Thursday, December 13, 2012

Are Democrats abandoning raising the Medicare eligibility age?

Health care reform demonstration with woman holding Here's a bit more tea leaf reading on what might be happening in fiscal cliff negotiating, on the Democratic side. If you squint at it right, the signs are there that raising the Medicare eligibility age is out of the mix. First, there's a kick-ass op-ed in USA Today from Democratic Leader Nancy Pelosi, detailing just how harmful the proposal could be.
[I]n the talks to avert the fiscal cliff, the idea of raising the Medicare age is central to the Republican proposal. There's just one critical problem: It doesn't work. It doesn't have public support. It's unfair. And it doesn't lower health expenditures.

Such a proposal is a reflection of the broader Republican plan: an assault on the middle class, seniors'and our future. Republicans like to talk about their ideas in terms of abstract numbers. However, we cannot ignore the adverse impacts of their policies on the American people. [...]

She goes on to detail how the cut would ripple throughout the health care system, adversely affecting everyone from employers to younger people. It's a high profile takedown of one of the main ideas being forwarded by the Very Serious People in Washington, and at least some of the folks who have a say. But is she speaking for President Obama and all Democrats? That's a big unknown, but the second piece of evidence out there could mean the idea is on the outs.

The Center for American Progress, an organization very closely allied to the Obama administration, just released this report unambigously titled "Raising the Medicare Eligibility Age Would Harm Seniors and Increase Health Care Spending." The crux of their argument:

Raising the eligibility age would harm seniors even if every state fully implements the Affordable Care Act's Medicaid expansion. But the proposal poses an even greater threat to low-income seniors now that the Supreme Court's decision upholding the law rendered the Medicaid expansion optional for states. As we explain below, tens of thousands of low-income 65- and 66-year-olds, who would be cut off from Medicare'particularly the most vulnerable seniors living below the federal poverty level'will have nowhere to turn for coverage if their states reject the Medicaid expansion.
Throwing more people off of Medicare makes no sense from a fiscal standpoint. It just shifts costs to individuals, to employers, to states and actually increases health care spending. And it hurts people. These arguments, and full-throated and sustained opposition from progressives, from advocacy organization, and from the public in poll after poll, might have just killed this idea for Democrats, at least for the time being. Two establishment figures'Nancy Pelosi and CAP'could be telegraphing that.

Which is good, if that's the case. Now we have to start to work shooting down the idea some Democrats are coalescing behind that more means testing for Medicare is the way to go. It's already means tested. Going further erodes the promise of equal care at equal charge for people who have paid into the system throughout their working lives.

3:39 PM PT: Or not. In an interview with ABC News, here's Obama:

Raising the Medicare eligibility age from 65 to 67 is "something that's been floated," Obama said, not dismissing the idea outright.

"When you look at the evidence, it's not clear that it actually saves a lot of money," he said. "But what I've said is let's look at every avenue, because what is true is we need to strengthen Social Security, we need to strengthen Medicare for future generations, the current path is not sustainable because we've got an aging population and health care costs are shooting up so quickly."

It's still a really bad idea, Mr. President.

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