Details of Public Option for Lowered Medicare Age Tradeoff

Here's some details on the upcoming deal to lower the age of Medicare and drop the public option.

Under the potential trade-off with party moderates, near-retirees beginning at age 55 or 60 who lack affordable insurance would be permitted to purchase coverage under Medicare, which generally provides medical care beginning at 65. Medicaid, the federal-state health care program for the poor, would be open to all comers under 300 percent of poverty, or slightly over $66,000 for a family of four.

So, it's only for those over 55 without affordable insurance. What does that mean? How many people is that? Why can't all people over 55 get it?

Sen. Mark Udall and ten other freshman senators who have drafted an "amendment package" will be holding a press conference tomorrow. Udall will be one of those speaking on the Senate floor.

The Republican effort to reject the Medicare cuts in the bill failed today. [More...]

The bill calls for cuts totaling $460 billion over a decade from projected Medicare spending, much of which would be used to provide subsidies to help lower and middle-income Americans purchase health care.

These details are important, but now Republicans want to dither over abortion ban wording so this won't get as much attention tomorrow.

At what point do the compromises outweigh any remaining benefits in the bill? I want to know when all is said and done, how many Americans does the bill directly help and how many will be adversely affected?

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  • Display: Sort:
    This doesn't really sound like (5.00 / 1) (#6)
    by andgarden on Mon Dec 07, 2009 at 07:29:08 PM EST
     "opening Medicare." I would ask them to come back with an offer that actually does that.

    AP stories (5.00 / 1) (#8)
    by Big Tent Democrat on Mon Dec 07, 2009 at 08:11:00 PM EST
    Especially by Espo, are like reading the National Enquirer.

    Any resemblance with the actual facts is sheer coincidence.

    Jeralyn and I have never agreed on the wisdom of using the AP as a source for a post.

    I try to avoid it at all costs.


    Well, that's fair enough, but I don't exactly (none / 0) (#9)
    by andgarden on Mon Dec 07, 2009 at 08:16:06 PM EST
    have a better source right now.

    Plenty of better sources (none / 0) (#10)
    by Big Tent Democrat on Mon Dec 07, 2009 at 08:17:17 PM EST
    Pains me to say it but Ezra is much closer to the key negotiators than Espo.

    Well sure, I assume that Ezra is telegraphing (none / 0) (#11)
    by andgarden on Mon Dec 07, 2009 at 08:19:38 PM EST
    the White House press office.

    updated story the same (none / 0) (#22)
    by Jeralyn on Tue Dec 08, 2009 at 02:09:38 AM EST
    here, not sure what you don't think is right. The point is the increase in medicare is a tradeoff for the public option. They aren't going to do both.

    ABC reports the same (none / 0) (#23)
    by Jeralyn on Tue Dec 08, 2009 at 02:38:15 AM EST
    That's the same article J (none / 0) (#26)
    by Big Tent Democrat on Tue Dec 08, 2009 at 07:22:10 AM EST
    " By DAVID ESPO AP Special Correspondent
    WASHINGTON December 7, 2009 (AP) "

    risk pool (none / 0) (#1)
    by jedimom on Mon Dec 07, 2009 at 06:35:53 PM EST
    if they kept the P.O. in this Medicare expansion would help alleviate the problem of the high risk high cost enrollees flooding the P.O. and spiking costs..

    but to trade if off against the 500b in Medicare cuts and eliminating the P.O. but keeping the mandate is IMO a path to disaster. I am against the bill though and have been since they first made noises about killing the real Medicare for all, opening of the Fed Employe Benefit Plan to all.

    cost? (none / 0) (#2)
    by diogenes on Mon Dec 07, 2009 at 06:40:02 PM EST
    How much would these proposed changes cost over the five years (2014-2019) during which they will presumably be in force?

