"Medicare at 50": Sen. Debbie Stabenow explains her Medicare buy-in plan

[workinclasszero]

As momentum builds around single-payer, the Michigan Democrat pitches a more incremental approach.

By Sarah [e-mail] Feb 13, 2019, 12:00pm EST

Over the past year, congressional Democrats have rolled out more than half a dozen plans to expand public health insurance as they increasingly line up behind universal coverage.

Sen. Debbie Stabenow (D-MI) is now stepping into the fray with a plan that would allow Americans 50 and older to buy into the Medicare program. Her “Medicare at 50” bill is a revised version of a proposal she has authored in previous sessions of Congress; the most notable difference is the age threshold for buying in has been lowered from 55 to 50.

A Medicare buy-in would make a big difference for older Americans who can, even under Obamacare, face steep prices in the individual market. The buy-in program would likely be able to offer lower premiums because Medicare typically pays doctors and hospitals lower prices than private insurers.

When the Congressional Budget Office scored a more limited Medicare buy-in plan (one that let older Americans start buying in at 62), it estimated that the premiums for the public plan would be about $7,600 annually — significantly lower than the average $15,300 premium on the Obamacare markets that a 64-year-old currently faces. It should be noted that many seniors with lower incomes would pay significantly less than either of those amounts because they could use the Affordable Care Act’s tax credits to purchase their coverage.

https://www.vox.com/2019/2/13/18220704/medicare-buy-in-universal-coverage-stabenow

[muntrv]

1. I like it. They should have pursued this instead of ACA.

Medicare is far more popular.

[mcar]

19. The ACA has benefitted millions of people

under age 50.

I like Stabenow's idea but it wouldn't have been better than ACA.

[MurrayDelph]

23. They tried

but Joe "My wife is a Health Insurance Lobbyist" Fucking Lieberman killed it.

[DBoon]

26. You mean Joe Lieberman - Senator representing Aetna?

nt

[SunSeeker]

2. K & R

[wasupaloopa]

3. What are you buying into? Part A, part B, Part D,

extended coverage?

I still say nobody knows what Medicare for all is.

There never are any specifics.

Those of you who like it, what is it you are liking?

You are liking talking points with no substance.

Congress would have to write a bill like they did with the ACA. There has to be compromizes and trade offs. It isn’t even written yet.

So far we have a slogan and we all like it.

[riverine]

4. Right - but at least this plan has a

funding source:

premiums for the public plan would be about $7,600 annually

Which is paid now by workers for those over 62 currently on Medicare. I presume that is a total that some actuary worked out and it sounds realistic.

The problem with the other MFA "plans" is that no one has priced them out.

[wasupaloopa]

6. You can't say that for sure. It doesn't even exist.

It hasn’t been scored. There is nothing specific in the plan.

It is all just talking points at this time.

[riverine]

8. I agree with you. It is not a bill at all. But at least there is an attempt to price it.

The other "plans" (not real plans) mislead people.

[virgogal]

10. Isn't it 65 now,not 62, for Medicare?

And where did you get the $7,600.00 figure?

[riverine]

12. I may be confusing it with Social Security early opt in

I am considerably younger than 62.

and the $7,600 came from the OP:

premiums for the public plan would be about $7,600 annually

[virgogal]

17. My apologies--I missed that.

[workinclasszero]

14. It's 65

or I'd be on it now.

[guillaumeb]

5. No, we have the example of Medicare, and its multiple components.

And the proposal is to lower the buy in age.

What else would be needed?

When I turned 65, I was given a choice of what I wanted to take. If I were given the same choice at an earlier age, that would be the only difference.

[wasupaloopa]

7. It is not that. That is what you may want.

How do you think Congress is going to get there?

Are they just going to vote to lower the age?

Think it through. Tell me what Congress is going to do. And include all possible players.

Insurers, providers, payers and administrators.

They are not going to “deal with it” when Congress votes to just lower the age.

[guillaumeb]

9. My opinion, not necessarily Senator Stabenow's idea,

is that the legislation be amended to substitute the number 50 for 65.

Are the votes there at this time? I do not know, but unless we start the conversation, we will never have the conversation.

[wasupaloopa]

13. That will never happen without a bill being written.

Congress does not vote for ideas.

I am not saying to not talk about it. I am saying give us some real meat on the bones.

Like I said we are just liking talking points with no idea how it will work.

[guillaumeb]

15. Medicare is an established system.

With a track record. The enabling legislation needs to be amended by a new Bill.

If the political will is there on both sides, it can be done relatively easily. The main objection, in my view, will be from the Insurance Lobby which will lose money.

[wasupaloopa]

29. I could not disagree more.

You can’t just add millions of people with a flip of a switch.


