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S. 470: Medicare at 50 Act

77% of people support lowering the minimum age for Medicare — including 69% of Republicans. Should Medicare be available for people as young as 50, down from the current 65?


Almost all Democrats want to expand access to government-run health care, but whether to swing for the fences or not is dividing the party.

Medicare is one of the most popular government-run programs, providing health care to those aged 65 and older. It’s often deemed a “third rail” issue because politicians of both parties are afraid to touch it, for fear that it would kill their political careers.

Nearly two-thirds of House Democrats last year sponsored a “Medicare for all” bill, but polling indicates the public at large may not show nearly the same level of support. Yet 77% support lowering the minimum age for Medicare — and that includes 69% of Republicans.

So instead of upending the entire health care system, what about incrementally expanding Medicare’s eligibility?

What the bill does

The Medicare at 50 Act does exactly what its name implies: allow people ages 50 to 64 access to Medicare, down from the current 65 minimum age.

The bill would not require that people ages 50 to 64 enroll, but rather allows people to opt in and sign up. Millions likely would, although the exact number can only be estimated at this point.

It was introduced in February as bill number S. 470 by Sen. Debbie Stabenow (D-MI).

Notably, Sen. Stabenow’s new version offers an eligibility starting five years lower than her previous bill, 2017’s Medicare at 55 Act which never received a Senate vote.

A House version has been announced that will supposedly be introduced soon, but has not yet been officially introduced as of this writing.

What supporters say

Supporters argue the bill expands one of the most popular government programs and gives potentially tens of millions of Americans more access to it.

“Our legislation is a win-win for Michigan families,” Sen. Stabenow said in a press release. “It will help strengthen Medicare, lower costs, and improve care for millions of people.”

“Our legislation will give millions of older Americans another choice for more affordable, quality health insurance coverage,” cosponsor Sen. Tammy Baldwin (D-WI) said in a press release. “For people between the ages of 50 and 64, this is a high quality option that can help reduce health care costs and increase competition in the marketplace.”

What opponents say

Opponents counter that the plan would harm hospitals and in turn the patients they treat, because Medicare reimburses hospitals less than private insurance does.

“Allowing more people into Medicare actually weakens the coverage options of people who currently depend on the individual insurance market, leaving them with fewer choices,” wrote Federation of American Hospitals President and CEO Chip Kahn.

“There is no question that Medicare works for seniors and others who depend on it,” Kahn continued. “But expanding the program with hospitals facing the lowest Medicare margins in history will make it more difficult to provide the critical care that all Americans expect and deserve.”

Of course, many opponents also criticize it from the left as being too timid. Nearly two-thirds of House Democrats last year sponsored a “Medicare for all” bill, which of course goes much further than a “Medicare for people age 50 and up” bill.

Odds of passage

The bill has so far attracted 19 Senate cosponsors, all Democrats. It awaits a potential vote in the Senate Finance Committee almost certainly won’t pass in the Republican-controlled chamber.

However, the soon-to-be-introduced House version could likely pass that chamber.

Last updated Mar 4, 2019. View all GovTrack summaries.

The summary below was written by the Congressional Research Service, which is a nonpartisan division of the Library of Congress, and was published on Feb 13, 2019.

Medicare at 50 Act

This bill establishes a Medicare buy-in option for certain qualifying individuals and also repeals restrictions relating to prescription drug prices under the Medicare prescription drug benefit.

Specifically, the bill allows individuals aged 50 to 64 to enroll in Medicare if such individuals would otherwise qualify for Medicare at the age of 65. The Centers for Medicare & Medicaid Services (CMS) must determine enrollment periods and set premiums for the buy-in option established under the bill, in accordance with specified requirements. The CMS must also award grants to states and nonprofit organizations for outreach and enrollment activities relating to the buy-in option.

The bill also repeals provisions that prohibit the CMS from negotiating the prices of prescription drugs or from establishing a formulary under the Medicare prescription drug benefit.