Many questions remain on Medicare expansion proposal

The  proposal to expand Medicare to include people aged 55 and older as part of an alternative to creating the public option may have expanded support for the Senate version of the overhaul bill, the Los Angeles Times reports. "Despite the enthusiasm, the proposal must clear at least one big hurdle: cost. The nonpartisan Congressional Budget Office has not yet analyzed the idea, and its conclusions could be a major factor -- positive or negative -- in determining whether the compromise opens the way for final Senate action on healthcare." The expansion proposal came Tuesday as part of a tentative agreement between liberals and moderates to back away from the public insurance option promoted by progressives (Levey and Jaspen, 12/10).

The expanded Medicare program could help cover the 4.3 million uninsured Americans in the 55 to 64 age group who are among the most expensive patients to insure, the Philadelphia Inquirer reports. That could be especially helpful to "people forced into early retirement by the economy and thereby forced out of their medical coverage." Details of the plan aren't available yet, and its unclear exactly which people in the age group would be eligible. The new Medicare recipients would have to buy into the program, unlike people over 65, but subsidies may be available (Bergen and Burling, 12/10).

The Wall Street Journal: Under the plan "congressional aides estimate that two million to three million people would participate." The approach "could be good news for some in the 55-64 bracket who currently don't have an easy way to get coverage. Those who must buy coverage on their own often face high premiums or are shut out entirely because of pre-existing conditions."

But their payments would also likley be more than those paid by people older than 65, who pay $100 a month or more for coverage, depending on their income. "Based on data from the Congressional Budget Office, a report by the seniors' lobby AARP estimated that an earlier proposal to expand Medicare to a narrower group would cost participants $634 a month. ... Another issue is whether participants will have access to the same doctors as they do on private insurance. Some doctors have stopped taking Medicare patients because of the lower payment rates" (Adamy, 12/10).

NPR reports that a previous CBO estimate -- done last year-- concluded that allowing people age 62-64 to buy into Medicare would cost $7,600 a year including drug coverage, more than the $4,722 for the average cost for purchasing coverage in the non-group market. And a 2002 estimate found that without subsidies "a Medicare buy-in would only cut a single percentage point from the proportion of uninsured adults ages 55 to 64, leaving 9 percent rather than 10 percent without coverage." But some think that allowing the non-disabled to buy in to Medicare could be less disruptive to the insurance market — and would cost less than a public option (Hensley, 12/9).