Senate Nearing Critical Stage of Negotiating Historic Medicare Expansion

Interview with Alex Lawson, executive director of Social Security Works, conducted by Scott Harris

After months of debate and negotiations, Democrats on the Senate Budget Committee agreed to a $3.5 trillion infrastructure package that includes an important expansion of Medicare that will include cover dental, hearing and vision, as well as strengthen social safety net programs, create a national paid family and medical leave program, fund free universal preschool for all 3- and 4-year-olds and extend the child tax credit expansion that was part of the Covid relief bill passed earlier in the year.
This set of proposals is expected to be voted on using reconciliation, the process Democrats plan to use to bypass a Republican party filibuster. A separate, bipartisan $1.2 trillion infrastructure bill that funds the repair and rebuilding of the nation’s roads and bridges is expected to be voted on separately.
Between The Lines’ Scott Harris spoke with Alex Lawson, executive director of Social Security Works. Here he talks about the proposed expansion of Medicare and other programs in the infrastructure package that could be largest expansion of federal programs since FDR’s New Deal and Lyndon Johnson’s Great Society.

ALEX LAWSON: The beautiful part of what Francis Perkins and FDR created with the New Deal and the Social Security Act is they understood that it’s actually an ongoing process. Every generation has to do its part. When FDR signed the Social Security Act into law, he said, “This act is a cornerstone that we’re building on.”

And that’s what we’re doing right now with these expansions. We’re not going to get everything. We want to get as much as possible, but we keep building a more and more just system that delivers economic security for people. And we know that you can’t have real economic security without healthcare. If people get sick and go bankrupt because of that, there’s no economic security there. That’s why we want to expand Medicare. We want to improve and expand Medicare to cover everyone in this country.

What we’re talking about in the Senate right now is sort of a step towards that. You know, we want to bring it down as low as possible. What is being discussed right now in D.C. is lowering the age from 65 to 60. We get inundated with messages from people telling us their story of hanging on until Medicare, until they turn 65. People don’t go and get things checked out because they know that if it is a cancer diagnosis, for example, they don’t have any care that they can get. So what’s the point in knowing. And you can see that in the numbers, you can see that reflected in the massive spike that happens right at 65. That’s because people don’t have the security before then. So we want to expand it down as far as possible. Right now, what they’re talking about is 60.

But we also know that Medicare — traditional Medicare on its own — has some problems. It has some holes in it. Most of them put there by industry so that they can sell their wares. So it doesn’t cover vision, hearing and dental, which makes absolutely no sense. Dental care is healthcare. Vision, hearing — that’s healthcare. So we want to add those benefits in and also, something that’s not in the press as much, but is super important — is an out-of-pocket cap on Medicare — on traditional Medicare — so that people aren’t faced with that 20 percent. Or, they need to buy another insurance product, Medigap, to cover any sort of a liability from a catastrophic cost.

So let me put that in plain English. If we add dental, people could go in and in this country they could be facing, you know, a hundred thousand dollars’ worth of dental work and if we don’t cap out-of-pocket costs for them they could be on the hook for 20 percent of that. It also is critical because without that out-of-pocket cap, too many people in this country are locked into Medicare Advantage. They don’t have the choice to transfer over to traditional Medicare if they want, because Medigap, the insurers don’t have to offer them the coverage after they initially sign up. So that’s another one that we’re really interested in adding there.

SCOTT HARRIS: As most of our listeners understand, the Senate is evenly divided. Fifty Democrats, 50 Republicans. Vice President Kamala Harris would be the tie-breaker. So you need all Democrats on board to get this through the reconciliation process. Joe Manchin, the U.S. senator who’s a Democrat from West Virginia; he’s hemmed and hawed, but he’s also said that he would only vote for this if it was fully funded. If this package of new benefits is fully funded. How is this paid for, Alex?

ALEX LAWSON: Simple fact is just by making the wealthy and corporations pay their fair share in a variety of ways. Generally, in Washington, D.C., senators make a big stink about paying for stuff when it’s for the people. When it’s for the rich, they just give it to them. You’ll never hear that about war. You never hear about how are we going to pay for that bomb that we’re throwing at someone? We never hear that question.
But in this case, it is paid for, and there are a lot of proposals out there and it’s sort of doing two things. One of them is providing these benefits that the American people deserve that we have earned by building this country. And that is what we’re going to demand and get. And at the same time, we’re going to pay for it by saying to the plutocrats, the rich and Wall Street and the corporations, that they can’t get away with paying less taxes then the rest of us. You know, the billionaires who are launching themselves into space, some of them pay zero in taxes. Jeff Bezos is now worth $200 billion or something like that. That is not because they’ve earned that money or built that wealth. That is because the system, the structure in this country is tilted so that there’s an upward redistribution of wealth. They’re literally picking our pockets. That’s where their money comes from.

For more information on Social Security Works, visit

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