Medicare Expansion Gains Momentum & Victories!

Last podcast, we discussed expanding and improving Medicare, and since then there are a couple of major updates on the budget moving through Congress, with implications for the M4A movement! We also discuss the history of expanding and improving Medicare (or degrading, in the case of privatization).

Show Notes

Last podcast, we discussed expanding and improving Medicare – way back 2 weeks ago – it was really an uphill fight, with the Biden administration focused only on expanded subsidies for the ACA. Thanks to a lot of grassroots pressure, it’s a whole new world now since even just two weeks ago. Ben and Stephanie update us on how the ground has really shifted, and share a couple of MAJOR updates on the budget moving through Congress, with implications for the M4A movement. 

Another thing we started thinking about since the last podcast is – when WAS the last major expansion of Medicare? How would these reforms fit in the history of expanding Medicare since it was passed in 1965? We did a little research on that, learned a lot of interesting things, and so we’ll also quickly take a tour of Medicare through the years and try to figure out where this moment is in all that historical context.  

The first major development is on the House side: the House Appropriations Committee for the first time in 45 years passed a budget WITHOUT the Hyde Amendment included. It’s unlikely to make it through the Senate, but we are getting closer and closer to eliminating the ban on public funding of abortion services.

The second major development is on the Senate side: Senate Dems & Biden have agreed to a $3.5 trillion number for the budget, not as much as Senator Sanders had wanted. But Chuck Schumer publicly announced that he will push to include dental, vision, and hearing in traditional Medicare – he’s crediting Bernie Sanders and the M4A movement with the proposal. This wasn’t even on the table a couple of weeks ago.

We don’t know the details of how extensive the dental, hearing and vision benefits will be, so we need to keep pushing to make sure the benefits are generous enough to undercut the privatized Medicare Advantage plans. The better the benefits, the fewer reasons there are to buy a private plan, putting more folks in the public pool, increasing efficiencies and lowering costs for patients.

The other thing very likely to be included in the budget is SOME FORM of Medicare negotiation of prescription drugs, but there is a fight shaping up within the Democratic caucus in the Senate about whether Medicare will be given real power to negotiate drug prices. HOW MANY drugs will Medicare be allowed to negotiate prices for? How will Medicare set prices for those drugs – particularly whether Medicare can use what’s called “international reference pricing”? The political barriers to Medicare drug negotiations are actually NOT primarily the centrist Democrats who you’ve been hearing so much about during this budget process – Joe Manchin (WV) and Kyrsten Sinema (AZ). The real dangers are the Senators who we in the M4A movement call the “Pharma darlings”: primarily Bob Menendez (NJ), but we’re also worried about Tom Carper (DE), and Catherine Cortez Masto (NV). We really need activists in those three states to step up their pressure.

(Sidenote to some M4A activists: instead of blasting champions like Rep. Cori Bush and Rep. Alexandria Ocasio-Cortez and other progressive women of color, could you focus on the Pharma darlings instead?)

The third proposal we’ve been advocating for is lowering the eligibility age for Medicare to 60, which we thought would be the hardest provision to win. But there is still a real chance to win within this budget, because of the way the budget process works.

Our allies in Congress who have been part of the process believe we could win lowering the age of Medicare, and they’ve asked the grassroots to push hard on this particular demand, so that’s what we’ve been doing. In particular if you are age 50-65, telling your story about how you’d be impacted by lowering the age of Medicare is really important. Consider writing a letter to the editor of your local paper, or recording a selfie video of your story and tagging your Senators and Member of Congress on social media.

The last Medicare expansion we’ve been fighting for is to set an out-of-pocket maximum for seniors who have Medicare.

Stephanie puts these proposals in historical context, with a rundown of all the expansions and reforms since Medicare was established in 1965: the addition of some people under 65 with specific conditions, the addition of some services, an ill-fated out-of-pocket cost cap (that was paid for with increased premiums and was quickly repealed).

When we talk about an out of pocket cap now, we’re not talking about paying for it through increased premiums! How about we tax the people who are sending rockets into space, for instance? (Image description: Jeff Bezos’s rocket blasting off, caption reading “This is why we can’t have nice things like healthcare. Tax the rich.”)

In 2003, we had an expansion that was entirely private – Medicare Part D, the optional prescription drug benefit offered only by private insurers. This created the dreaded “Donut Hole,” which was finally eliminated in 2010 by the ACA.

Action steps!

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1 Comment

  1. Eyde Arndell on August 11, 2021 at 6:36 pm

    Read the “Deficit Myth” by Stephanie Kelton. The Federal government is the ISSUER of our currency. States, cities and households are the USERS of our currency. That distinction makes all the difference. We CAN afford nice things. What we can’t afford is to stop pushing for universal single payer Medicare for All. This is an improvement, yes. Thats fine. Still pales in comparison to what is critically needed. At the very least, they are feeling the heat to do something!