When White House Chief of Staff Rahm Emanuel implored Senate Majority Leader Harry Reid (D-Nev.) on Sunday to agree to demands to drop a provision to expand Medicare coverage, he was abandoning principles of health care reform that he once supported.
Back in November 2007, the then-Illinois Representative and head of the Democratic Congressional Campaign Committee penned an op-ed for the Washington Post in which he specifically vouched for the provision he now opposes.
Titled "Before We're 64", Emanuel and Bruce Reed, president of the moderate Democratic Leadership Council, wrote that allowing those as young as 55 to buy into Medicare was essential to relieve the financial burdens on American workers and businesses.
In 2005, Americans ages 55 to 64 were the fastest-growing segment of the population to become uninsured. For those employees lucky enough to still have insurance, the percentage of workers with deductibles of $500 or more has nearly tripled.
Covering early retirees is the most acute problem for workers and employers alike. Younger workers have fewer health needs and cost far less to cover; older retirees have much of their higher costs covered by Medicare. The average annual cost of covering a 30-year-old employee is $2,222. The average yearly cost for an employee who retires at 60 is $6,139.
We can't afford to let American workers and companies wither on the vine. We can ease the cost crunch for both by giving employers and unions a new option: buying Medicare coverage for retirees ages 55 to 64. Retirees would get quality care from a program they can trust. Employers would get to buy affordable insurance and take spiraling health costs off their books.
At the time, Democrats controlled Congress but not the White House. And the notion of enacting health care reform was tempered by the implicit recognition that you needed a president willing to do the heavy lifting. Emanuel, then and now, was considered a pragmatist above all else. But in writing about the benefits of a Medicare buy-in, he referenced virtually the same arguments that champions of the proposal have today: that it would alleviate costs on companies who provide health insurance to this age group without costing the taxpayers money.
Those points seem largely moot at this juncture of the current health care debate as Emanuel, the president and Democratic leadership in Congress have said they value the passage of legislation over any one particular provision. But the Washington Post op-ed remains a vivid illustration of how the current political system creates an inverse relationship between political power and policy passion. Emanuel, today, is in a far better place to enact the Medicare buy-in proposal. But he reportedly played the persuasive role in getting it sacrificed.