For one Medicare reimburses providers about 80% less than insurance companies. They need to find a way to keep providers in the system. The same goes for hospitals and clinics.

There will need to be a subsidy paid to providers.

Insurance companies are not going to be willing to close their doors, dump their investors and fire all their workers.

Centers for Medicare and Medicaid services are not equipped to handle a 100 fold increase in administrative paperwork.

I know we want some kind of single payer but we need to educate ourselves about how to get from here to their.

You are not adding to the debate by saying just enlarge a current system.

These symplistic ideas need to be thought out further.

[guillaumeb]

31. If millions are in the Medicare system,

any doctors who refuse to treat Medicare patients will lose patients.

Insurance companies also provide other types of insurance, and Medicare Advantage plans.

Medicare expansion might require more staffing, and perhaps former insurance workers will apply for those jobs.

We are not inventing the wheel here, we are merely catching up with Canada, and Europe, and every other country with a similar system.

And millions in the US were quickly added to Social Security in the 1930s. Are you saying that for some reason we are now unable to duplicate that effort?

I could not disagree more.

[zipplewrath]

27. I suspect

They'll actually have to make some provisions to ensure that people lower than 65 continue to be allowed to engage with their employers healthcare plans. It will also have to be determined whether this buy in is before or after income taxes. They'll have to address whether employees who choose to engage the plan, and are employed, can or must have an employer contribution. Can people who are 62 have it taken directly out of a social security check.

I don't think you'll get alot of push back from the insurance companies. Even the pharmaceuticals probably won't complain too much. Younger people in Part D can only be a good thing for them. The primary concern is going to be ensuring that those buying in are truly paying the actual "costs" of letting them in the program. Many congress critters aren't going to want to have this become just another social/entitlement program. It better look more like the "public option" than anything else.

I don't see any of this anywhere near the ACA issues, mostly because the insurance companies would love to see older people get out of the "exchanges" and onto medicare where they belong.

[ooky]

11. What's magic about "50"?

Why not just extend a public option to everyone who needs a public option?

The core issue is people who don't have access to affordable health care. Why not just focus on everybody having access to affordable health care? Those who already have access to affordable health care just keep what they have, and protect the ones who don't.

[Wounded Bear]

16. It's a stepping stone...

as one who has been through it, healthcare for those between late 40's and Medicare is terrible. Hard to find jobs with decent healthcare coverage, and employers don't want to take on older workers because it drives their rates up.

This would cover millions of those with no or inadequate coverage.

I'm good with the drive to continue expanding healthcare, and offering Medicare/Medicaid as a public option is a great idea. Meanwhile, this idea would be a step toward that.

[ooky]

18. My family goes through it every day.

My son is type 1 diabetic. He's 32, and that plan is a no-solution plan for him. While some may consider Stabenow's plan a stepping stone, for us its a detour.

A public option for those who need a public option would help those in their late 40's and older too.

[Wounded Bear]

20. I understand, I'm Type 2 diabetic...

if I didn't have access to VA, I'd be screwed. My state has pretty good Medicaid options, so there's that.

I'm all for getting your family covered. Best of luck in that, and if it comes up, I will definitely support it.

My thought is that the cheapest way to do healthcare is to cover everybody for everything and set up the tax structure to pay for it.

[area51]

21. Here's PNHP's point on a public option or Medicare buy-in:

at this link.

[wasupaloopa]

30. I don't agree with the administrative cost savings idea.

I was a controller for a medical clinic. I also worked for a county alcohol, drug and mental health services department.

Without required administration there is no money. Without money there is no services.

The federal government is calling for more administration oversite rather than less. Without it fraud and waste are rampant.

I must say it here as I say it everywhere. These ideas have no real flesh on the bones. There is never a substantive description of the mechanics of the system.
All these discussions are symplified overviews and wish lists.

[TCJ70]

22. So...start at a proposed 50 and end up at 60 after negotiations are over?

Assuming there are negotiations. How about we start at "All" and end up with a buy-in at 30 or less? I really don't get peoples insistence on starting at the ideal (or "pragmatic"...ugh)! Go for the gold!

[Horse with no Name]

24. This makes so much sense

Especially as it is so difficult for over 50 folks to find jobs if they are laid off.

[MurrayDelph]

25. I would love it

I got laid off almost nine years ago. I started on Medicare last April. My wife's insurance costs us almost as much a month for just her as the insurance for both of us did four years ago. And she still has 2.5 years to go before she gets Medicare.

[Hermit-The-Prog]

28. the health insurance industry is a big parasite

Health insurance does not provide health care. It does not improve health care. It only sucks money away from health care.

Eventually, people will need to face the fact that the entire health insurance industry is nothing but a parasite that needs to be removed.