WashPost: The Health 202: Expansions could be coming to Medicare

Expansions are coming to the Medicare program, if Democrats can achieve one of their biggest health policy goals this year.

But they may have an easier time broadening what the program covers, versus trying to lower its eligibility age.

House Democrats have introduced a bill to include vision, dental and hearing coverage in Medicare.

The legislation, rolled out yesterday, aims to correct a long-standing challenge for seniors and those with disabilities who primarily rely on the traditional Medicare program for coverage: It doesn’t cover dental, hearing or vision care.

“I think many Medicare beneficiaries are shocked when they find out they’re on their own for these costs,” said Eliot Fishman, senior director of health policy for Families USA.

A free eye exam is performed on a patient in Los Angeles. Medicaid typically covers eye exams, while Medicare doesn’t. (Damian Dovarganes/AP)

If enrollees want such coverage, they must either switch to a private Medicare Advantage plan or purchase supplemental coverage. Just 53 percent of seniors said they have dental coverage in a poll carried out by the University of Michigan Institute for Healthcare Policy and Innovation. The seniors indicated that having dental coverage was a big reason they enrolled in Medicare Advantage instead of the traditional program; 72 percent said they chose Medicare Advantage at least partly for that reason.

Seventy-six Democrats signed on to the bill from Rep. Lloyd Doggett (D-Tex.), which would initially add preventive dental, hearing and vision care to Medicare’s “Part B” program and later on expand the benefits to cover basic impairments.

“This bill … fulfills the original purpose of Medicare — to assure dignity — helping those who have difficulty seeing, hearing or eating,” Doggett said in a statement.

WaPo Photo

Progressive Sen. Bernie Sanders (I-Vt.) has also been at the forefront of urging this change.

“Millions of senior citizens have teeth rotting in their mouths, are unable to hear what their children and grandchildren say or can’t read a newspaper because of failing eyesight,” he wrote in a recent Washington Post op-ed, co-written with Rep. Pramila Jayapal (D-Wash.). “It is a cruel irony that older Americans do not have coverage for these benefits at the time when they need it the most.”

Senate Majority Leader Charles E. Schumer (D-N.Y.)  is also on board:

Chuck Schumer tweet

The lawmakers want the legislation included in whatever budget reconciliation package moves through the House and Senate this fall, requiring just Democratic votes to pass. The details are starting to be discussed and negotiated, as the House prepares to get the ball rolling by passing a budget resolution sometime before the August recess. 

That effort is unfolding alongside bipartisan negotiations between the White House and Republicans over an infrastructure deal. Democrats are hoping to throw a bunch of partisan priorities into the separate reconciliation package, including several provisions to expand health coverage in the United States.

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