WASHINGTON – Rep. Brian Higgins made his case for expanding Medicare to those over age 50 at a congressional hearing Tuesday that showed just how many choices Democrats face for reforming America's health care system.
Higgins' bill, which would allow many middle-aged Americans to voluntarily buy into the federal health plan for seniors, was one of nine proposals a congressional subcommittee considered without taking action. Those bills ranged from the modest – such as one which would encourage states to expand their Medicaid systems – to the massive: replacing all private insurance with a public "Medicare for All" plan.
Somewhere in the middle stood Higgins' plan, which he billed as a common-sense way to provide health insurance to a group of people who often need it.
"All of these bills are outstanding," Higgins, a Buffalo Democrat, told the House Energy and Commerce Committee's subcommittee on health. "But we need to make progress by using the best public option that already exists, and that's Medicare."
Noting that Medicare is broadly popular, Higgins said it makes sense to make it available as an option to those over the age of 50 because that demographic is in need of a public health care option. More than half of Americans aged 50 to 64 have a preexisting medical condition and therefore face very high costs for insurance premiums, deductibles and copays, he said.
Offering them a public option could lower their health care costs by upwards of 48% compared to the "gold plans" on the Affordable Care Act marketplace, according to the Rand Corp., an independent research agency. That being the case, Rand estimated that about 6 million Americans between the ages of 50 and 64 would choose to go on Medicare if Congress were to pass Higgins' proposal.
Meantime, a Kaiser Family Foundation poll earlier this year found that 77% of those surveyed favor a Medicare buy-in for people over age 50, making it the most popular health care reform option in the poll.
In contrast, only 56% favored the Medicare for All proposal that has dominated the 2020 Democratic presidential campaign. And other polls have found that support for Medicare for All drops when respondents hear that that bill would eliminate private health insurance.
Adding it all up, Higgins said both the research and the polling show his approach to be the one Congress should pursue.
"It's good on the politics, it's good on the substance," he said. "We need the next exciting iteration of Medicare expansion, I believe that my bill should be in that conversation relative to that goal."
Higgins' bill met a mixed reaction drawn along ideological lines.
Sara Rosenbaum, a professor of health law and policy at George Washington University, said Higgins' bill could be a cost-saver. So would a broader proposal by Rep. Antonio Delgado, D-Rhinebeck, which would open Medicare to all Americans, she said.
"What they would do is introduce a competitive alternative to private plans for especially vulnerable older Americans whose health care costs are quite expensive, relatively speaking," Rosenbaum said.
But Douglas Holtz-Eakin, of the conservative American Action Forum, questioned whether Higgins' plan would have much effect. Holtz-Eakin offered a wildly different estimate of the number of middle-aged Americans who would sign up for Medicare, putting it at about 500,000. He never explained why his estimate was so much lower than Rand's 6 million figure.
Tuesday's hearing was the third the House held this year that touched upon Higgins' plan, which – along with other health reforms – has been slowed by the debate among Democratic presidential candidates over what approach the party should take.
Republicans at the hearing repeated their frequent criticisms that the Democratic bills represent either a slow creep toward socialized medicine or a headlong rush toward to the end of private health care in America.