Unions Demand Pelosi and Schumer Include Lower Medicare Age, Drug Pricing Reform in Infrastructure Plan

By Brett Wilkins, staff writer for Common Dreams. Originally published at Common Dreams

Echoing earlier demands from progressive groups and lawmakers, over 100 labor unions and their allies on Wednesday called on the Biden administration and Democratic congressional leaders to include expanded Medicare eligibility and prescription drug pricing reform in the $1.8 trillion American Families Plan, part of President Joe Biden’s three-part Build Back Better economic and infrastructure proposal.

In a letter (pdf) to Senate Majority Leader Chuck Schumer (D-N.Y.) and House Speaker Nancy Pelosi (D-Calif.), 103 labor, faith, healthcare, racial justice, and other allied groups urged Biden and Congress “to include robust Medicare drug price negotiation in the American Families Plan package and to reinvest significant savings from negotiations [in] the Medicare program, alongside other critical investments in health equity, coverage, and affordability.

“By using the savings to improve dental, vision, and hearing services, capping out-of-pocket costs, lowering the Medicare eligibility age, and taking other bold steps to improve our nation’s health, the Biden administration and Congress would be delivering on key promises and improving the lives of millions,” the letter states. Currently, Americans are eligible for Medicare benefits at age 65.

“The American Families Plan must center the needs and priorities of BIPOC communities and expanding Medicare would help to increase coverage and access to care for communities of color who are disproportionately uninsured or under-insured,” it says.

The letter continues:

The United States spends far more than any other country for prescription pharmaceuticals, and the largest purchaser in the world is the Medicare Part D program. High U.S. drug spending is driven by excessive prices charged by prescription drug corporations, which lead to treatment rationing and preventable negative health outcomes, including death. Enacting a robust system of direct government drug price negotiation and price spike protections that provides relief to patients regardless of medical condition, insurance provider, or status will save lives and prevent suffering and financial hardship for families across the nation.

Bold drug pricing reform will support building a healthier America, as well as produce hundreds of billions of dollars in savings to reinvest in bolstering coverage,” the letter asserts. “With these significant estimated savings, over 10 years, it is a crucial time to address other needs of Medicare enrollees.”

“In addition, by expanding access to Medicare to Americans 50 and older, the Biden administration and Congress could deliver crucial progress on expanding healthcare,” the letter continues.

The signers explain:

Medicare has achieved universal coverage for Americans 65 and older, while the uninsured rate for adults 50–64 is 10.5%. Americans approaching retirement age have faced significant job loss as a result of the recession brought on by the pandemic and are at a particular disadvantage in states that have refused to expand Medicaid, leaving low-income Americans in those states particularly at risk of going without coverage and needed care. And given that most people experience increased medical needs as they age, lacking insurance at such a crucial time can mean financial ruin.

“Far too many Americans continue to struggle to get the care and medicine they need when they need it. Establishing government drug price negotiations and price spike protections will provide countless Americans with relief and put an end to treatment rationing,” the letter says.

“Expanding Medicare to those 50 and older would mean giving the peace of mind that Medicare enrollees already have to 63 million additional Americans, while expanding it to only adults 60 and older would expand eligibility for Medicare to an additional 20 million Americans,” it concludes. “Now is the time for action to lower drug prices and improve access to care for millions.”

The groups’ demand follows similar calls from 17 Democratic senators in an April letter that argued Medicare, which was signed into law by President Lyndon Johnson in 1965, is “one of the most successful and popular federal programs in our nation’s history.”

“The time is long overdue for us to expand and improve this program so that millions of older Americans can receive the healthcare they need, including eyeglasses, hearing aids, and dental care,” the senators asserted.

The lawmakers also said that lowering the Medicare eligibility age to as young as 50 would be a way to expand coverage, save lives, and implement a popular reform to a program that is already favored by a majority of the American people across the political spectrum.

Indeed, an April 2021 Data for Progress survey found that 86% of Americans—including 82% of Republicans—support adding dental, hearing, and vision benefits to Medicare.Three-quarters of Democrats, a majority of Independents, and nearly half of Republicans also favor lowering the Medicare eligibility age to 55.

“We have a unique opportunity to finally address the exploding cost of prescription drugs,” said Dan Bauer, director of government affairs at the Communication Workers of America (CWA), in an statement Wednesday. “These rising costs have put necessary and lifesaving treatments out of reach for working families and retirees and bold action is needed.”

