Older man and woman at work with younger woman Bill sponsors say costs would potentially belower for both exchanges and Medicare itself, with youngerconsumers seeing their premiums fall with the extraction of the50-to-65 crowd from exchange risk pools. (Photo: Getty)

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Democrats in both the House and Senate have taken a step forwardon the Medicare for All issue with a billthat would allow anyone 50 and older to buy in to Medicare.

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Politico reports that the bill, co-sponsored by TammyBaldwin, D-WI, Sen. Debbie Stabenow, D-MI, Rep. Brian Higgins, D-NYand Rep. Joe Courtney, D-CT, would allow people between ages 50 and65 to buy a private Medicare plan with the same tax credits andcost-sharing subsidies available on exchangesfor the Affordable Care Act.

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Related: 4 FAQs about 2019 Medicare rates

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The plan will pay for itself with premiums from those buyingcoverage, sponsors say, and more of the money would go to healthcare than is the case for private insurance, since Medicare haslower overhead and a relative lack of profitrequirements.

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“The money paid into Medicare goes to health care. It doesn't goto paying high salaries,” Higgins said

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The plan, which would be kept separate from Medicare proper, isdesigned to counter arguments that it would undermine care forseniors. Premiums from buy-in customers would be put into a“Medicare Buy-In Trust Fund” that would provide cost-sharing forthose who need it and not tap into traditional Medicare funds.

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And costs would potentially be lower for both exchanges andMedicare itself, with younger consumers seeing their premiums fallwith the extraction of the 50-to-65 crowd from exchange risk pools,and Medicare recipients possibly seeing the same benefit as younger(the 50-to-65s) joining their risk pools—so both parts of theequation could benefit from the plan.

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According to Politico, the bill would “target $500 million ayear for outreach to the newly eligible group,” which is five timeswhat was spent on ACA enrollment outreach effors by the Obamaadministration.

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Naturally, for-profit hospitals are already attacking the plan,with the Federation of American Hospitals warning in a statementthat members already serving large Medicare populations wouldsuffer from the buy-in because they need private insurers' higherreimbursements rather than the lower rates Medicare provides.

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“Expanding the program with hospitals facing the lowest Medicaremargins in history will make it more difficult to provide thecritical care that all Americans expect and deserve,” FAH presidentand CEO Chip Kahn said.

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But advocates for Medicare for All say that such opposition isexactly why there should be a push for “something much moreambitious.” In fact, a number of supporters of this latest measureare actually advocates for Medicare for All, seeing this bill as astepping stone that's politically less explosive and not asdisruptive as a leap directly to Medicare for All.

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“The opposition, the insurance companies and pharma, they willcome out against anything, whether it's a half-measure or even aone-quarter measure,” Bonnie Castillo, the executive director ofNational Nurses United, said. “That's why we have to aim high.”

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Marlene Satter

Marlene Y. Satter has worked in and written about the financial industry for decades.