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President Joe Biden speaks to members of the media with Senate Majority Leader Chuck Schumer, D-N.Y., left, at the U.S. Capitol in Washington, D.C., on July 14, 2021.
President Joe Biden speaks to members of the media with Senate Majority Leader Chuck Schumer, D-N.Y., left, at the U.S. Capitol in Washington, D.C., on July 14, 2021. (Al Drago/Bloomberg)

Senate Democrats' plan to expand Medicare coverage would help a growing senior population often struggling with hefty out-of-pocket medical expenses, potentially providing ballast for the economy in coming years.

Democrats on the Senate Budget Committee agreed Tuesday on a $3.5 trillion spending level for a bill to carry most of President Joe Biden's economic agenda into law without Republican support. The bill would include one key item that wasn't in Biden's plans: vision, dental and hearing benefits for Medicare recipients, who are disproportionately those over 65 years old.

That would provide tens of millions of seniors — many of whom have low incomes — with care that they don't currently have, likely boosting not only health spending but also freeing up money to go toward other goods and services, particularly essential goods. With 10,000 Baby Boomers turning 65 each day across the U.S., Democrats hope the expanded coverage will also help provide political wins.

"This would be a very significant change for Medicare," said Tricia Neuman, executive director of the Kaiser Family Foundation's program on Medicare policy, who said it would be the biggest change since the start of Medicare's drug benefit in 2006. "How big an impact it will have will depend on the details of the proposals."

Democrats are leaning toward expanding Medicare Part B, which pays for outpatient services, to include these new benefits, according to two senior Senate staffers familiar with the discussions. Like many other parts of Medicare, there would be no cost-sharing for preventative services and limited copays for elective procedures.

Part B is voluntary and includes premiums, which could rise with the addition of new benefits.

The additional benefits would increase Medicare spending by roughly $358 billion in the decade through 2029, according to a Congressional Budget Office estimate of a previous similar proposal. Two-thirds of that would be for dental and oral health, the nonpartisan agency said. Government spending on this level would provide a boost for gross domestic product.

Dental care, which is closely linked to overall health, is one of the most expensive services. About 30 million seniors haven't had a dental appointment in the past year, according to the Kaiser Family Foundation, including 16 million with annual incomes above $40,000.

About a quarter of Americans over 65 years old have disabling hearing loss, according to the National Institute on Deafness and Other Communication Disorders.

People with hearing loss have much higher health costs and lower employment, said Amanda Davis, a senior adviser at AARP. For Medicare-aged beneficiaries, that carries knock-on costs for the government and retirement savings, as those with hearing loss have less in savings and higher medical bills.

Hearing loss is estimated to cost those affected $297,000 over their lifetime, according to a study published in 2000 by the International Journal of Technology Assessment in Health Care. And the total national cost of first-year hearing loss treatment is projected to rise to $51.4 billion in 2030 from $8.2 billion in 2002, according to a 2010 study in Journal of the American Geriatrics Society.

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