“Pursuing bold reform will also create substantial savings that can be used to expand Medicare to more seniors and cover important treatments for seniors like vision, hearing, and dental care,” Bauer added. “These are important steps to ensure affordable care for working families and retirees throughout the country.”

Eagan Kemp, health policy advocate for Public Citizen, added that “lowering the Medicare eligibility age to 50, capping out-of-pocket costs, and expanding benefits to include dental, hearing, and vision would improve access to care for millions of Americans.”

“Far too many Americans have lost their insurance or put off needed care due to the Covid-19 crisis,” said Kemp. “The Biden administration and Congress have a chance to deliver important progress at a crucial time.”

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  1. tegnost

    One might think that the infra bill sausage making has been done for a long time and now we’re in the “what can I pay you to get your vote” phase, so a little late in the game, no?. This is more “progressive” negotiating,cement the rights of capital then pay lip service to citizens…um voters…um consumers! I knew I would come up with the right word eventually…
    Fighting for!

  2. Pat

    Hmmmm. If unions are lobbying for lower eligibility for Medicare, I wonder what other changes they may be lobbying for. Right now you can delay enrollment in Medicare if you are covered by an employer plan. How does this figure into union calculations.
    Either this action is as much “for show” as most Democratic candidates campaign promises OR they will also be trying to change that eligibility clause surreptitiously. Because as I see it if the reason unions don’t want single payer Is that healthcare plans are a selling point, being able to shift older workers to Medicare is a huge boon. They are the costliest employees to insure. I am not sure what how they would handle contributions, maybe as an elder health savings plan that could be used for supplemental insurance or for dental and vision care, but no doubt it would allow for more comprehensive coverage for younger workers without increases in that contribution on their part.

    We’ll see eventually.

    1. d w

      i suspect both parties do lots of things for show

      course some if it might be because employers really want it too, evidence of that is how many businesses actually dont like the extra cost of health benefits. they just dont want to advocate for it them selves

  3. Arizona Slim

    Why not lower the Medicare age to zero?

    The problem with these arbitrary age cutoffs is that some people are worthy enough for Medicare, but others are not. What if you’re 49? Or 37? Or 22?

    Medicare for All.

    1. Pat

      Here! Here!
      I would only add remove all negotiating constraints from the service along with acceptance of Medicare being a requirement of all medical licensing.

      But then that would make us a first world country and we can’t have that.

    2. synoia

      Free College for all too. an MD generally graduates with a large amount of debt.

      The lenders are a parasite on the body public.

    3. lordkoos

      Yep… the first thing I noticed when reading this headline was that they were not asking for universal health care.

      1. Susan the other

        Our dear congress can probably get this past their big donors (the pharma and med insurance con artists) easier because something is left on the table for them so they can still make a few donations. For pharma especially they will still be able to extort the youngest wage earners and that will be enough to give congress some bribes – to the nancy-pelosis and the chucky-schumers and of course the big guy of the moment. The same for med insurance. Med insurance is pure skim and cheat – they do nothing to help society. So both get to keep some pretty filthy profits. And employers are finally coming around to the very good idea of single payer/M4A because it helps them out significantly. 50 or 55 is sixes. So they really should go for 50 and make it work. This proposal works for both opposing interests. For now. It shouldn’t take too long for the under-50 crowd to get sick and tired of being exploited, and when that time comes all the voters will be engaged against the grifters, the life-long-legislating grifters, and they might actually get voted out. It has been such a disgraceful battle, I wonder how it will go down in history. Part of the most shameful days of America.

        1. John Zelnicker

          @Susan the other
          June 17, 2021 at 12:25 pm

          I hope you’re right about employers coming around. Single payer would save them a ton of money. As a tax accountant I see my clients W-2’s every year. For about a decade now, employers have been required to report on the W-2 the amount they spent providing insurance for that employee and their family, if covered. It doesn’t affect their taxes, it’s just for information.

          It’s a lot. For large national employers it can range between $10-15,000 and more per year.

          With tens of thousands of employees, that adds up fast.

          Which brings me to an idea I haven’t seen anywhere else, modulo my limited range of sources.

          Once single-payer is finally a reality (I’m an optimist), the big companies will get a windfall profit when they no longer have to shell out millions for health insurance. That money needs to go to the wage earners, not to the executives and shareholders, yet not one proposal I have seen even mentions this.

