Medicare Expansion: President Clinton's Proposals to Allow Coverage Before Age 65

Publication Date: March 1998

Publisher: Library of Congress. Congressional Research Service

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Keywords: Health conditions and policy--Health and health policy and financing

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President Clinton has proposed allowing people ages 62 through 64 to buy into Medicare if they do not have access to employer-sponsored or federal health insurance. Displaced workers ages 55 through 61 generally would also be allowed to buy in if they lost employer-sponsored insurance. In addition, retirees ages 55 and over whose former employers terminated or substantially reduced retiree health insurance would be permitted to extend their COBRA coverage (defined on page 6) until age 65. The proposals have been introduced as H.R. 3470 (Representative Stark) and S. 1789 (Senator Moynihan).

The President’s proposals would help people in these age groups obtain health insurance. While most of them already are covered by employment-based, government, or private non-group plans, nearly one in seven is uninsured. Many without coverage find that private non-group insurance is too expensive or, if they have pre-existing medical conditions, unavailable. However, the cost of buying into Medicare (estimated to be $300 to $400 a month) or continuing COBRA coverage may also exceed what most uninsured can afford. Questions have been raised about whether Medicare buy-ins would result in costs to the federal government and whether Medicare should be expanded in light of the anticipated insolvency of the Part A trust fund. Some argue that legislative action should be deferred until the issue is considered by the National Bipartisan Commission on the Future of Medicare. Proponents argue that the proposal is largely self-funded and is needed now to address a growing problem.