Reps. Higgins, Larson & Courtney Announce New Legislation that Makes Medicare Buy-In an Option for Americans Ages 50-64
Washington, D.C. - As the national dialogue heats up around healthcare and Americans are seeking real solutions that address their long-term needs, Reps. Brian Higgins (NY-26), John Larson (CT-01) and Joe Courtney (CT-02) are announcing introduction of the “Medicare Buy-In and Healthcare Stabilization Act”, a bill that improves on the successes of the Medicare program and provides middle-age Americans a new option for affordable, quality healthcare. The Medicare Buy-In Act will lower the Medicare eligibility age to 50 years and offer the option to buy-in to Medicare thus avoiding the increase in premiums that older Americans often face. Additionally, working Americans who wish to buy into the program would have the option to do so, and their employers could continue to contribute to their premiums pre-tax, a win-win for those employers and employees. The buy-in option will hold down costs in both Medicare and the private market.
Congress approved legislation authorizing Medicare and Medicaid in 1965 through the Social Social Security Act. In the first 6 months of 1966, 19 million people enrolled in Medicare. In 2016 approximately 57 million people received health insurance through the Medicare program.
“For more than 50 years Medicare has been a reliable, efficient, and popular healthcare delivery system for older Americans and it is time to build on healthcare that works,” said Congressman Higgins. “Americans pay too much for health care and still the country ranks near the bottom, among similar sized nations, in quality for its investment. This legislation would allow us to leverage the purchasing power of the millions of people to deliver better care at lower costs.”
“In public events and town halls across the country, the American people have spoken up and demanded solutions. They have rejected ACA repeal and they have rejected partisan bickering. That is why I have joined with Reps. Higgins and Courtney to develop a simple and commonsense solution that offers one path forward to strengthen our health care system. This proposal will give Americans (ages 50-64) the ability to buy-into Medicare should they find their current options on the private market unaffordable or unsatisfactory,” said Rep. Larson. “Additionally, through targeted reforms focused on improving the quality and delivery of care, we are looking to the future to strengthen the long-term solvency of Medicare, and the health care system overall.”
Congressman Courtney said, “With the demise of “repeal” which was structured from day 1 as a hyper partisan Republican exercise, it is time Congress listens to what the American people have been saying loud and clear for several years. We need to work together to fix the weaknesses in the ACA rather than butcher it. The Medicare Buy In and Health Care Stabilization Act provides relief for the higher cost, older population in the individual and small business market, and restores the market stabilizers that Republicans have undermined and to caused insurance premiums to spike in 2017 and 2018. Lastly, the bill provides exciting new ways to reduce health care spending by cracking down on fraud and instructs the Department of Health and Human Services to employ tried and true tools to cut costs in the area of prescription drugs. This bill not only does not add to the deficit, but it will, in fact, save money for America’s taxpayers.”
“As Congress considers improvements to the Affordable Care Act, it is a no-brainer to provide Americans approaching retirement with quality affordable health care by expanding the popular and successful Medicare program,” said Rep. Welch. “I am particularly pleased that this bill includes my legislation to empower the federal government to negotiate lower Medicare drug prices with pharmaceutical companies. It simply makes no sense for the federal government to continue to buy drugs at wholesale while paying retail prices.”
"Instead of the dangerous and partisan approach Republicans in Congress are pursuing that will rip health insurance away from millions of Americans and make health care more expensive for seniors and families, we should be working together to help more Americans afford high quality health care,” said Rep. Huffman. “That’s why today we’re introducing the ‘Medicare Buy-In and Healthcare Stabilization Act’ to take one of our nation’s most successful programs -- Medicare -- and open it up to millions of Americans. The more people who can buy into Medicare, the better for everyone. Congress ought to work together to provide more affordable health care options for our constituents, instead of working to take it away."
Rep. Deutch added, “As Republicans play games around the repeal of the Affordable Care Act, we’re offering an alternative: a thoughtful bill that works to repair some problems in our healthcare system. Between Trumpcare’s age tax, repeal of protections for people with pre-existing conditions, and unrestrained costs to consumers, older Americans are at particular risk. Our bill takes the successes of Medicare and expands it to millions more Americans. It’s time for Republicans to pull the health care debate out of the shadows, stop buying votes with backroom deals, and start meaningful discussions across the aisle to find real solutions to our problems.”
Medicare Buy-In and Healthcare Stabilization Act
What the bill does:
Gives Americans ages 50-64 the option to purchase Medicare. Buy-in would be available through the exchanges during open enrollment, giving people the ability to comparison shop and allowing individuals eligible for premium tax credits or cost sharing reductions to apply them toward the buy-in premium. The Medicare buy-in would also be available to individuals who obtain healthcare through their employer, allowing for employer contributions.
Who is eligible?
According to the 2010 census, approximately 58 million people in the United States are between ages 50 and 64. This group is traditionally viewed by insurance companies as higher-risk and therefore face higher costs for health coverage. The AARP recently reported that four out of 10 adults ages 50-64 – about 25 million people – have preexisting conditions. Both the Senate and House versions of repeal and replace would allow insurers to charge older people five times more than younger beneficiaries beginning in 2018.
Currently 1 in 5 Americans are covered under Medicare and the majority of Medicare recipients are happy with their coverage.
Medicare is a cost-effective program. CMS reports, “Administrative costs in 2015 were about 2.0 percent, 1.1 percent, and 0.4 percent of expenditures for Part A (hospital coverage), Part B (physician coverage), and Part D (drug coverage), respectively.”
How does it save consumers?
The buy-in option holds down costs by leveraging the buying power of Medicare. Participants could buy-into Medicare, including Part A, B and D, for an annual premium potentially as low as $8,212. By comparison, a 60 year-old purchasing a Gold health care plan on the exchange would pay approximately $13,308 (before subsidies).
Participants continue to pay into the Medicare Trust Fund, protecting its future and allowing those who select the Medicare buy-in to receive the full Medicare benefits available to them upon reaching the age of 65.
Includes Mechanisms to Bend the Cost Curve and Stabilize the Marketplace:
The legislation builds on Medicare program integrity efforts to fight fraud and abuse in the system that hurts the long-term solvency of the programs and harms our beneficiaries.
It also ensures the enhancement of catastrophic reinsurance, reinstating the risk corridors that expired in the Affordable Care Act (ACA) and makes the Cost Sharing Subsidies a permanent part of the baseline.
Congressman Brian Higgins serves as Vice-Ranking Member on the House Committee on Ways and Means including its Subcommittee on Health. Congressman John Larson is a longtime member of the House Ways & Means Committee and serves as Ranking Member of the Subcommittee on Social Security. Rep. Joe Courtney is a member of the House Education and Workforce Committee where he serves on the Health, Employment, Labor and Pensions subcommittee.
Additional cosponsors of the “Medicare Buy-In and Healthcare Stabilization Act” include: Rep. Peter Welch (VT-At Large), Rep. Jared Huffman (CA-2), Rep. Ro Khanna (CA-17), Rep. Steve Cohen (TN-9), Rep. David Cicilline (RI-1), Rep. Paul Tonko (NY-20), Rep. Jim McGovern (MA-2), Rep. Tim Ryan (OH-13), Rep. Betty McCollum (MN-4) and Rep. Ted Deutch (FL-22).