Congressional Democrats plan to use their multi-trillion-dollar spending proposal to achieve their longstanding goals of broadening Medicare benefits for seniors.
Senate Majority Leader Chuck Schumer said late Tuesday the Budget Committee’s $3.5 trillion plan would include a historic expansion of Medicare to cover hearing, dental and vision care for the first time.
Adding these benefits to the 56-year-old health insurance program for seniors and the disabled has been a top priority for the committee’s chair, Sen. Bernie Sanders of Vermont. While President Joe Biden has voiced support for broadening the services and mentioned it in his budget proposal, he did not include it in his sweeping American Families Plan earlier this year.
Just what will be in spending bill remains largely unknown beyond Schumer’s comments, and it faces a rocky road to passage, which will almost certainly have to be done through reconciliation so no Republican votes are needed. The agreement reached Tuesday focused mainly on the price tag, which is far lower than what Sanders had hoped for, meaning some items on the progressive wish list will have to be left out.
But Democrats have been pushing hard for the expansion of benefits for months. Massachusetts Sen. Elizabeth Warren in June pressed Health and Human Services Secretary Xavier Becerra on the administration’s goals for Medicare.
“We have ways that we can expand these services, and in fact, we must because we know it’s to our own benefit to provide these preventative services as early as possible to our seniors,” Becerra said at the Senate Finance Committee hearing, noting that reducing prescription drug prices are a way to pay for the additional services. “So we’re looking forward to working with you to make sure that we continue to make Medicare even better and where we go, I know that really will depend on Congress, but we’re ready. We want to make it work.”
Where things stand
Many Democrats in Congress are also ready. Just before Biden released the American Families Plan in late April, 17 senators wrote to him asking to add hearing, dental and vision services to Medicare in the proposal, along with lowering the eligibility age, implementing a cap on out-of-pocket expenses and allowing the program to negotiate lower drug prices. House Democrats also urged him to include the benefits expansion in the plan.
Last week, Democratic Rep. Lloyd Doggett of Texas introduced a bill with 75 other members that would broaden Medicare’s services. He cited a 2018 Commonwealth Fund report that outlined how vision, hearing and dental care are often out of reach for beneficiaries: 43% who have trouble seeing did not have an eye exam in the past year; 75% who needed a hearing aid, which can range in cost from $1,000 to $6,000, did not have one, and 70% who have difficulty eating because of their teeth had not visited a dentist in the past year.
(Most enrollees in Medicare Advantage, which covered 39% of Medicare’s 62 million beneficiaries in 2020, are in plans that provide access to eye exams or glasses, dental care and hearing aids, according to the Kaiser Family Foundation.)
But adding these benefits to the traditional Medicare program will be pricey. That’s why many Democrats are also focusing on allowing Medicare to negotiate drug prices – a very controversial idea, but one that could help offset the cost of enhancing Medicare.
Including vision, dental and hearing care would raise spending by about $358 billion over a 10-year period, according to a 2019 Congressional Budget Office estimate of an earlier House proposal. Allowing Medicare to negotiate the price of certain prescription drugs would reduce spending by $345 billion over a decade, according to another CBO estimate of the House bill.
Schumer said: “Every major program that President Biden has asked us for is funded in a robust way.” But he did not provide details on how the spending measure would be paid for.