As the cost of President Joe Biden’s spending package shrinks from $3.5 trillion closer to $2 trillion, Senator Bernie Sanders’s proposal to add dental, vision and hearing coverage to Medicare has emerged as a sticking point in negotiations. Opposing Sanders are Democrats such as Congressman Jim Clyburn of South Carolina who would like to prioritize spending to benefit low-income people — including by providing health insurance for the poor in states that have refused to expand Medicaid.
There is a way to compromise — to add new benefits to Medicare without spending so much that there’s no room in the budget for helping the Medicaid-deprived.
Rather than simply offer dental, vision and hearing benefits to all Medicare beneficiaries, create an optional, buy-in policy. This would enable seniors to take advantage of the federal government’s purchasing power but still limit the cost to taxpayers. It would keep Medicare solvent longer. And it would provide standardized plans for beneficiaries — rather than the patchwork of coverage now available to those who sign up for Medicare Advantage or supplemental Medicare plans.
Older Americans clearly need affordable dental, vision and hearing coverage. The only question is how best to pay for it. A buy-in program could be structured like the Affordable Care Act and the Medicare Part D prescription drug benefit, both of which give subsidies to people below a certain income threshold.
