On Medicare’s 56th birthday, Democrats have a golden opportunity to expand benefits

July 30 is Medicare’s fifty-sixth birthday. It is a time to celebrate — and to recognize both the work that still lies ahead and the historic opportunity we have to make progress.

Medicare is a huge success story. Before Medicare, almost half of Americans age 65 or older could not afford health insurance. Now, it’s only two percent that are uninsured. That is in stark contrast to Americans under age 65, whose uninsured rate prior to the pandemic in 2019 was 10.9 percent.  

From the start, Medicare was intended as a first step toward government-sponsored health insurance for all. Robert M. Ball, a key architect of Medicare, laid this out clearly in a 1995 essay:

“[A]ll of us who developed Medicare and fought for it … had been advocates of universal national health insurance. We all saw insurance for the elderly as a fallback position, which we advocated solely because it seemed to have the best chance politically … [W]e expected Medicare to be a first step toward universal national health insurance, perhaps with ‘Kiddicare’ as another step.”

In 1972, Medicare was expanded to cover people with disabilities. But that is when progress toward Medicare for All stopped. Until now. 

This year, Congress has the best opportunity in half a century to strengthen and expand Medicare. Whether you support Medicare for All or not, all of us should support five wise, sound expansions to Medicare and Medicaid, both celebrating their fifty-sixth birthdays on July 30. 

At long last, Medicare should have a cap on out-of-pocket payments. 

Currently, Medicare beneficiaries must purchase private health insurance in order to avoid astronomical medical bills. The absence of an out-of-pocket cap in traditional Medicare gives Medicare Advantage an unfair leg up. Adding an out-of-pocket cap will protect Medicare beneficiaries against bankruptcy without forcing them into Medicare Advantage or into purchasing a supplemental Medigap policy. No one should go bankrupt trying to pay medical bills.

At long last, Medicare should cover the essential benefits of hearing, dental, and vision. 

Inability to hear is extremely isolating, resulting in serious depression, dementia, and other mental challenges. Dental problems can have even more profound consequences on health, leading to malnutrition, as well as heart and lung disease. The inability to see is also tremendously limiting and can result in falls and other accidents requiring medical treatment.  

Hearing, dental, and vision problems tend to come with aging. It makes no sense to exclude hearing, dental, and vision benefits from a program designed for seniors.

At long last, people should be able to age in our own homes and communities, not forced into institutions. 

People generally much prefer to live at home, surrounded by friends and family. Yet, as people age, they tend to need assistance with basic tasks of life, such as dressing, bathing, and preparing food. Medicare does not cover these services, while Medicaid is skewed toward institutional care. That expensive and cruel policy should change. We must enact a system of home and community-based care, so people who are able to age in place have the ability to do so.

At long last, Medicare’s eligibility age should be reduced.       

Lowering the Medicare age will save lives. Currently, 65-year-olds are considerably more likely to be diagnosed with cancer than their 61- to 64-year-old counterparts. That’s because many people in their early sixties, especially if they are uninsured, put off cancer screenings until they are eligible for Medicare. Tragically, this can mean that the cancer isn’t discovered until it’s too late for effective treatment. 

Medicare’s eligibility age should be reduced from age 65 to at least age 60, as President Biden has proposed. For those of us who support Medicare for All, we would like to see the age reduced to birth. But there is no question the age should be lowered.

At long last, Medicare should have the power to negotiate lower prescription drug prices, not just for seniors, but for everyone.  

Emergency rooms across the country are filled with seniors who can’t afford the vital medicines their doctors prescribe. Americans should no longer pay the highest drug prices in the world, or worse, not be able to afford their medications. Our tax dollars pay for the development of those life-saving medications, and we should not have to pay twice! Allowing Medicare to negotiate lower prices will save money for the program, as well as for beneficiaries. This will help pay for the other Medicare improvements.

Congressional Democrats are currently in the midst of crafting a reconciliation package that can, and should, include all of these benefit expansions. Strengthening and expanding Medicare is smart politics for any Democrat that wants to win reelection in 2022. More importantly, it’s the morally right thing to do. 

Our leaders tell us that health care is a right, not a privilege. Congress should celebrate Medicare’s birthday by taking important steps to make that profound truth a reality.