# Grayson Introduces Medicare Buy-in Provision into Healthcare Bill **URL:** \ **Category:** Great Debates\ **Created:** [March 12, 2010, 4:33am UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206 "2010-03-12T04:33:22Z")\ **Posts on this page:** 19\ **Page:** 1
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 4:33am UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/1 "2010-03-12T04:33:22Z")
Full text of bill [here](http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.4789:). Essentially, every person under 65 will be able to buy into Medicare at a monthly rate equal to costs incurred by individuals in his/her age group. Thus, the bill costs nothing since the individuals who opt into the plan pay their own way. This is a much better form of the public option than that originally proposed, since it’s simple and builds on an already existing federal program. Is it likely to make it into the final bill? ---
**Author:** ![Mighty\_Mouse](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/mighty_mouse/32/7776_2.png) [@Mighty\_Mouse](https://boards.straightdope.com/u/Mighty_Mouse)\ **Post date:** [March 12, 2010, 4:37am UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/2 "2010-03-12T04:37:24Z")
> [@sleeping](#): > > Full text of bill [here](http://thomas.loc.gov/cgi-bin/query/z?c111:H.R.4789:). > > Essentially, every person under 65 will be able to buy into Medicare at a monthly rate equal to costs incurred by individuals in his/her age group. Thus, the bill costs nothing since the individuals who opt into the plan pay their own way. > > This is a much better form of the public option than that originally proposed, since it’s simple and builds on an already existing federal program. > > Is it likely to make it into the final bill? I don’t see how this avoids the problem of all the people with pre-existing conditions (that would cause their premiums from a commercial insurer to be much higher than average) signing on to Medicare, while the healthier ones sign on to commercial insurance at a much lower cost. Until they get some horribly expensive disease of course, when it is off to the medicare plan. ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 4:41am UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/3 "2010-03-12T04:41:46Z")
> [@Mighty\_Mouse](#): > > I don’t see how this avoids the problem of all the people with pre-existing conditions (that would cause their premiums from a commercial insurer to be much higher than average) signing on to Medicare, while the healthier ones sign on to commercial insurance at a much lower cost. Until they get some horribly expensive disease of course, when it is off to the medicare plan. Well, the current healthcare bill prohibits discrimination based on pre-existing conditions (although I believe it’s enforced with a fine). How do you know the Medicare monthly premiums would be greater than those of private insurance? ---
**Author:** ![boytyperanma](https://avatars.discourse-cdn.com/v4/letter/b/4491bb/32.png) [@boytyperanma](https://boards.straightdope.com/u/boytyperanma)\ **Post date:** [March 12, 2010, 12:32pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/4 "2010-03-12T12:32:53Z")
It is another pointless activity in the house. Personally I like the bill but it has no chance of ever becoming law. Even if it passes in the house it’s unlikely to ever be heard in the senate. Until the senate is fixed they should go home and only come in to vote of senate bills. We’re are at about 300 bills that have passed the house and are waiting for senate votes whats the point of adding more to that pile. ---
**Author:** ![Happy\_Fun\_Ball](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_fun_ball/32/17664_2.png) [@Happy\_Fun\_Ball](https://boards.straightdope.com/u/Happy_Fun_Ball)\ **Post date:** [March 12, 2010, 5:12pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/5 "2010-03-12T17:12:45Z")
> [@sleeping](#): > > \ > > Is it likely to make it into the final bill? No. It’s too bad, I would support this. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [March 12, 2010, 5:39pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/6 "2010-03-12T17:39:15Z")
