Medicare in the United States would be expanded to include dental, hearing, and vision benefits under a budget proposal introduced by Democrats in the U.S. Senate, who narrowly control the legislative chamber.
As described in an article at Fierce Healthcare, the Medicare proposal is part of a larger proposed budget resolution that totals about $3.5 trillion, and also includes major infrastructure spending. This budget proposal is separate from another pending bipartisan infrastructure package, which includes about $1.2 trillion for building and upgrading roads, bridges, railways, ports, and more. While the smaller bipartisan proposal is expected to see a vote in the Senate very soon, and is expected to pass, the larger budget resolution is still being negotiated and may not see a vote for several weeks.
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The new Medicare proposal aims to close what Senate Majority Leader Chuck Schumer has called a “gaping hole” in coverage under the federal insurance program, which mostly covers Americans ages 65 and older, as well as some younger people with certain disabilities and health conditions. One report from 2019, published by the Kaiser Family Foundation, found that 65% of Medicare beneficiaries — about 37 million people — lack dental coverage, and 49% had not seen a dentist in the last year. As a result, the report found, many people on Medicare experience untreated oral health conditions that can turn into serious medical problems. Ironically, Medicare will typically cover treatment for serious medical problems linked to oral health conditions, at a far greater cost than routine dental care. So even though expanded dental coverage under Medicare is unlikely to pay for itself, it may end up being less expensive in the long run than initial cost estimates suggest.
One reason why the Senate proposal on Medicare is not yet finalized is that Democrats in the House of Representatives are hoping to add a provision that would allow Medicare to negotiate drug prices with pharmaceutical companies. Currently, federal law forbids Medicare to negotiate prescription drug prices — which is one reason why Americans face prescription drug prices that are over 2.5 times as high, on average, as in 32 other major countries, according to a report from earlier this year by the RAND Corporation. For brand-name prescription drugs, the gap is even greater, with Americans paying over 3.4 times as much for the same drugs as residents of other countries. It’s unclear, though, whether there is enough support for allowing Medicare drug price negotiations in the Senate to include this provision in the larger budget resolution. House Speaker Nancy Pelosi has said that the House will debate and vote on both Senate spending packages only after they pass the Senate, so the House won’t be offering its own proposal to allow Medicare to negotiate drug prices.
It remains to be seen exactly what dental, hearing, and vision benefits the final version of the Senate budget package will offer. As noted in a CNBC article, proposals recently introduced in the House would cover preventive and emergency dental care, dentures, eye exams, eyeglasses, hearing exams, and hearing aids, among other services. It also remains to be seen what share of the cost Medicare beneficiaries will required to pay for any new covered services.
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