Bridging the Gap

The Kaiser Family Foundation notes the idea has a lot of support from the public. In its policy brief released in May, Health Insurance Coverage for Older Adults: Implications of a Medicare Buy-In,
it cited polling in 2000, 2004, and 2008 that showed around 76% of
adults have consistently supported a buy-in for this age group. “A
Medicare buy-in has the potential to bridge the gap for those without
access to other sources of affordable coverage,” according to the
brief. “It is an approach that could be relatively easy to put in place
in the short-term, providing immediate help to retirees who have great
difficulty purchasing coverage in the current insurance environment.”

Money, of course, is an issue. Baucus calls his approach “budget neutral”; Kaiser’s report implies that it likely can’t be done.

“Under
my plan, Medicare would charge those participating in the buy-in an
annual premium, which would be calculated so that the total costs for
the buy-in population would be budget neutral. In other words, the
program would not increase federal spending,” wrote Baucus.

Kaiser
says affordability would remain a problem. Government subsidies, it
writes, would be key to the buy-in’s success, which would increase
federal spending: “Without fairly generous subsidies, many of the
uninsured—particularly those with modest incomes—would be unlikely to
afford the premiums. With subsidies, a Medicare buy-in would help to
reduce the number of uninsured older adults; the generosity of these
subsidies would drive participation and government spending.”

The idea is getting plenty of attention, and lawmakers are set to debate the issue soon.

“The proposal has legs for the first time in years,” Stuart Guterman, a policy analyst at the Commonwealth Fund, a private foundation that researches health-care issues, told the Dallas Morning News. “Suddenly, the notion of buying into Medicare has friends in high places.”