> [@boytyperanma](#): > > It is another pointless activity in the house. Personally I like the bill but it has no chance of ever becoming law. Even if it passes in the house it’s unlikely to ever be heard in the senate. Until the senate is fixed they should go home and only come in to vote of senate bills. We’re are at about 300 bills that have passed the house and are waiting for senate votes whats the point of adding more to that pile. You have not been paying attention. It is a lot closer than you think. I am having a hard time following all the parliamentary fiddly-bits that need to be overcome but I think Dems have finally realized they need to get something done. Via reconciliation the Dems can sidestep Republican intervention and pass it via a simple majority vote (which the Blue Dog Dems are not enough to stop either). The Senate parliamentarian tossed a road block in the way but not an insurmountable one. Have to wait and see. Currently they are waiting on CBO scoring before moving ahead. ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [March 12, 2010, 5:46pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/7 "2010-03-12T17:46:46Z")
I’ve never thought it was realistic to get any problem nearly of this magnitude fixed entirely in one go. Health care is going to need continued maintenance and adjustments over the years, just like anything else. The important thing is to make major progress with this bill, get it done, get it established, and get the concept that progress can be made established as well. I do agree that expanding Medicare into a national single-payer program instead of a seniors-only one is the obvious, and least contestable, way to get the last major problem fixed. We already know it’s far more efficient than the private sector, and it wouldn’t represent a new bureaucracy that can be effectively demagogued. But implementation can wait, and be added later once the fearmongering over the current approach has been falsified and forgotten. Grayson’s amendment, like the Senate proposal last year to lower the eligibility age partway, establishes the seed of the concept, and that may be all he really expected. **Whack** , the CBO’s scoring has already come in. It reduces the deficit by $118 billion over 10 years. Let the Pubbies complain about that. :rolleyes: ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [March 12, 2010, 5:50pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/8 "2010-03-12T17:50:19Z")
To the OP: I do not know if Grayson’s provision has a chance or not. That said there is a teeny ray of hope a Public Option will make it in. > [@](#): > > The second-ranking Democrat in the Senate said on Friday that he would “aggressively” rally votes for a public option for insurance coverage if House Democrats included the proposal in their reconciliation fixes for health care reform. But minutes after the pledge, House Speaker Nancy Pelosi threw a bit of cold water on the idea. > > \ > > On Friday, however, Pelosi said that a government-run insurance option was not in her chamber’s reconciliation package (while not addressing whether it could be added at a later date) > > \ > > A public option could conceivably be included in the reconciliation package that originates with Pelosi. But leadership seems to think that it would endanger the coalition of Democrats backing reconciliation in the Senate. Progressives in that chamber – notably, Sen. Bernie Sanders (I-VT) – have hinted that they would try to add a public option as an amendment. But Durbin’s office has basically announced it will fight such a maneuver. > > SOURCE: [http://www.huffingtonpost.com/2010/03/12/dick-durbin-ill-whip-aggr\_n\_496559.html](http://www.huffingtonpost.com/2010/03/12/dick-durbin-ill-whip-aggr_n_496559.html) All very confusing and it seems Congress is in major flux as it considers all the ins-and-outs of this and what they can do. ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 6:03pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/9 "2010-03-12T18:03:01Z")
> [@Whack-a-Mole](#): > > You have not been paying attention. It is a lot closer than you think. > > I am having a hard time following all the parliamentary fiddly-bits that need to be overcome but I think Dems have finally realized they need to get something done. Via reconciliation the Dems can sidestep Republican intervention and pass it via a simple majority vote (which the Blue Dog Dems are not enough to stop either). > > The Senate parliamentarian tossed a road block in the way but not an insurmountable one. Have to wait and see. > > Currently they are waiting on CBO scoring before moving ahead. So far, 40 senators have signed on to passing the public option via reconciliation. If the House passes it, Durbin could conceivably whip up the needed votes. Pelosi has been keen on the public option, although yesterday Stupak et al were tossed aside, obviating the abortion issue, but making the necessary votes that much harder to get. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [March 12, 2010, 6:33pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/10 "2010-03-12T18:33:48Z")
