Feb 14, 2019

The battle over moderate Democrats' "Medicare at 50"

Photo: Mark Wilson/Getty Images

Insurers and hospitals came out swinging yesterday against Democrats' proposal to let people older than 50 buy into Medicare — a reminder that almost any expansion of public health coverage will provoke a battle with the health care industry.

Between the lines: Politically, an age-restricted Medicare buy-in is about as moderate as it gets for Democrats in the age of "Medicare for All."

  • It is not a proposal for universal coverage, and it's a far cry from trying to eliminate private insurance. It would be optional, only a relatively small slice of people would have the option, and they would need to pay a monthly premium.

Yes, but: Being on the more moderate end of the political spectrum does not shield you from a fight.

  • Expanding Medicare would hurt hospitals' bottom lines, because Medicare pays hospitals less than private insurance does.
  • That's why the Federation of American Hospitals said yesterday that the idea "would harm more Americans than it would help."
  • The buy-in plan would primarily compete with employer-based health coverage (that's what people between 50 and 65 are likely to have). And America's Health Insurance Plans said the idea "is a slippery slope to government-run health care for every American."

The bottom line: Any proposal that would compete with (never mind eliminate) private coverage, particularly employer coverage, will meet this kind of resistance.

That's why Medicaid is the public program Democrats and industry can agree to love. Expanded access to Medicaid has rarely been an alternative to commercial insurance — it's usually an alternative to being uninsured.

  • The uninsured were the primary beneficiaries of the Affordable Care Act's Medicaid expansion, and the Medicaid buy-in proposals now popping in the states are aimed at the people who are most likely to be foregoing private ACA coverage because of its cost.

Go deeper: The detail that could make Medicare for All generous — and expensive

Go deeper

Coronavirus dashboard

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  1. Global: Total confirmed cases as of 4:30 p.m. ET: 1,579,690 — Total deaths: 94,567 — Total recoveries: 346,780Map.
  2. U.S.: Total confirmed cases as of 4:30 p.m. ET: 452,582 — Total deaths: 16,129 — Total recoveries: 24,790Map.
  3. Public health latest: U.S. has expelled thousands of migrants under coronavirus public health orderDr. Anthony Fauci said social distancing could reduce the U.S. death toll to 60,000.
  4. Business latest: The Fed will lend up to $2.3 trillion for businesses, state and city governments — Another 6.6 million jobless claims were filed last week.
  5. World latest: Boris Johnson is moved out of ICU but remains in hospital with coronavirus.
  6. In Congress: Senate in stalemate over additional funding for small business relief program.
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Biden rolls out new policies in effort to court Sanders supporters

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The Biden campaign announced two new policies on Thursday on health care and student debt that are squarely aimed at appealing to supporters of Bernie Sanders, who ended his campaign for the Democratic nomination on Wednesday.

Why it matters: The policies don't go as far as Sanders' platform, but they signal that Biden is serious about incorporating elements of his former rival's agenda in an effort to help unify the Democratic Party and defeat President Trump in the general election.

Reports: Saudi Arabia and Russia reach major deal to cut oil production

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OPEC+, led by mega-producers Saudi Arabia and Russia, reached a tentative agreement Thursday to impose large cuts in oil production as the coronavirus pandemic fuels an unprecedented collapse in demand, per Bloomberg and Reuters.

Why it matters: The revival of the OPEC+ collaboration patches up the early March rupture between the countries, which had pushed already depressed prices down much further by threatening to unleash even more new supplies into the saturated market.