Broad Coalition of Democrats Presses Biden to Expand Medicare

WASHINGTON — A broad coalition of Democrats from across the ideological spectrum plans on Thursday to begin what it promises will be a noisy and sustained campaign to pressure President Biden to include a major expansion of Medicare in his infrastructure package.

More than 150 House Democrats — including Representative Pramila Jayapal of Washington, the leader of the progressive wing in the House, and Representative Jared Golden of Maine, one of the chamber’s most centrist Democrats — have teamed up on the effort, which is all but certain to draw Republican opposition but contains proposals that are popular with a wide segment of voters.

Disappointed that Mr. Biden has yet to act on a campaign promise to expand Medicare benefits, members of the group, who together represent nearly 70 percent of House Democrats, have signed on to a letter that kicks off their pressure campaign. Organizers say it will include opinion pieces and press events. Representatives Conor Lamb of Pennsylvania and Joe Neguse of Colorado are also leading the push.

“It is really unusual to get this level of intensity on a health care proposal,” Ms. Jayapal said in an interview.

At the heart of the plan is a call to lower the eligibility age for Medicare to 60 from 65, adding about 23 million Americans to the federal health program for seniors at a cost of $200 billion over 10 years. The lawmakers also are pushing to expand Medicare benefits to to cover dental, vision and hearing, which would cost about $350 billion over 10 years.

The lawmakers say the costs would be more than offset by the third element of their package: empowering Medicare to negotiate drug prices. Ms. Jayapal said that change — one that Democrats have been pushing unsuccessfully for years — could generate as much as $650 billion over a decade, although the Congressional Budget Office has estimated the savings at about $450 billion over that period.

Mr. Golden, who has opposed some big-ticket spending items in the past, including Mr. Biden’s nearly $1.9 trillion stimulus law, said the Department of Veterans Affairs, which is empowered to negotiate drug prices for veterans, pays far less for prescription medicines than the rest of the government does.

The Government Accountability Office found that the department paid an average of 54 percent less in 2017 for prescription drugs than Medicare did.

The lawmakers have been engaged in Zoom calls with White House officials over the proposal, which they hope Mr. Biden will incorporate into a large spending package that can pass the Senate through the fast-track budget reconciliation process this year.

It is not clear whether Mr. Biden and other Democrats in Congress will embrace the push, given that Democratic leaders have been focused on a competing effort to make permanent a temporary expansion of health subsidies under the Affordable Care Act that was included in the stimulus law. That proposal has widespread support, including from hospitals, which want to be paid the higher private insurance rates, and insurers, which want more people buy their products. Any effort to expand Medicare is likely to be met with resistance from those same groups.

But Ms. Jayapal argued that the two health care proposals were compatible. She said that negotiating lower drug prices could generate enough money to pay for the changes to the Affordable Care Act as well. If not, “there are lots of revenue raisers that are possible and necessary,” she said.

The Medicare proposals have proved popular among the so-called frontline Democrats — those who represent conservative-leaning districts — with more than a dozen signed on to the effort, underscoring its cross-party appeal.

After meeting with White House officials on the issue, Mr. Neguse argued that Democrats could go even further and lower the Medicare eligibility age to 55 to cover more than 40 million additional people.

“Many of our nation’s seniors are unable to receive care for their ailments because Medicare benefits are not as a broad as they should be,” he said.

The Democrats say at least 75 percent of Medicare beneficiaries who need a hearing aid do not have one and much of the country has low rates of visiting the dentist or getting eye exams.

Mr. Golden said that when he talked to voters, he repeatedly heard that the change would help residents in his district.

“How crazy is it that we pay into Medicare all our working lives, and then at the time when you probably need dental care the most, Medicare doesn’t even cover it?” he said. “I know seniors are frustrated by that.”

Nearly 20 senators, led by Senator Bernie Sanders, the Vermont independent, have joined together for a similar call for White House action on the issue.