The Treatment

Will the Public Buy the Medicare Buy-in?

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The Medicare buy-in that the Democrats are weighing could certainly diminish some of the political resistance that the public option stirred up amongst recalcitrant Senate moderates. But polling data that suggests a Medicare expansion would also play very well outside the Beltway. Yes, the majority of Americans have supported the public option for months nowbut support has consistently spiked when the plan has been compared to Medicare. 

Back in August, for example, CBS News conducted a split-sample poll on the public option, asking half how they felt about a government health insurance plan that was “similar to Medicare, that people age 65 and older receive,” and the other half about a public plan that made no reference to Medicare. The most significant difference was between the undecidedsonly 6 percent said they “didn’t know” if they’d support a public option that was like Medicare, while 11 percent of those responding to question without the Medicare reference said they were undecided.  

Essentiallyand unsurprisinglythe public feels more comfortable with a plan that’s similar to a long-standing, ubiquitous, and successful program. Without such a reference point, in fact, even Americans who may be supportive of a government plan may not know what they’re really asking for. According to a recent Vanity Fair poll, two-thirds of Americans said they weren’t confident they could explain the public option to someone else.

To be sure, public opinion hasn’t exactly dictated the negotiations on Capitol Hill. But such sentiments could bode well for the public reception of a Medicare buy-in, which-- depending on the price tag of the compromise--could help the Democratic leadership shore up the votes it needs for the bill. In fact, the bigger political sticking point could ultimately be the second, less prominent part of the new proposal: an expansion of Medicaid coverage from 133% to 150% above the poverty line, matching the levels in the House. Medicaid doesn’t carry the same political or popular appeal as Medicare, and it may be costly to bolster its notoriously low payments to providersa fix that’s in the House bill, but which hasn’t yet been included on the Senate side. It’s not clear yet how strongly the Democrats will push to keep both parts of this compromise on boardbut perhaps the poor, too, could be able to benefit from the popularity of helping the nation’s baby-boomers.

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