Plan would provide uninsured North Carolinians a way around NC GOP’s Medicaid expansion blockade
WASHINGTON — New Medicare benefits for older Americans, like dental care.
An expansion of eligibility for Medicaid for low-income people in Republican-controlled states that have declined to take that step.
And potentially an historic effort to rein in prescription drug prices — if congressional Democrats can work through objections from moderates in their party.
The massive $3.5 trillion budget reconciliation package that House Democrats finished sketching out this week would make significant changes to how Americans obtain health care.
The proposals were drafted based on President Joe Biden’s “Build Back Better” policy plan. The House Democrats’ outline may be altered in the Senate, where some senators want to tweak those policies (including getting those upgraded Medicare benefits to seniors sooner).
Any plans also will need to pass procedural muster with the Senate’s parliamentarian, who could rule that certain sections of the bill can’t be enacted using the reconciliation process. That procedure allows bills to be passed with just a majority vote in the evenly divided Senate — meaning reconciliation could reach the president’s desk without any support from Republicans.
Here’s more on the health care provisions woven into that legislation, and how they would work:
Dental, hearing and vision coverage for seniors
One ambition of the proposal advancing in the House is to fill in holes in Medicare’s coverage. The federal health insurance program for seniors and people with disabilities currently doesn’t cover most dental, hearing or vision care — services that beneficiaries now must pay for out of pocket or through supplemental coverage.
The pending legislation would add those benefits, so that dentures, hearing aids, eye exams and glasses would be part of the traditional Medicare program.
However, the dental benefits would not go into effect until 2028, years after the hearing and vision coverage. Some Senate Democrats have opposed that lengthy timeline for incorporating dentists into the Medicare program, and have floated a voucher program to shorten the transition.
Not in House bill? Lowering Medicare eligibility age
One Medicare change sought unsuccessfully by some Democrats was to lower the age for Medicare enrollment, from the current 65 to 60.
That effort — backed by Sen. Bernie Sanders, a Vermont independent who caucuses with Democrats, as well as some centrist House Democrats — didn’t make it into the House legislation. It could be added in the Senate, but it’s likely to face tougher odds in that chamber.
More access to Medicaid
Another major shift would be the expansion of health insurance coverage to more low-income Americans. That would happen in part by broadening eligibility in 12 states that have declined to accept federal funding to extend their programs.
The 12 states that have refused to align with Medicaid eligibility requirements in the 2010 Affordable Care Act — which extended coverage to adults with incomes up to 138% of the poverty level — include Wisconsin, Kansas, Tennessee, North Carolina, Georgia, and Florida, according to the Kaiser Family Foundation.
Starting in 2025, residents in states that have not expanded Medicaid would be able to join a federally managed Medicaid program. Read more