Tuesday, December 8, 2009

There Is One Word In This Deal That Needs To Change

TPM: "That buy-in option would initially be made available to uninsured people aged 55-64 in 2011, three years before the exchanges open".

As Chris Bowers points out, this opens Medicare to at most 3.24 million people. In other words, bupkis. A compromise in the House wherein anyone above 55 can buy into Medicare would be a reasonable compromise.

7 comments:

Gerry Canavan said...

Is there some reason why a person over 55 couldn't just voluntarily drop their insurance, thereby become "uninsured," and then take the Medicare buy-in?

janinsanfran said...

Gerry: Probably they'll build in a waiting period for pre-existing conditions to prevent such "free-riding" ...

Our Congresscritters are self-referential entitled blowhards who are refusing to find a way to do the job a majority elected them to do.

Ron E. said...

In a Senate run by Majority Leader Nelson and Majority Whip Lieberman, reasonable compromises aren't possible.

Nicholas Beaudrot said...

The press seems to be using "uninsured" to mean "exchange eligible". And in the current structure, if your employer offers affordable, creditable insurance, you aren't exchange eligible.

janinsanfran said...

According to Igor Volsky at the Wonk Room, the smidgen of persons eligible to buy into Medicare between ages 55 and 64 (unemployed and uninsured individuals -- maybe 2 million) would have to pay $633 a month. Yeah, right...

They put the country through this for that? You could almost draw the conclusion that they want to convince us that government (and winning elections for Democrats) is useless.

Zeke said...

It's true that the bill would be much better if this change were made, but I think we need to look at this in context. The public option was never going to be made available to the general public; it has always been the case that it would be open to people on the exchanges. Given that, I think that the medicare buy-in is actually superior to the public option as it was likely to be constructed, even without considering the possibility that we can bring the eligibility age farther down in the future.

ikl said...

That is not a lot of people, however -

a) it is likely to grow over time since employers are likely to offer less, not more health care.

b) There is a good chance that elligibility for exchanges will be expanded in the future in various ways. This would be relatively easy to do (compared to the difficulty of getting this reform done). The Medicare buy-in makes such future expansions more valuable.

c) it establishes a useful precedent for expanding Medicare elligibility

d) removing the oldest people from the exchange risk pool would seem to have the likely effect of making insurance cheaper for everyone else. This would save money or people buying money on the exchange and save the government money on subsidies to people buying on the exchange