I have no recollection of discussion of Medicare options other than what became law.
I imagine, though, that it simply never occurred to them. It might have occurred to the R's had they been participating in crafting the legislation, which would have provoked some negotiation and possibly the result you suggest, but, left to their own devices, not something the D's would likely come up with. The cohort here is poor. D's are not likely to expect them to contribute at that income level. Also, D's are constitutionally indisposed to tiered benefits. They would be more likely to ask for a co-pay than a second class benefit.
It would have been awkward, too, to give the new Medicaids poorer benefits than original Medicaids, and then charge them for participation, to boot. I don't see how one could argue to the public for that.
I believe many have reached a point where they think the entitlement state needs to have at least an element of beneficiary contribution or effort.
Which many? Not the Medicare for all folks.
As for the law surviving, the D's were concerned about the viability of the marketplace part of Obamacare but what could threaten the survival of the Medicare extension? There's no inherent threat and a dismantling by the R's would require would require both a government takeover and reneging on a benefit to millions of voters, again not likely. |
