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What is the Medicare expansion bill? Who supports it?

Expanding Medicare, part of the sweeping “care economy” bill congressional Democrats are hammering out, has become a sticking point in negotiations.

Expanding Medicare, part of the sweeping “care economy” bill congressional Democrats are hammering out, has become a sticking point in negotiations.

Democrats are trying to reach a deal on reshaping America’s safety net, combating climate change and creating a fairer tax code. Expanding Medicare has become a point of contention in the intra-party negotiations and could be yet another measure that gets stripped from the final bill.

Centrist Democratic Senator Joe Manchin has stated that he wants to stabilize the program before there is any expansion. However, progressive members of the party are drawing a line in the sand demanding that the provisions set out in the bill must stay in order for there to be any deal.

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What is in the Medicare expansion?

Medicare was first introduced in 1965 for people ages 65 and over, regardless of income, medical history, or health status. Over the years it has been expanded and now provides healthcare to over 60 million older people and younger people with disabilities. However, it is far from exhaustive and certain services are only covered through private healthcare insurance policies or Medicare Advantage plans.

Democrats after taking control of the White House and Senate and maintaining control of the House saw an opportunity to fill in some of the gaps in coverage. Earlier this year President Biden called on Congress to pass his Build Back Better plan which included expanding Medicare to cover dental, hearing and vision. These measures were as part of the original proposals for the $3.5 trillion resolution spending bill that Democrats plan to push through Congress without GOP support.

However, Senator Joe Manchin has been using the clout of his crucial vote in the Senate to force his colleagues to bring down the cost of the “care economy” and climate change combating bill. His latest focus is to remove the proposed expansions stating worries about the potential insolvency of Medicare by 2026.

“That's a lifeline," Manchin said on Monday. "You've got to stabilize that first before you look at basically expansion. So, if we're not being fiscally responsible, that's a concern."

Progressives dig in their heels over including Medicare expansion

As the Democrats’ spending bill gets whittled down, currently in the ballpark of $2 trillion, progressives in the House and Senate have been vocal about the idea of leaving the Medicare expansion out of the final deal. They have drawn a red line with Senator Bernie Sanders, Chair of the Senate Budget Committee, saying on Tuesday that a “serious reconciliation bill must include expanding Medicare to cover dental, hearing aids and eyeglasses.” Over the weekend in a tweet he stated "It's not coming out."

In the House, Progressive Caucus Chair Pramila Jayapal told Politico that her members have "no intention of backing down." Part of the calculus beyond helping seniors and those on fixed incomes is the political pay off in next year’s midterm elections. The proponents of the expansion point to the popularity of expanding coverage to dental, hearing and vision and that it will provide real near-term benefits to those on Medicare.

Cost of Medicare expansion would be offset by allowing negotiation of drug prices

In order to offset the cost of the Medicare expansion Democrats have also included legislation that would allow Medicare to negotiate drug prices with pharmaceutical companies. Senator Manchin supports this idea but the other holdout vote in the Senate, Senator Kyrsten Sinema does not, further complicating matters.


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