“I
have said that means-testing on Medicare, meaning people like myself —
I’m going to be turning 50 in a week, so I’m starting to think a little
bit more about Medicare eligibility — but you can envision a situation
for somebody in my position, me having to pay a little bit more on
premiums or co-pays would be appropriate. And again, that would make a
difference,” the president said at a press conference. “What we are not
willing to do is restructure the program in the ways we have seen coming
out of the House in recent months.”
The comment was the first public
acknowledgment from the White House that the president would support
changing the payment structure of the entitlement program. Prior to
Obama’s remarks, multiple sources in both parties told The Huffington
Post that the administration was making it clear to debt ceiling
negotiators that such a structural change to Medicare was on the table.
The
proposal is not entirely controversial among health care economists.
But it will rankle a good chunk of the president’s own party, which has
sought to keep Medicare’s structure as a basic insurance program.
Medicare premiums for doctors and for prescription drugs are already
means tested. Making top earners pay even more — while potentially sound
policy — opens the program to politically potent charge that it is
health care welfare for lower income Americans.
The
Obama administration’s embrace of the idea came during talks between
lawmakers and Vice President Joseph Biden. The exact contours of what
was proposed are not entirely clear. But a version that House Majority
Leader Eric Cantor (R-Va.) proposed in later discussions would have
saved the government an estimated $38 billion by charging those
high-income beneficiaries 10 percent more for the cost of hospital stays
and prescription drugs.
Obama’s
nominal support for means-testing Medicare, however, does fit into the
larger outlines of his plan for the debt ceiling debate. In an effort to
both win the support of Republicans and tackle as many
deficit-contributing issues as possible, the administration has placed
entitlement programs like Social Security and Medicare (“sacred cows”
for the Democratic Party) squarely on the table. The president also lent
his support to a plan to raise the eligibility age of Medicare from 65
to 67, over the course of roughly 25 years. His team has, additionally,
discussed various changes to the way in which Social Security benefits
are measured and paid.
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