Getting old sucks and it is expensive.
Covering kids and young adults had been an easy fall-back option for Democrats and some Republicans prior to the passage of PPACA because it is an easy thing to do. SCHIP expansion was one of the first bills that passed the 2009 Congress with only two Democrats in the House defecting to vote against it, and nine Republican Senators voting for it. The Vermont Dr. Dynasaur program that was a strong selling point for Howard Dean was primarily near universal healthcare for people under the age of 18. The Rahm Emmanual fall-back plan after Scott Brown (R-MA) got elected to the Senate from Massachusetts in January 2010 was to take another whack at covering more kids.
These plans are simple because they are cheap. Kids and yound adults are cheap to cover. The Incidental Economist is passing along some great data that I’ve reformated on how cheap kids and young adults are to cover:
People under the age of 50 cost less than average while people over 50 cost more than average. Costs accelerate as people get older and statistically sicker. Medicare currently takes care of most of the very high cost individual population groups. Dropping Medicare buy-in age to 55 would have removed the next most expensive cohort that is overwhelmingly on private insurance from the private insurance market and thus would have lowered premiums for both group and Exchange products. This would have worked as Medicare tends to pay less per procedure than private group insurance. Quality payment system reform would probably also decrease utilization.