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Sanders and Warren Urge Biden to Expand Medicare in the American Families Plan

Lawmakers argue that lowering the Medicare eligibility age would enact a broadly popular reform to the program.

U.S. President Joe Biden speaks before a meeting with the Congressional Hispanic Caucus in the Oval Office of the White House April 20, 2021, in Washington, DC.

President Joe Biden’s top challenger in last year’s Democratic primary, Sen. Bernie Sanders of Vermont, spearheaded a letter sent to the White House on Sunday urging the president embrace an “historic opportunity” and include key expansions to the U.S. Medicare program when he announces a detailed vision for a major federal investment and tax reform plan later this week.

The two-page letter (pdf) from Sanders and 17 Democratic senators — including other 2020 presidential candidates Cory Booker of New Jersey and Elizabeth Warren of Massachusetts — asks Biden to “propose reducing the Medicare eligibility age, expanding Medicare benefits to include hearing, dental, and vision care, implementing a cap on out-of-pocket expenses under traditional Medicare, and negotiating lower drug prices” as part of the president’s “American Families Plan” that he is expected to showcase during his first address to Congress Wednesday night.

Calling Medicare, signed into law by President Lyndon Johnson in 1965, “one of the most successful and popular federal programs in our nation’s history,” the letter argues “the time is long overdue for us to expand and improve this program so that millions of older Americans can receive the health care they need, including eyeglasses, hearing aids, and dental care.”

The lawmakers argue that lowering the Medicare eligibility age — currently set at 65 — down to 60, 55, or even 50 would be a way to expand coverage, save lives, and enact a broadly popular reform to a program that is already wildly popular by a majority of the American people across the political spectrum. The letter states:

Lowering the eligibility age for Medicare would help [millions of uninsured or under-insured older Americans] significantly. Twenty-seven percent of adults age 50 to 64 are not confident that they can afford health insurance over the next year, and more than a quarter report issues with navigating health insurance options, coverage decisions, and how their choices will affect their out-of-pocket costs. Researchers have found that there is a massive spike in the diagnosis of cancer among Americans who reach the age of 65 that could have been diagnosed much earlier if the Medicare eligibility age had been lower. Lowering the Medicare eligibility age to 60 could expand Medicare coverage to 23 million people, including nearly 2 million uninsured people, while lowering it to 55 could give over 42million people access to the program, and lowering it to 50 could cover 63 million Americans. Lowering the Medicare eligibility age is not only the right thing to do from a public policy perspective, it is also what the overwhelming majority of Americans support. According to a recent Gallup poll, 65 percent of Americans support lowering the Medicare eligibility age.

In addition to Sanders, Booker, and Warren, the letter sent to Biden on Sunday was signed by Sens. Ben Cardin (D-Md.), Debbie Stabenow (D-Mich.), Tammy Baldwin (D-Wisc.), Richard Blumenthal (D-Conn.), Sherrod Brown (D-Ohio), Tammy Duckworth (D-Ill.), Dick Durbin (D-Ill.), Kirsten Gillibrand (D-N.Y.), Edward Markey (D-Mass.), Jeff Merkley (D-Ore.), Alex Padilla (D-Calif.), Tina Smith (D-Minn.), Chris Van Hollen (D-Md.), and Sheldon Whitehouse (D-R.I.).

Biden’s proposal for an approximately $1.8 trillion spending plan, the Washington Post reported Saturday, is expected to devote “hundreds of billions of dollars to national child care, prekindergarten, paid family leave and tuition-free community college, among other domestic priorities.” On healthcare reforms specifically, however, the White House has not finalized how far it is willing to go.

According to the Post:

In a potential last-minute change, White House officials as of Friday were planning to include about $200 billion to extend an increase in health insurance subsidies through the Affordable Care Act exchanges, according to three people who spoke on the condition of anonymity to reveal internal discussions.

House Speaker Nancy Pelosi has been the key driver in Congress pushing for increased federal subsidies to private insurers under the Affordable Care Act in order to make the program created under the Obama administration more affordable and widely available, but Sanders has been leading the charge on the call to expand Medicare.

“We cannot continue to deal with millions and millions of seniors — primarily low-income seniors — who cannot afford to go to a dentist, so cannot ingest the food they eat, or the millions of seniors who live in isolation because they can’t hear,” Sanders told the Post earlier this month.

On Friday, the Congressional Progressive Caucus backed a both/and, as opposed to an either/or, approach when it comes to healthcare expansion under the Biden plan.

“Voters delivered us governing majorities and now we must deliver for them on health care policies that are not only urgent but wildly popular,” Rep. Pramila Jayapal (D-Wash.), chair of the CPC, said in a statement.

“We must immediately lower the cost of prescription drugs and use the massive savings from this to lower Medicare’s eligibility age and improve benefits while at the same time ensuring the permanent affordability of health plans obtained through the Affordable Care Act,” Jayapal said. “These necessary policies that are supported by large bipartisan majorities of the American people enjoy the strong support of our Democratic Caucus, and can be accomplished simultaneously.”

Citing the American Rescue Plan signed into law as Biden’s first major piece of legislation earlier this year, Jayapal argued passage of that Covid-19 recovery and stimulus legislation should be a lesson to Democrats “that American people of all parties support us when we enact bold, populist policies that deliver for them.”

Alex Lawson, executive director of the advocacy group Social Security Works, struck a similar message when speaking to the Post earlier this month about the competing plans in Congress and what Democrats should understand about what’s at stake in terms of healthcare policy and reforms.

“Before the next election, we need the American people — and particularly seniors, who have suffered so much during this pandemic — to see that this government is working for them,” Lawson advised. “People would get hearing aids, get their teeth checked, before the next election. That will show them Biden is on their side. Democrats have to deliver for seniors if they are going to win.”

And as Sunday’s letter to Biden concluded, “We have an historic opportunity to make the most significant expansion of Medicare since it was signed into law. We look forward to working with you to make this a reality and, in the process, substantially improve the lives of millions of older Americans and persons with disabilities.”

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