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Don’t Undermine Medicare via Means Testing in Build Back Better

October 15, 2021

Summary: Means test Medicare? What? Yes, suggested by a conservative Democrat for the proposed Medicare improvements in the huge social infrastructure bill in Congress. This would undermine the solidarity of support for a great program, and leave many elders without insurance or care. It must be stopped.

Means Testing is the Wrong Approach to Medicare Expansion
The Hill
October 11, 2021
By Max Richtman

The debate over Medicare expansion has hurled a bad idea back into the public square:  means-testing seniors’ health care benefits. This is something seniors’ advocates have long opposed, because it would hurt beneficiaries and undermine support for the Medicare program itself. Means-testing benefits should have no role in the expansion of Medicare to include dental, vision, and hearing coverage — which are part of President Biden’s Build Back Better Plan working its way through Congress. 

These expanded coverages would plug a gaping hole in Medicare that has prevented millions of seniors from obtaining proper care for their eyes, ears, and teeth — the gateways to good health. But now some centrist members of Congress want to limit those crucial, new coverages to an income-restricted segment of beneficiaries. That amounts to means testing of benefits — something that has been anathema to Medicare since its inception.

Manchin’s Means-Testing and Work Requirements Are a Recipe for Building Back Worse
Common Dreams
October 13, 2021
By Nancy J. Altman

If Manchin forces work requirements and intrusive, demeaning means tests, it will be substantially easier for Republicans to drown Biden’s legacy in the bathtub once they are back in control.

Manchin’s demands for work requirements and means-testing would save money largely by making federal programs inaccessible to many who need them, including those who need them the most. Those most in need often have the most trouble navigating complicated and burdensome eligibility requirements, because they generally lack the necessary time, resources, and family support. Experience teaches that much of the money saved on benefits would be spent on wasteful and intrusive administration.

Comment by: Eagan Kemp

The universal nature of Medicare coverage for seniors is one of the key reasons that it has often been referred to as the third rail of U.S. politics. Politicians have been loath to try to cut Medicare, even as they have sought to privatize it. Adding means testing would threaten the very foundation of Medicare and open it to future cuts and debasements. It would also impose administrative barriers, meaning many seniors would lose coverage (something we see regularly for Medicaid beneficiaries).

If Manchin and others worry that the wealthy will get benefits they could otherwise afford, then the better solution is for the wealthy to finally pay their fair share in taxes. A strong Medicare system is truly universal, one of the key reasons we fight for Medicare for All.

Under Medicare for All, funded by progressive taxation, we would finally guarantee that everyone gets the care they need, regardless of cost. And ensure that wealthier Americans contribute to financing while benefitting from high-quality care.

Although sufficient social solidarity is necessary to set up a universal healthcare system, it is also true that countries with universal healthcare systems develop a level of pride in their system far beyond what anyone would claim for our fragmented and profit-focused system. Means testing in Medicare would disrupt one of the few bright spots in our health coverage. We must do everything in our power to stop it from happening.

About the Commentator, Eagan Kemp

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Eagan Kemp is the health care policy advocate for Public Citizen’s Congress Watch division. He is an expert on a broad range of policy topics including single-payer systems, private health insurance, Medicare, Medicaid, the Children’s Health Insurance Program, the Veterans Health Administration, the U.S. Food and Drug Administration, social determinants of health, mental health, and drug shortages. He previously served as senior policy analyst at the U.S. Government Accountability Office.

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