Older Americans would see their health coverage expanded as part of the $ 3.5 trillion budget plan approved by the House on Tuesday.
Medicare, which most Americans rely on once they reach the eligibility age of 65, would provide coverage for dental, vision and hearing as part of the budget resolution. Also, the age at which people can register would be lowered, most likely to 60, as President Joe Biden has said he supports.
The proposals are part of Democrats’ goal to strengthen the social safety net and invest in efforts to fight climate change. The House’s approval of the budget resolution – based on a 220-212 vote for the party line – paves the way for lawmakers to draft legislation reflecting the content of the spending plan and, potentially, pass the massive package without supporting Republicans through a process called fiscal reconciliation.
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While there is no certainty that everything in the budget plan will pass through the full process of Congress, Medicare advocates are hopeful that additional benefit coverage will materialize.
“This would be a very big deal for the Medicare program and Medicare beneficiaries,” said David Lipschutz, associate director and senior counsel for the Center for Medicare Advocacy.
“If Congress adds [those] benefits, this would fill some significant gaps in the program’s coverage since its inception, ”said Lipschutz.
About 62.8 million people are enrolled in Medicare, the majority of which are 65 years of age or older and depend on it for their primary health insurance. The program was created by congressional legislation in 1965 under President Lyndon Johnson and largely mirrored the standards of the time, which did not involve widespread coverage of dental, vision and hearing care, said Lipschutz.
“But as the healthcare system has evolved, Medicare has often been slow to catch up,” he said.
Original Medicare consists of Part A (inpatient coverage) and Part B (outpatient care coverage). With limited exceptions, there is no coverage related to dental, vision or hearing care, which may lead beneficiaries to forgo care.
“It would be a significant improvement [to provide coverage] for people who often go without needed care because they cannot afford it and for people who pay dearly for the care they need, ”said Tricia Neuman, Executive Director of the Kaiser Family Program Foundation on Medicare Policy.
Some beneficiaries have limited coverage for dental, vision and hearing if they choose to receive their Part A and B benefits through an Advantage (Part C) plan, which often includes these extras. About 40% of beneficiaries are enrolled in Advantage plans.
However, Lipschutz said, the additional coverage is usually not comprehensive. On the other hand, if extended benefits – no matter how generous – were required as part of the original health insurance, they would become the norm in an Advantage plan.
“We hope this will enrich the benefits for all beneficiaries,” Lipschutz said.
Democrats said their budget plan would be funded by higher tax revenues, savings on health care and long-term economic growth. Biden has proposed imposing higher taxes on the wealthy and businesses, as well as providing more money to the IRS to bolster its enforcement efforts.
While the plan includes few details on proposed changes for Medicare, other efforts to expand program coverage may offer some clues.
A House bill introduced in July by Representative Lloyd Doggett, D-Texas would include items such as dentures, preventive and emergency dental care, eye exams and refractive glasses, as well as hearing aids and exams.
The expanded coverage was also included in a larger healthcare-related bill that authorized the House in 2019 but was not taken up by the Senate. Under this proposal, beneficiaries would have contributed the standard 20% for some dental coverage.
Major treatments – for example, bridges, crowns, root canals – would have cost more. Dentures would also have been covered, within certain limits. And routine eye and hearing exams, along with hearing aids, contact lenses, and glasses, were also reportedly included.