Will Medicare be expanded in the final reconciliation bill?

On Thursday, 28 October, Speaker Nancy Pelosi failed to bring the $500 billion infrastructure bill to a vote in the House for the second time. Progressive members of her party have stood firm in their position that they will not vote to approve the bill until the reconciliation package is brought to a vote.

In speaking to the press, Chairwoman of the Progressive Caucus, Pramilia Jayapal said that she was sure the bill would not pass because according to her calculations there were still "too many no votes."

Earlier on Thursday, President Biden had announced that a compromise between the White House and more conservative Democrats had been reached. However, this news was not enough for Progressives to vote to approve the infrastructure package. Many believe the President gave up to much as the "compromise" widdled the $3.5 trillion reconciliation bill to one almost half the size.

From the East Room of the White House, President Biden told the press: "I'm pleased to announce that after months of tough and thoughtful negotiations. I think we have – I know we have – a historic economic framework," adding that "No one got everything they wanted – including me. But that's what compromise is."

A limited Medicare expansion

During his remarks, the President also highlighted the various measures that made it into the compromise legislation. Biden did note that the bill "will expand Medicare to cover hearing services so that older Americans can access the affordable care they need." Currently, only around 30 percent of seniors, who purchase a Part C Medicare Advantage Plan have health insurance that covers hearing services.

However, Progressives, including Bernie Sanders had hoped to expand the program to cover vision and dental as well, services that are desperately needed by the nation's oldest residents. Nearly a fifth of seniors have lost all of their teeth, and for Black Medicare beneficiaries, the rate is double the national average.

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What other programs have been scrapped from the reconciliation bill?

In order to cut the price tag for the package in half, many publically popular items had to be cut.

Medicare

In addition to the expansion of Medicare to include dental and vision, the measure to lower the eligibility age to sixty was also cut. Lowing the eligibility age could have provided coverage to 1.6 million people between sixty and sixty-four who are currently uninsured.

The Kaiser Family Foundation also reported that if the age was decreased, more than 11 million workers between sixty and sixty-four who rely on their employer-based insurance would be able to opt-in to Medicare. This change could reduce costs for businesses and organizations who could then provide other benefits to older and younger workers alike.

Prescription Drugs

A group of lawmakers had proposed a measure that would have allowed the federal government to negotiate with pharmaceutical companies to bring down the cost of prescription drugs. 

These costs can be a major burden for those on Medicare. Currently, almost three-quarters of those on Medicare have purchased a Part D plan to help keep the cost of prescriptions down. The negotiating power could have helped limit the number of seniors who felt it necessary to purchase additional coverage.

The bill does repeal a Trump era rebate that the White House says, "would have increased senior's drug premiums."