"Why The White House Should Embrace Grayson’s Medicare Buy-In Proposal"
Rep. Alan Grayson (D-FL) has provided the White House with a real opportunity to win back its disillusioned Democratic base and take the next logical step to reforming the health care system. Last night, Grayson introduced the “Public Option Act,” also known as the “Medicare You Can Buy Into Act,” which would give all citizens and permanent residents under the age of 65 an opportunity to buy unsubsidized coverage in the Medicare program. The bill instructs the Secretary of Health And Human Services to “establish enrollment periods and coverage” guidelines and requires the newly insured to pay premiums that reflect the “costs incurred for individuals within each age.”
“What it does is it takes this enormously valuable public resource called the Medicare provider network and makes it available to all Americans,” Grayson said on the floor, remarking that the government “spends billions” on putting together a provider network that benefits “only 1/8 of the population.” “It’s like saying only senior citizens can drive on federal highways. That is how important the network is and we have to open it to everybody”:
GRAYSON: We’re going to be seeing a Senate bill that doesn’t have a public option. We’re going to be seeing reconciliation that doesn’t have a public option. But Americans need a public option. That’s why I’ve introduced this bill….This is not a plan for subsidies. Everyone would have to pay their own costs. This is not a plan that is not meant to help everybody except for the people who can’t otherwise get insurance…I’m asking the speaker and the leadership, if we have to vote on this senate bill, if we have to vote on this reconciliation amendment that doesn’t have a public option on it, isn’t it time we did something good for America?
As Grayson himself admits, in of itself, the unsubsidized Medicare buy-in would wouldn’t provide an affordable option for most Americans. Clinton era reformers sought to expand the Medicare program but were never able to provide enrollees with affordable premiums on an unsubsidized basis. According to a CBO analysis of a Medicare buy-in for uninsured Americans between 62 and 64 — that group would have to pay a premium plus an administrative fee of 5 percent — “the annual premium for single coverage in 2011 would be about $7,600 (that figure includes the cost of Part D coverage).”
The significance of this amendment lies in its political implications. After all, most progressives lost faith in the Senate health care bill after Reid’s deal to replace the opt-out public option with a Medicare buy in for 55 to 64 year olds fell apart. Running on a platform that calls for a Medicare buy in could rally the base, get out the vote, and provide Democrats with an offensive campaign strategy in response to the GOP’s anticipated ‘repeal it’ campaign. Most importantly, it would allow Democrats to rally behind a very popular element of health care reform and help offset the public’s reaction to the Senate bill. It’s a win-win for Democrats. The White House would be keen to pursue it.