Will Congress Pass A Medicare Expansion?

Congress is currently working with a bill to permit Americans to buy into Medicare at the age of 55. It has been touted as an option to ensure that Baby Boomers and the aging Boomer echo generation will have coverage as they near retirement.

Naturally, the initial reaction from this demographic has been positive. As late-life health issues begin to emerge, people naturally seek the most cost-effective means to address them. They make the changes they need in order to remain healthy; battling sodium, sugar, and cholesterol with dietary changes, and working to avoid injuries at home with entry ramps, stair lifts, and updated bathrooms.

With such broad appeal to an important sector of the voting public, this type of effort to expand government health care is nothing new. Bernie Sanders introduced a similar option during the campaign, but his primary loss brought that idea to a close.

The first thing to consider is just how effective this legislation would be. With the future of the Affordable Care Act still uncertain, there may be a sizable portion of the population who would welcome the opportunity to go ahead and secure health care coverage now.

So while enrollment numbers would probably be significant, there remains the issue of whether it can get through Congress. To begin with, there is still a Republican majority, making any single-payer option a long shot at best.

But should a shift take place in the mid-term elections, the odds will remain poor. Politicians must often vote based on what is expected to happen, because there’s no way to know if it definitely will happen. The ACA is a perfect example. There was no way to predict how it would work, so Congress essentially voted on assumptions.

With open availability of Medicare at age 55, there are certain assumptions that must be made by elected officials. The most important of these is whether the system will remain financially solvent if the change is made. Here is how they’ll likely assess that.

As with any insurance system, there needs to be the correct mix of low-cost enrollees–healthy people, in this case–and high-cost enrollees, which would include people with chronic conditions like diabetes. If this balance is skewed too far toward the sick, the system will suffer a major financial shock.

Is such an imbalance likely? It seems to be. One of the big problems in the Affordable Care Act has been its inability to convince young, healthy people to sign on. It makes sense that the 55-year-olds who are seeking coverage now are the same people passing on insurance as 20-somethings today. When health problems start to set in, they’ll seek coverage.

There is no guarantee that this will happen, but the probability is good that it will play out in this manner. And just like in criminal law, a reasonable doubt is enough. No politician wants the burden of a failed expansion to be an issue in the next campaign.

So while the prospects are marginal at best for passage of this Medicare expansion, it’s important to note the overall context of this bill. There was a time when this type of legislation would have never seen a committee, so at the very least, it appears that there is forward momentum to make changes to health care. Voters should work to inform themselves about what each bill would do, because there will be a continuous stream of them in the coming years.

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