Rep. Alan Grayson (D-FL) has submitted his public option legislation as an amendment to the Rules Committee. The “Universal Medicare Buy-in Option” — which has been heralded as the next step in health care reform by some progressives — would give all citizens and permanent residents under the age of 65 an opportunity to buy unsubsidized coverage in the Medicare program. Grayson’s amendment has attracted 80 co-sponsors in the House.
It’s unlikely that Grayson’s amendment will be offered on the floor. The rules committee is expected adopt a closed rule prohibiting amendments from being offered on the floor to the reconciliation bill. As Sarah Binder explains, “Republicans relied on closed rules when they controlled the House, a practice they inherited from the Democrats who ruled before them.”
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).”