    Beginning year (5.00 / 1) (#3)
    by christinep on Mon Dec 07, 2009 at 07:05:28 PM EST
    Just a thought: Because the Medicare structure is already very much in place, a proposal for expansion should not require the amount of time projected for starting a totally new option. I would guess some temporary reg writing, and increased implementation/compliance staff--a year or so?

    So -- start it next year (5.00 / 1) (#5)
    by Cream City on Mon Dec 07, 2009 at 07:23:09 PM EST
    as the excuse for delaying it until after the next election would be gone.

    Not to mention that I just might get something out of all this before I'm too old to know what is going on in Washington or anywhere anymore.  That begins to sound like the ignorance that is bliss.


    Keep that sense of humor (none / 0) (#7)
    by christinep on Mon Dec 07, 2009 at 08:04:12 PM EST
    a year or so? (none / 0) (#19)
    by beowulf on Mon Dec 07, 2009 at 10:43:37 PM EST
    Well, lets see, President Clinton signed the law creating the SCHIP program in August 1997, the program began on October 1997 . So a year would be plenty of time, even if we were to spot CMS a 9 month agency-wide sabbatical.

    The only reason the exchange is waiting till 201 is because President Obama idiotically put a $900 billion over 10 year cap on healthcare reform.  The only way the Senate could meet that 10 year target is to sit on their hands and not spend any money for the first four years.  

    Unfortunately, those math wizards didn't  adequately factor in that Democrats get to run in 2010 and 2012 having to defend votes raising taxes, cutting Medicare and imposing an individual mandate 2 or 4 years before the taxpayers have received any benefits from  affordability subsidies, insurance exchanges or guaranteed issue regulations.  

    The Democrats should have kept only the subsidies and a public option that starts next year.   Everything else in the bill is dead weight for Democrats running for office next year.


    sorry, exchange and subsidies start in 2014 n/t (none / 0) (#27)
    by beowulf on Tue Dec 08, 2009 at 07:37:00 AM EST
    For all those slippery slopers (none / 0) (#4)
    by magster on Mon Dec 07, 2009 at 07:20:34 PM EST
    I would rather have a public option.  

    Seems like every election a Dem could run on lowering the Medicare buy in age eligibility by five-ten years until everyone is covered.

    Could be very easily done. (none / 0) (#12)
    by caseyOR on Mon Dec 07, 2009 at 08:24:56 PM EST
    Bill Clinton wanted to open Medicare to anyone 55 and over, but there were senate Democrats who refused to consider it. Bill might have an old and detailed plan gathering dust somewhere.

     And Teddy Kennedy introduced a Medicare expansion bill in either 2006 or 2007. His bill included a rate structure and a method for collecting premiums.

    Seems like a lot of the heavy lifting has already been done. No good reason Medicare expansion for anyone 55 and older could not be up and running in 6-9 months.

    Shouldn't it be open (none / 0) (#13)
    by nycstray on Mon Dec 07, 2009 at 08:27:29 PM EST
    to anyone, regardless of age, who would have be qualified for the PO?

    Of course not (5.00 / 3) (#21)
    by shoephone on Tue Dec 08, 2009 at 12:30:56 AM EST
    That would be the moral and ethical thing to do. We can't allow that. We must insist that our legislators force us under-fifty-fivers to buy private insurance that we cannot afford. No public option. No subsidies. Let them screw us coming or going. It's the Amurikan way.

    How do I despise them? Let me count the ways.


    Exactly - the logical, fair, and workable (5.00 / 1) (#28)
    by ruffian on Tue Dec 08, 2009 at 08:19:19 AM EST
    options were long since discarded in favor of the for-profit insurance model.

    Republicans are fighting against (none / 0) (#14)
    by oculus on Mon Dec 07, 2009 at 08:36:38 PM EST
    cuts to Medicare?  Is the Pope German?

