Senate Democrats could send seniors $1,000 cash vouchers to buy expanded Medicare benefits next year

Senate Democrats could send seniors $1,000 cash vouchers to buy expanded Medicare benefits next year
Senate Majority Leader Chuck Schumer and Budget Committee Chairman Bernie Sanders hold a meeting with Budget Committee Democrats at the Capitol on June 16, 2021. Samuel Corum/Getty Images
  • Senate Democrats are weighing sending millions of seniors up to $1,000 cash vouchers so they can purchase new Medicare benefits next year.
  • Democrats want to produce tangible benefits in people's lives ahead of next year's midterms.
  • The Bush administration once offered prescription drug cards, but critics complained the program was complicated to sign up for.

Senate Democrats are weighing issuing millions of seniors up to $1,000 in cash vouchers in the $3.5 trillion social spending plan so they can purchase new Medicare benefits next year while they're set up, according to a person familiar with the talks.

The person spoke on condition of anonymity to share details of private negotiations. The Washington Post first reported the story.

Senior Democrats haven't finalized an amount, though $600 to $1,000 is the range under consideration with figures still in flux.

Senate Democrats are seeking to expand Medicare so it covers dental, vision, and hearing benefits in their party-line social spending package, which they will press through the reconciliation process requiring only a simple majority vote. It's a top priority for Sen. Bernie Sanders, chair of the Senate Budget Committee, and it has support from Senate Majority Leader Chuck Schumer.

They want to set up the programs as quickly as possible, and they're clashing with House Democrats who introduced legislation gradually initiating vision coverage next year, hearing in 2023, with dental covered in 2028.


It reflects the mounting desire among many Democrats to produce concrete benefits in people's lives ahead of the 2022 midterms because they'll be defending needle-thin majorities in the House and Senate. Seniors over age 65 generally vote at higher rates, making them a key voting bloc and more so in midterm races.

"I think Democrats feel very strongly that it's important to move now so, in particular, we have results to show the American people a year from now in the late summer or early fall of 2022," Sen. Ron Wyden of Oregon, chair of the Senate Finance Committee, said in an interview last week.

Sanders balked at the House version of the Medicare expansion on Wednesday. "I don't want to see it as drawn out as far as the House has proposed," he said on a press call.

Still, experts say it could take years for Medicare to stand up the new programs. Medicare was last expanded in 2003 under President George W. Bush to cover prescription drugs, and it started insuring people three years later. In addition, some benefits may be easier than others to get off the ground.

"To implement a new dental benefit successfully will take some time, primarily because Medicare doesn't have a relationship with dentists across the country," Tricia Neuman, executive director of Medicare policy at the Kaiser Family Foundation, told Insider.


Part of the process at the federal level includes setting reimbursement rates, a thorny undertaking given many dentists will likely balk at the lower prices Medicare would offer compared to private health insurance. Then policymakers have to enroll enough dentists for tens of millions of seniors and ensure their coverage is widely accepted.

Around 47% of all Medicare beneficiaries, or 24 million people, don't have dental coverage, according to the Kaiser Family Foundation. An equal amount of program beneficiaries did not visit a dentist within the past year.

Neuman noted the federal government has issued vouchers or drug cards in the past. In 2004, the Bush administration started offering discount cards to cut costs for seniors while Medicare prepared to administer the new prescription drug benefits and insurance plans. Critics at the time complained it was difficult and confusing for seniors to sign up for one.

"Another thing about vouchers it would need to be done carefully to protect against fraud," Neumann said.

Not every effort is successful. Last year, President Donald Trump floated sending $200 prescription drug cards for seniors just before the presidential election. It never materialized and Democrats argued the program was legally dubious.


The nonpartisan Congressional Budget Office projected enlarging Medicare to cover vision, hearing, and dental would cost $358 billion over a decade.

That doesn't include the cost of the potential stop-gap benefit, which is competing for limited funding along with other Democratic priorities like Medicaid expansion, a permanent extension of Affordable Care Act subsidies, and a renewal of the child tax credit.