          IMNSHO, any single-payer proposal should include provisions to re-allocate those insurance costs to increasing the wages and salaries of the employees, and prevent the windfall profits. And, I mean all of the costs, not just a minimal amount.

          1. Susan the other

            Yes. That’s a good catch. It should be earmarked for wages. Logically too, that is what will boost the economy; instead of clogging it up with more inequality.

    4. Oh

      After talking to people who are eligible for Medicaid, I find it may be a better program than Medicare and covers dental and other benefits with less deductibles. It might be better to convert Medicare to Medicaid for all and leave Medicare Advantageand Pharma behind. If some states refuse to go with Medicaid it’s time to cut their funding for other programs to make them fall in line.

      1. Louis

        The problem with Medicaid is that many providers do not accept it due to low reimbursement rates. If you want to expand Medicaid you either need higher reimbursement rates or legally mandate–if constitutional which I don’t know if it is–that all providers accept it.

        As for cutting funding for other programs to force adoption of Medicaid, that could run into some constutional issues as well, depending on the specifics.

    5. Kay Tillow

      Yes, Make the age zero–but we must remove the private insurers, the Medicare Advantage plans that are privatizing and destroying Medicare. We will have to pass legislation that takes the profits out of health care, removes all the deductibles and copays, and assures that the savings go into care. Join the March for Medicare for All, July 24. Make it happen! https://m4m4all.org/

    6. Glen


      That’s what we need if small businesses are going to have a fighting chance against the mega corporations!

      And we need small business to flourish if we are going to revive our country.

    7. Yves Smith

      Medicare sucks. My current plan is way better.

      Why should a universal program stick enrollees in HMOs or PPOs?

      And many MDs and even some hospitals don’t take Medicare. The Hospital for Special Surgery, where I got my new hips, doesn’t.

  4. Nikkikat

    I wouldn’t hold my breath on Medicare age being lowered any time soon. Even if they did, it would only be so they can get enrollment up on the crappy advantage plans they dupe unsuspecting seniors into taking. After all straight Medicare requires ridiculous amounts of money be spent on drug plans and supplemental plans that cost 3 or 4 hundred per month along with your Medicare premiums. All of Obama’s administration now sits on boards of companies pushing these plans…along with managing nursing homes.

      1. Oh

        Their latest property purchase was in Hawaii, where they bought ocean front property after getting some of the regulations waived to pave the way. If sea level rises over there the Obamas may need a floating mansion.

  5. Kay Tillow

    Lowering the age would help some–but it would be a huge break for corporations and insurance companies. Corporations would pockets massive funds when they could stop paying health benefits for their older employees. And putting these younger seniors on Medicare would open new paths to riches for the privatized Medicare Advantage plans. Lowering the age would shift health care costs from employers to the public–leaving in place the whole for profit health care system. Everybody in–profits out. National single payer health care–NOW.

    1. Harrold

      Not too sure corporations would benefit too much. What would happen to employee retention if health insurance was taken out of the equation?

      If the Medicare age was reduced to 62, I think you’d see an immediate increase in employees retiring.

      1. d w

        well many corporations offer health insurance any more (for them its too expensive any more). and they didnt increase the wages they paid either (wage growth for the last 10-15 years has been abysmal at best unless you were an executive). but just because they can stop offering health care, doesnt mean they retain workers. they can offer group life insurance, dental and vision plans. none of those are offered by Medicare, and advantage programs do offer vision and dental, just not very many.

        and the cost for those offerings is minimal (compared to health). so not exactly expensive i guess, do get a big bonus for those that do offer health care, they can cut spending on that, and either put money into the others, the most unlikely, raise wages. which some are already having to do, since offering minimum wage, doesnt seem to get much interest from prospects.

      2. CitizenSissy

        If Medicare age was lowered to 62, stay away from the workplace exits; otherwise you’ll be trampled by the exiting employees.

  6. CitizenSissy

    IMHO lowered Medicare age may help two situations: 1) take a bit of the edge off age discrimination in hiring by removing the increased insurance premiums for senior employees; 2) remove insurance job lock for employees who would otherwise, save for healthcare, be in a position to retire early or would quit to start their own business.

