly's Steve Benen gushes. "[I]n general, this will be appealing to many progressive lawmakers. After all, Medicare is a socialized, single-payer system that Americans know, love, and trust. Indeed, the starting point for many liberals is 'Medicare for all.' This, obviously, doesn't go nearly that far, but expanding eligibility brings that many more Americans into the system."
  • Ditch Weakened Public Option  Politics Daily's Jill Lawrence makes the case. "The public option in the Senate was devolving into a shadow of what I and others had envisioned at the start of the health reform process -- that is, a publicly administered, non-profit insurance plan that would compete with private plans and pressure insurers to keep prices low." She lists five alternatives under consideration, including the Medicare expansion. "I would hardly miss the public option if all of those ideas were adopted. They won't be, of course, but I'd settle for three out of five. The Medicare proposal is especially appealing."
This article is from the archive of our partner The Wire.