Allow Medicare buy-in for older adults

The Affordable Care Act was enacted into law nearly 10 years ago with the premise that all Americans should have universal access to comprehensive health insurance coverage. The patient protections and coverage expansions included in it were designed to help manage the uncertainty and instability that comes with the onset of disease and treatment.

The ACA was always seen as a start, not a finish, in the journey toward achieving universal coverage in our country, and despite its successes in bringing health insurance to millions of Americans who previously didn’t have any, we are still paying too much for high-quality care.

For example, when Congress was deliberating early drafts of the ACA, a public insurance option was included to act as a force to stabilize the market and protect consumers against unreasonable price increases. I supported the “public option” and was disappointed that it was left out of the final bill text.

For the past several years under the Trump administration, the ACA has been under constant attack, and we have a lot of work to do just to repair the damage that has already been done. The combined effect of those actions—which include lawsuits and executive orders pushing “junk plans”—has pushed more Americans out of the marketplace and driven costs up even higher for millions.

Americans ages 50-64 who buy insurance through the exchanges are the ones who are hit hardest with these excessive premium increases. This pre-Medicare population is to the 21st century what the traditional Medicare population was in the first half of the 20th century before Medicare was enacted. That is, private insurers are able to charge the highest premiums to this population because they statistically use more healthcare. For many in this group, healthcare is difficult to access and unaffordable. Without additional action from Congress, those Americans, who are the most likely demographic to have pre-existing conditions and face premium increases as they near retirement, have no alternative but to absorb these price shocks.

A renewed discussion on the public option, a further step toward universal coverage, will help this group. This year, I was joined by Reps. John Larson (D-Conn.), Joe Courtney (D-Conn.) and Peter Welch (D-Vt.) to introduce our bill, H.R. 1346, the Medicare Buy-In and Health Care Stabilization Act.

Our legislation, which has 47 co-sponsors in the House, would allow Americans ages 50-64 the option of buying into Medicare, saving at least 40% in annual premium costs when compared with a gold plan on the individual market.

Creating more choice for these consumers will help keep costs down and stabilize insurance markets. Similar legislation has been introduced in the Senate by Sens. Debbie Stabenow (D-Mich.) and Tammy Baldwin (D-Wis.), and it has support from 19 more senators.

There are good reasons to model the public option on Medicare. To start, Medicare is viewed favorably by more than 80% of Americans. It has the most positive rating of any health insurance coverage option in the country and has reliably covered millions of elderly Americans for more than 50 years. It’s also the only health coverage option that has always covered pre-existing conditions.

Polling from the Kaiser Family Foundation also indicates that among the current proposals to expand Medicare, a buy-in option for those ages 50-64 has the strongest support, at 77%.

Medicare is the best public option that already exists. And the best public option that already exists should be made available to more Americans by continuing to build on the achievements made possible by the ACA and improving it to make healthcare more affordable and accessible for everyone.

More commentaries from members of the 116th Congress on the state of healthcare

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