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The $3.5 trillion spending plan proposed by the Biden administration would make significant changes to the Medicare program. Oliver Contreras/Sipa/Bloomberg via Getty Images
  • The Biden administration’s “human infrastructure” proposal would expand Medicare coverage for dental, vision, and hearing aids.
  • It also would attempt to lower the cost for prescription drugs.
  • The proposal also explores the possibility of lowering the eligibility age to under 65.

Some experts call the current proposed Medicare changes the most expansive since President Lyndon Johnson signed the health plan into law in 1965.

The proposals are part of the Biden administration’s “human infrastructure” package. Senate Democrats passed the framework of a budget resolution for the plan and sent it to the House.

It has a big price tag — $3.5 trillion dollars — but few details.

The resolution instructs the Senate Committee on Finance to expand Medicare to include “dental, vision, and hearing benefits.”

“Adding dental, vision, and hearing coverage would be a real game changer,” said Kate Ashford, a Medicare specialist for the personal finance site Nerdwallet.

“Sometimes older adults go without, which isn’t ideal,” she told Healthline.

And it appears a majority of older adults would be onboard.

According to a recent survey by Nerdwallet, 71 percent of the 2,000 seniors they polled supported those changes.

However, from there, the other proposals are a bit more murky in terms of how they would work.

The resolution asks the finance committee to provide “long-term care for seniors and persons with disabilities.”

“Sounds great, but I’m not exactly sure what that looks like. And no one is sure what that looks like yet,” said Ashford.

The most controversial portion of the budget proposal may be its recommendation to lower the eligibility age. The document doesn’t specify what age, but 60 years old is the age proponents suggested.

“I think that’s going to be a harder hill to climb,” said Jonathan Oberlander, PhD, a professor of social medicine and health policy and management at the University of North Carolina at Chapel Hill and author of “The Political Life of Medicare.”

“It’s a return to the original Medicare vision. When it was designed, its architects expected it would expand over time and bring in other younger people,” he told Healthline. “It brought in people 65 and older first, but it never really did the second part.”

“Medicare became defined as a fiscal problem. Policymakers were intent on slowing down Medicare spending not expanding it,” Oberlander said.

And he suspects opponents would say a “Medicare for More” scenario would be too expensive.

Finally, the resolution calls on the finance committee to allow for “hundreds of billions in additional savings by lowering the price of prescription drugs.”

That’s another thing seniors in the Nerdwallet survey supported, this time with a 78 percent majority.

“It would have an immediate and concrete impact on seniors, particularly people who are struggling with expensive prescription medications,” Ashford said.

“People aren’t taking their medications as prescribed, they’re not filling prescriptions, taking over-the-counter drugs instead, cutting pills in half or skipping doses,” she said.

“Of all the changes mentioned in the budget resolution, it seems like reducing prescription drug prices is probably the one with the highest potential for success. Lowering drug costs is something that has bipartisan support,” Ashford said.

Oberlander suggests the Medicare expansion proposals could face a bumpy road ahead. Why?

First because the Democrats are trying to pass the plan on their own.

“The Democratic Party itself is divided. They have grand ambitions, but a small majority,” he said.

The benefits, Oberlander says, include good politics.

“The kind of thing you might want to do before midterm elections or really, any time,” he said.

“And do Republicans want to run in 2022 midterms on a platform of opposing coverage for hearing aids, vision care, and dental care? That’s a dangerous place to be politically for any party,” Oberlander said.

The clock is ticking.

The various committees have a target date of mid-September to have their portions of the bill ready.