> [@sleeping](#): > > So far, 40 senators have signed on to passing the public option via reconciliation. If the House passes it, Durbin could conceivably whip up the needed votes. > > Pelosi has been keen on the public option, although yesterday Stupak et al were tossed aside, obviating the abortion issue, but making the necessary votes that much harder to get. I agree the Public Option is a stretch but the last whip count I saw (and maddeningly cannot find the cite for now) started with those 40 and was able to count up to 51 (52?) with the final ones being suggested as probable. They only need 50 as Biden can cast the tiebreaker. Not sure how it is in the House but last I saw it was pretty close as well. That said my post you quoted was more about healthcare reform passing at all than reform with a public option. It seems likely that the reform will probably get in sans a public option. The public option would be icing. ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 7:19pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/11 "2010-03-12T19:19:22Z")
> [@Whack-a-Mole](#): > > I agree the Public Option is a stretch but the last whip count I saw (and maddeningly cannot find the cite for now) started with those 40 and was able to count up to 51 (52?) with the final ones being suggested as probable. They only need 50 as Biden can cast the tiebreaker. Not sure if this is what you’re referring to, but [53 Senators are open](http://www.openleft.com/diary/17757/senate-whip-count-reconciliation-reaches-53-public-option-reaches-40) to using reconciliation on the healthcare bill. Meanwhile, Grayson’s Medicare buy-in already has 50 co-sponsors in the House. But, just to be clear, it is a separate piece of legislation. I initially misunderstood and the thread title is misleading–Grayson’s bill has its own number and can be voted on separately. Also, as far as I understand, it is _not_ an amendment to the healthcare bill, so the Senate’s opposition to a future amendment should not be a problem here. ---
**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\ **Post date:** [March 12, 2010, 8:59pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/12 "2010-03-12T20:59:13Z")
I’m really coming to like this Alan Grayson guy. Balls and principles; that’s a rare combination in a politician. ---
**Author:** ![Whack-a-Mole](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/whack-a-mole/32/141_2.png) [@Whack-a-Mole](https://boards.straightdope.com/u/Whack-a-Mole)\ **Post date:** [March 12, 2010, 9:17pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/13 "2010-03-12T21:17:47Z")
> [@Chronos](#): > > I’m really coming to like this Alan Grayson guy. Balls and principles; that’s a rare combination in a politician. Me too. You’d think other Dems would take notice. Particularly when Grayson is the leading candidate in the Republican primary in his state (yes I typed that right). > [@](#): > > The candidate leading the Florida GOP primary to determine who will take on Rep. Alan Grayson, the Democrat who represents the Orlando-based district, is none other than Grayson himself, according to a poll paid for by his campaign. Grayson is a freshman congressman who has drawn scorn from the GOP and has quickly built a nationwide following of progressives. > > The poll has Grayson leading the 13 Republicans – among Republicans – with 27.8 percent of the vote. The congressman who mocked the GOP health care plan by saying that it amounts to telling people not to get sick and if they do, to die quickly, received more support than all of the Republican candidates combined. > > No GOP candidate scored above 3.7 percent; 57.7 percent said they were undecided. > > SOURCE: [http://tpmcafe.talkingpointsmemo.com/talk/blogs/i/c/ickyma/2010/03/grayson-leading-in-republican.php](http://tpmcafe.talkingpointsmemo.com/talk/blogs/i/c/ickyma/2010/03/grayson-leading-in-republican.php) ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 9:26pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/14 "2010-03-12T21:26:35Z")
