Older man and woman at work with younger woman Bill sponsors say costs would potentially be lower for both exchanges and Medicare itself, with younger consumers seeing their premiums fall with the extraction of the 50-to-65 crowd from exchange risk pools. (Photo: Getty)

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

Politico reports that the bill, co-sponsored by Tammy Baldwin, D-WI, Sen. Debbie Stabenow, D-MI, Rep. Brian Higgins, D-NY and Rep. Joe Courtney, D-CT, would allow people between ages 50 and 65 to buy a private Medicare plan with the same tax credits and cost-sharing subsidies available on exchanges for the Affordable Care Act.

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The plan will pay for itself with premiums from those buying coverage, sponsors say, and more of the money would go to health care than is the case for private insurance, since Medicare has lower overhead and a relative lack of profit requirements.

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

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

And costs would potentially be lower for both exchanges and Medicare itself, with younger consumers seeing their premiums fall with 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 the equation could benefit from the plan.

According to Politico, the bill would “target $500 million a year for outreach to the newly eligible group,” which is five times what was spent on ACA enrollment outreach effors by the Obama administration.

Naturally, for-profit hospitals are already attacking the plan, with the Federation of American Hospitals warning in a statement that members already serving large Medicare populations would suffer from the buy-in because they need private insurers’ higher reimbursements rather than the lower rates Medicare provides.

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

But advocates for Medicare for All say that such opposition is exactly why there should be a push for “something much more ambitious.” In fact, a number of supporters of this latest measure are actually advocates for Medicare for All, seeing this bill as a stepping stone that’s politically less explosive and not as disruptive as a leap directly to Medicare for All.

“The opposition, the insurance companies and pharma, they will come out against anything, whether it’s a half-measure or even a one-quarter measure,” Bonnie Castillo, the executive director of National Nurses United, said. “That’s why we have to aim high.”

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