    1. d w

      many companies are self insured, so they are paying costs for older employees (but oddly enough they only fixate on non executive or management jobs (same thing happened with pension, companies cut all but the executive/management pensions, even though the pension in the worst shape was……the executive/management pension).
      so maybe lowering Medicare eligibility would help companies out s lot (who actually offer health insurance), might even lower the targets on older workers backs, since they actually might cost less in health insurance cost, even with most being paid more. while job lock is real, you really cant safe for health care, cause when even minor procedures cost roughly $70,000 and thats just to find out where the problem is, not fix it.

      and allowing younger people into Medicare, would also lower the cost of it over all, since younger folks need less care, than older folks. and thats the basic reason that insurance companies got out of insulating older people (and no Advantage programs are that, they just add on to Medicare coverage, leaving Medicare to pick up what they dont cover)

  7. Telee

    The question in my mind is Medicare in the process of being dismantled and being replaced by Medicare Advantage plans. At this time nearly 40% of people who qualify for Medicare are now in Medicare Advantage plans which are private but subsidized by funds for traditional Medicare. Perhaps we will have Medicare Advantage for all. This represents a doubling since 2000. That would be in line with the neoliberal trend opening new markets for privatization.

    Ralph Nadar is very concerned. https://nader.org/2019/11/21/beware-of-the-medicare-.-corporate-trap-wake-up-aarp/
    Is anybody else concerned?

    1. Jim Hannan

      Myself and most folks I know sign up for Advantage plans. They typically have no monthly premiums where I live, and offer other benefits like free gym memberships and a small dental plan. Classic Medicare only covers 80%, so everyone then signs up for a Medigap plan, which can start at $150 per month and increase yearly. So, the Advantage plans save us a minimum of $2000 per year and usually more in hard out of pocket cost.
      On the flip side, my Advantage plan is an HMO, so services are restricted to network providers. It has co-pays, deductibles and other fees. My total potential out of pocket is about $2800 this year.
      So choosing Advantage versus Classic Medicare with the Medigap supplement is a personal choice, which typically depends on whether someone is ok with the network providers, if they travel a lot, etc.
      I personally have been quite happy with the Advantage plans, I did switch companies a couple of years ago as plans change every year.

      1. Oh

        You do pay a monthly premium for the Medicare Advantage Plan; it’s taken out of your social security check so you don’t see it.

        1. Jim Hannan

          The government fee is paid by all Medicare recipients, so both Classic Medicare and Advantage. It now runs about $148 per month, and is deducted from the monthly Social Security payment.

          Someone making under about $1500 per month can have this fee waived under SLMB or QMB, administered by individual states.

          1. Noone from Nowheresville

            QMB and SLMB are under the Medicaid umbrella of programs. Counted assets as defined / administered by the individual states come into play as well as monthly income. States have similar requirements but they are not exactly the same.

            There is also a separate program called Extra Help for prescription drugs. If one qualifies, Medicare assigns a drug insurance company (you can switch to a different company).

        2. John Zelnicker

          June 17, 2021 at 8:47 pm

          That premium is deducted from everyone’s Social Security; it’s the Medicare Part B premium and it’s not optional. If you have an Advantage plan then the government simply passes that premium on to the insurance company instead of keeping it. Last year the Part B premium was a minimum of $1,735, high income taxpayers pay a multiple of that amount. I have clients who pay as much as four times the minimum.

          There is no additional deduction for Advantage plans.

          Some Advantage plans with more bells and whistles will charge an additional premium, but that doesn’t come from your SS check. You pay that out-of-pocket.

        3. Telee

          True, I think it is now over $100 per month which amounts tom at least $1,200/year. From my reading many of the insurance companies excesses which were ended by the ACA, are still being practiced by the Advantage plans.

          So it looks like the governmental Medicare trust fund is being used to finance this rapid transition to private insurance.

      2. Telee

        From what I’ve read, the deficits of the Advantage plan become apparent when the holder has a serious illness or injury that require hospitalization, scans and surgical procedures. This is when people enrolled in Advantage plans try to switch back into traditional Medicare because of cost, greater freedom in choosing a specialist and being subject to denial of coverage for expensive procedures. So if good health is maintained the Advantage plans may be preferable but the opposite also seems to be true. It sounds like you are in good health and that’s a blessing.

        1. Jim Hannan

          I think you’ve really hit the nail on the head about health status. A friend of mine had some health issues when she was signing up and her health insurance agent strongly urged her to go with Classic Medicare. And if someone wants to switch from Advantage to Classic later on with health issues, the medigap premiums might be significant.

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