EDITORIAL: Higgins-backed plan to expand buy-in for Medicare could help contain costs

May 5—Rep. Brian Higgins believes the time is right for Congress to pass his "Medicare for more" proposal. He makes a strong case.

Sen. Debbie Stabenow, D-Mich., this year introduced a new version of her "Medicare at 50" act, which would allow people aged 50-64 to buy into the federal health insurance program for people 65 and older. Sen. Kirsten Gillibrand, D-N.Y., is one of 18 co-sponsors and the bill is supported by Higgins, a Buffalo Democrat who introduced a similar bill in the House.

President Biden, who is expected to make a major health care speech this month, has reportedly been considering lowering the Medicare age from 65 to 60, a promise he made while campaigning. That idea is supported by Sen. Bernie Sanders, I-Vt., who wants to give Medicare the power to negotiate drug prices which he says would raise enough revenue to pay for expanded Medicare eligibility.

The Higgins and Stabenow bills are a better bet. Individuals aged 50-64 who elect to join Medicare would buy in with their premium dollars, moving from policies they purchased themselves or ones funded through their employer, labor union or other arrangement. Those who choose Medicare would pay for it at cost, minimizing the impact on the Medicare Trust Fund.

Some hospital interests oppose the change in Medicare eligibility, as reimbursement rates run about 50% lower than from private insurers. Higgins counters that more competition from Medicare could drive down health care costs for millions of Americans.

In a conversation with The News this week, Higgins said there's been a myth that doctors and hospitals don't like Medicare.

"Well, they all take it," he said. "There's a high acceptance level and it's because they're a reliable payer."

A study by the Kaiser Family Foundation, a nonprofit and nonpartisan think tank focused on health care, found that people moving to Medicare would see their total health costs reduced when compared to employer coverage.

The Rand Corp., another independent research group, found that offering individuals aged 50-64 a public option could lower their health care costs by upward of 48% compared to the "gold plans" on the Affordable Care Act marketplace.

With younger, lower-cost people shifting into the Medicare risk pool, Medicare premiums for all beneficiaries could also decline, Kaiser found. A Rand model, meanwhile, showed that premiums paid by those remaining in the individual market might go up after older subscribers move to Medicare, as the younger people who buy Obamacare policies tend to require more medical care.

Higgins points out that in 2019, the U.S. spent more than $1.4 trillion on Medicare and Medicaid alone.

"That's 34% of the total health care spending in the country," Higgins said. "Now, as I often say, that's a lot of money, but it's also a lot of leverage and the federal government should use the leverage that it has to drive down the cost of health care and drive up the quality of health care."

It's one reason why Congress should, in fact, allow Medicare to negotiate for lower drug prices, which can be prohibitively high in this country. Indeed, that should have been done years ago, as part of the Affordable Care Act. It's bad business practice for any entity not to take advantage of its purchasing power.

In the polarized environment of Capitol Hill, it seems there is no such thing as bipartisan legislation. If one party put forth a bill saying it's illegal to light a car on fire in a school playground, it would not get 100 votes in the Senate.

However, the Medicare program is very popular with the public. Even lowering the Medicare eligibility age gets support from both sides of the aisle. A Kaiser Family Foundation tracking poll from January 2019 found that about 85% of Democrats and 69% of Republicans favored allowing those as young as 50 to buy into Medicare.

"It's also good politics," said Higgins. "If you've got 60 million people between the ages of 50 and 65, and let's say 10%, 6 million, take advantage of it, you know, those people vote."

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