Mark Weisbrot

Joe Biden has surged since the South Carolina primary, and the received wisdom is that this was mainly because of the perception by his voters that he was the most electable candidate against President Donald Trump. But there are some potential pitfalls that have not yet surfaced, and some of them concern voters who are currently among Biden’s strongest base of support: Americans over 65 years old.

Biden has proposed a plan for health care reform that has quite literally left senior citizens out in the cold.

This could become increasingly, and vitally, important as the threat of coronavirus increases exponentially. Older Americans are at a vastly higher risk than the general population; people over 65 have accounted for the vast majority of deaths in other countries.

His plan is basically an expansion of the ACA, or Obamacare. It proposes, for example, to increase the subsidies that the government will provide for people who buy private insurance under the program. It has also proposed a public option, run by the federal government, that people could buy into.

When an American reaches the age of 65, he or she becomes eligible for Medicare. However, there are sizable gaps in the Medicare system that lower living standards for many senior citizens, and can even push them below the poverty line.

For example, Medicare does not pay for eyeglasses or hearing aids. It does not cover dental care. And it does not pay for long-term care. Although Medicaid, our federal and state public health insurance program for low-income Americans, does pay for long-term care, it only does so after someone has depleted their life savings, and is poor enough to qualify for Medicaid in the state in which they live.

Amazingly, the Biden plan doesn’t do anything to help seniors with any of these gaps in coverage under the current system. The only exception in Biden’s plan is his proposal for a non-refundable tax credit of $5,000 to pay for long-term care. But this tax credit won’t be available for the majority of the people on Medicare who would need it.

The gaps in Medicare are costly for senior citizens, most of whom have limited income. The median income for people on Medicare is about $26,000. On average, their out-of-pocket costs for spending on Medicare are more than $5400 per year; and there is no limit on out-of-pocket costs.

These costs to people on Medicare would almost all be eliminated by Bernie Sanders’ Medicare for All plan. It would cover eyeglasses and vision exams, dental care, hearing aids and other important medical needs now excluded by traditional Medicare.

Biden’s health care is deficient in other important ways for much of the rest of the population. Unlike, for example, Sanders’ proposal for Medicare for All, the Biden plan does not establish health care as a right for all Americans. Instead, it proposes to increase subsidies so that the maximum percentage of their income that people will pay for insurance on the individual marketplace will be lowered from 9.86 to 8.5 percent. But millions of Americans would still fall through the cracks.

As a political matter, Americans over 65 have some electoral clout because their participation in elections is much higher than that of other demographic groups. Biden has supported serious cuts to Social Security benefits for decades, as recently as 2013; Sanders, by contrast, has opposed such cuts and fought for increased Social Security benefits since he entered Congress nearly 20 years ago, and even before that. Biden now supports increasing Social Security benefits, although not nearly as much as Sanders.

But hardly anyone has heard of the vast difference between the two candidates on the health care, income and poverty of Americans over 65. These voters would understandably take much more interest in these differences, if they were aware of them. They are much more at risk in the coming months, as compared to previously, of needing urgent medical care — as the coronavirus spreads.

Mark Weisbrot is an economist and the co-director of the Center for Economic and Policy Research in Washington and is the co-author, with Dean Baker, of “Social Security: The Phony Crisis” (University of Chicago Press).