> [@Chronos](#): > > I’m really coming to like this Alan Grayson guy. Balls and principles; that’s a rare combination in a politician. Indeed. He’s also very well-read, if his bio/interview in this month’s MoJo is anything to go by. Also, the House is getting creative: > [@](#): > > Party leaders have discussed the possibility of using the House Rules Committee to avoid an actual vote on the Senate’s bill, according to leadership aides. They would do this by writing what’s called a “self-executing rule,” meaning the Senate bill would be attached to a package of fixes being negotiated between the two chambers – without an actual vote on the Senate’s legislation. > > Under this scenario, the Senate bill would be automatically attached to the reconciliation package, if the House passes reconciliation. In other words, Bill A would just become part of Bill B if the House passes Bill B, and the Senate could then vote on a reconciliation package before sending it to the president. This allows House members to approve the broader measure without actually voting on it. > … > This would allow them to deal with the Senate bill without forcing their members to go on record in support of unpopular items, like the now-infamous Cornhusker Kickback or the so-called Louisiana Purchase, that could be used against them on the campaign trail in the fall. > > [http://www.politico.com/livepulse/0310/A\_dizzying\_array\_of\_options\_to\_pass\_health\_care.html?showall](http://www.politico.com/livepulse/0310/A_dizzying_array_of_options_to_pass_health_care.html?showall) Although the Senate parliamentarian (the adviser on Senate rules, Alan Frumin) has ruled that they can’t do that: > [@](#): > > House Democratic leaders have been searching for a way to ensure that any move they make to approve the Senate-passed $871 billion health care reform bill is followed by Senate action on a reconciliation package of adjustments to the original bill. **One idea is to have the House and Senate act on reconciliation prior to House action on the Senate’s original health care bill.** > > Information Republicans say they have received from the Senate Parliamentarian’s Office eliminates that option. House Democratic leaders last week began looking at crafting a legislative rule that would allow the House to approve the Senate health care bill, but not forward it to Obama for his signature until the Senate clears the reconciliation package > > [http://cdn.rollcall.com/media/44110-1.html](http://cdn.rollcall.com/media/44110-1.html) ---
**Author:** ![ElvisL1ves](https://avatars.discourse-cdn.com/v4/letter/e/5daacb/32.png) [@ElvisL1ves](https://boards.straightdope.com/u/ElvisL1ves)\ **Post date:** [March 12, 2010, 9:30pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/15 "2010-03-12T21:30:15Z")
Don’t take information you get from the Republicans at face value. [That ain’t so.](http://www.politico.com/livepulse/0310/An_option_still_on_table.html) ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 9:34pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/16 "2010-03-12T21:34:21Z")
> [@ElvisL1ves](#): > > Don’t take information you get from the Republicans at face value. [That ain’t so.](http://www.politico.com/livepulse/0310/An_option_still_on_table.html) Ha! That’s great. It’ll be like a Rube Goldberg machine. ---
**Author:** ![Happy\_Fun\_Ball](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/happy_fun_ball/32/17664_2.png) [@Happy\_Fun\_Ball](https://boards.straightdope.com/u/Happy_Fun_Ball)\ **Post date:** [March 12, 2010, 10:43pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/17 "2010-03-12T22:43:44Z")
> [@Whack-a-Mole](#): > > Me too. > > You’d think other Dems would take notice. Particularly when Grayson is the leading candidate in the Republican primary in his state (yes I typed that right). Damn I like that guy! ---
**Author:** ![sleeping](https://avatars.discourse-cdn.com/v4/letter/s/839c29/32.png) [@sleeping](https://boards.straightdope.com/u/sleeping)\ **Post date:** [March 12, 2010, 11:35pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/18 "2010-03-12T23:35:02Z")
Grayson’s bill now has 64 co-sponsors. It will be interesting to see the arguments of its opponents. It’s budget neutral, so they can’t claim it will actually raise spending. Nor is there a mandate attached. So, if they try to build either of these strawmen, they would essentially be creating an argument for using reconciliation (if it really did affect the budget)–or they would have to admit that they are lying. ---
**Author:** ![BrightNShiny](https://avatars.discourse-cdn.com/v4/letter/b/7bcc69/32.png) [@BrightNShiny](https://boards.straightdope.com/u/BrightNShiny)\ **Post date:** [March 12, 2010, 11:48pm UTC](https://boards.straightdope.com/t/grayson-introduces-medicare-buy-in-provision-into-healthcare-bill/532206/19 "2010-03-12T23:48:39Z")
I don’t know why they didn’t just do this from the very beginning. Okay, I know why, but the political approach of the Dems during the HCR debate has just been plain stupid. If they had done this from the beginning, it would have been much simpler for people to understand and therefore less susceptible to misinformation campaigns. But yeah, I doubt this will go anywhere right now. The Dems could have then pushed for the other cost control measures in the next session, after the Medicare buy-in had taken effect.