Dem single-payer fight set to shift to battle over Medicare ‘buy-in’

Dem single-payer fight set to shift to battle over Medicare ‘buy-in’
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Momentum is building among House Democrats for a more moderate alternative to single-payer health-care legislation.

The legislation, which would allow people aged 50 to 65 to buy Medicare, is being championed by Rep. Brian HigginsBrian HigginsDems offer smaller step toward ‘Medicare for all' Overnight Health Care — Sponsored by America's 340B Hospitals — Powerful House committee turns to drug pricing | Utah governor defies voters on Medicaid expansion | Dems want answers on controversial new opioid Assault weapons ban push tests Dem support MORE (D-N.Y.), who supported House Minority Nancy PelosiNancy Patricia D'Alesandro PelosiDonald Trump proved himself by winning fight for border security Trump should beware the 'clawback' Congress The national emergency will haunt Republicans come election season MORE (D-Calif.) for Speaker in exchange for a commitment to work on his bill when Democrats take control of the House early next year.

“We agreed in principle to get this done,” Higgins told The Hill.

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Higgins told The Hill that Pelosi’s support of his buy-in legislation was the key to switching his position on her Speakership.

Higgins said he wasn’t promised a vote on the legislation, just a commitment that he will be the point person of the effort to shepherd it through the legislative process.

“It’s got to be scored, go through committee. It’s got to do a lot of things,” Higgins said. “We fell short of a vote in committee [with Republicans in control]. So now that changes.”

Under Higgins’s plan, anyone aged 50 to 64 who buys insurance through the health-care exchanges would be eligible to buy in to Medicare.

It would also apply to people with employer-sponsored insurance and allow employers to pay Medicare premiums on their behalf — a feature that could expand the number of older working individuals who select the buy-in option.

Hillary ClintonHillary Diane Rodham ClintonRoger Stone shares, quickly deletes Instagram photo of federal judge on his case Barack, Michelle Obama expected to refrain from endorsing in 2020 Dem primary: report Why the national emergency? A second term may be Trump’s only shield from an indictment MORE offered a similar proposal when she ran for president in 2016. Former President Bill ClintonWilliam (Bill) Jefferson ClintonHarris off to best start among Dems in race, say strategists, donors For 2020, Democrats are lookin’ for somebody to love A year since Parkland: we have a solution MORE also proposed expanding Medicare in 1998 by allowing certain workers between the ages of 55 and 65 to buy Medicare. Those workers had to either lack insurance or be retired or laid-off.

Rep. Frank Pallone Jr.Frank Joseph PalloneHigh stakes as Trump, Dems open drug price talks Overnight Health Care — Presented by PCMA — Lawmakers pay tribute to John Dingell's legacy on health care | White House denies officials are sabotaging ObamaCare | FDA wants meeting with Juul, Altria execs on youth vaping Hillicon Valley: Dems ready to subpoena Trump Tower meeting phone records | Dems, Whitaker in standoff over testimony | Bezos accuses National Enquirer of 'extortion' | Amazon offers rules for facial recognition | Apple releases FaceTime fix MORE (D-N.J.), the likely chairman of the Energy and Commerce Committee next year, said he thinks a Medicare buy-in should be on the agenda next year.

“We certainly would consider a Medicare buy-in,” Pallone told The Hill. “I think we’ve got to wait and see what the caucus wants to do and what the committee wants to do, but I’ll just say it’s certainly something we should consider.”

“Medicare for all” supporters are energized after sweeping Democratic victories in the midterm elections, however, and see the Medicare buy-in bill as too small a step.

“We are dead set against any buy-in or public option,” said Kenneth Zinn, political director of National Nurses United. “Our goal as RNs is to ensure a universal system of guaranteed health care for everyone and this does not accomplish that. I would urge Congress to reject it.”

Zinn said private insurance shouldn’t have any role in health coverage moving forward. A single-payer plan covers everyone, regardless of income, and eliminates copays, deductibles and premiums. It also eliminates private insurance.

Rep. Pramila JayapalPramila JayapalOvernight Health Care — Sponsored by America's 340B Hospitals — Push for cosponsors for new 'Medicare for all' bill | Court lets Dems defend ObamaCare | Flu season not as severe as last year, CDC says Democrats seek cosponsors for new 'Medicare for all' bill Overnight Health Care — Sponsored by America's 340B Hospitals — Utah tests Trump on Medicaid expansion | Dems roll out Medicare buy-in proposal | Medicare for all could get hearing next month | Doctors group faces political risks on guns MORE (D-Wash.), who is co-chair of the Medicare for All Caucus in the House, told The Hill said she has spoken with Higgins and expressed her concerns about his bill.

“We have to be careful not to perpetuate the system we have,” Jayapal said.  “I would prefer to have a reduction of the age of Medicare so that more people could qualify but not a buy-in, because that continues the problems that we have right now.”

Jayapal added that lowering the eligibility age “would be an appropriate way to go where we’re taking a step forward towards a system that will ultimately cover everybody.”

Still, she said with Democrats in control of the House, there will be more of an “exchange of ideas” than there has been previously.  

Higgins said a Medicare buy-in is quicker and cheaper to implement than single-payer. It can also be a bridge to Medicare for all, he said.

“I support the exploration of Medicare for all, but you have to be well balanced and practical about this. Establishing a brand-new health insurance program is going to take time,” Higgins said.

Adam Green, co-founder of the Progressive Change Campaign Committee, said he supports giving everyone the option to buy in to Medicare, and thinks the legislation from Higgins will start a conversation. He wants a "buy-in for all" to be the “new floor” in the debate.

“It’s ironic that it took a conservative Democrat to jumpstart the momentum for Medicare buy-in but now that it’s there, there will be a huge push for Medicare option for all,” Green said. 

“It’s jumpstarting the concept of a buy-in in 2019 and will lead to momentum of a buy-in for every family and small business.”