    Well (5.00 / 1) (#15)
    by Ga6thDem on Mon Dec 07, 2009 at 10:04:01 PM EST
    why wouldnt Republicans fight medicare cuts? I mean that's their base now---aging evangelicals. The GOP has come up with a "Senior Bill of Rights"

    I know many, many people who receive (5.00 / 1) (#16)
    by oculus on Mon Dec 07, 2009 at 10:05:12 PM EST
    Medicare whom I would not classify as evangelicals.

    Right (5.00 / 1) (#17)
    by Ga6thDem on Mon Dec 07, 2009 at 10:11:13 PM EST
    but look at the age and the demographics of people on Medicare and I'm willing to bet it's tilted toward the GOP.

    They are taking (none / 0) (#18)
    by Steve M on Mon Dec 07, 2009 at 10:41:19 PM EST
    cost-saving cuts and pretending like they are benefit cuts, because that's the kind of stunt you get to pull when you're in the minority.

    Of course maybe they will turn out to be benefit cuts.  The smart money probably doesn't bet on Republicans to be right very often though.


    In a certain sense, only the Democrats (none / 0) (#20)
    by andgarden on Mon Dec 07, 2009 at 11:12:43 PM EST
    could cut Medicare.

    Yes, how weird is that, (5.00 / 1) (#24)
    by BrassTacks on Tue Dec 08, 2009 at 02:42:53 AM EST
    Democrats cutting medicare!  I REALLY, REALLY, REALLY do NOT like this!  

    Medicare Advantage Cuts Are Aimed DIRECTLY AT (5.00 / 2) (#25)
    by azhealer on Tue Dec 08, 2009 at 06:37:24 AM EST
    Low income and minority seniors

    >80% of Hispanic/Latino seniors making less than $20,000 per year have MA

    1 in 4 of all African-American Seniors have MA
    1 in 3 of all Hispanic/Latino seniors have MA

    the bill guts those subsidies with no back up plan --- more costs to non-white seniors.

    We may not like this-- since MA is seriously flawed --- but the simple fact is that cutting the payments to MA plans will mean minorities and low income seniors lose, with no plan to help them pay for their new AARP Medigap policy


    home health (none / 0) (#29)
    by jedimom on Tue Dec 08, 2009 at 09:37:35 AM EST
    the cuts to home health are plenty real
    the amendment to strip just the Medicare home health the cuts was defeated yesterday, by Democrats

    Well, the minority party has, at least (none / 0) (#31)
    by KeysDan on Tue Dec 08, 2009 at 11:19:53 AM EST
    and, at last, taken on discussion of a serious component of the health reform bill--major reliance on Medicare "savings/cuts" to finance extension to those under 65.   Rather than their 'death panels' and teabagger rants, this half of the financing is as worthy of political debate as the half that seeks new income or excise taxes. Medicare is, on the one hand, described as being on the ropes owing to advances in costs, and on the other, that it is awash in fat that can be easily rung out to the tune of $500 billion. Indeed, the "savings" from undefined and questionable means (given the amount showcased, e.g., Obama's explanation of gains from duplicative laboratory tests) has received short shrift with a wave to its unassailable premise. Republicans are being Republicans, of course, but their underlying point is a real one.

    who will decide? (none / 0) (#30)
    by fly on Tue Dec 08, 2009 at 10:01:50 AM EST
    what affordable is? I have health insurance through my husbands Union,( hubby is retired)  it costs us $2,600.00 a month,1/3 is paid by us and 2/3rds more is paid by his former employers at an additional cost of $5,200.00 per month for a grand total of $7,800.00 per month. We know many of the retiree's who can not afford to pay the $2,600. a month and have let it drop, and once they let it drop they can not go back and get it again.
    So who will decide what is affordable? We can afford to pay the cost , but we do without alot to do so, others are not so fortunate, but the costs are choking us to death.

    As in everything else, the devil is in the details.

    Who will decide what is affordable????Our congress critters? or some Insurance board? Our unions? the mam behind the curtain in The wizard of Oz?

    We can hardly afford what we have but we can't afford to not have it...who can afford to retire when they have to pay $2,600. a month for health insurance, before anything else?