The scenario is not so far-fetched: an American worker nears retirement. Her 65th birthday is drawing close. She's paid into Medicare her entire life, expecting it to be there to cover her health care in her golden years -- just like it was for her parents.
She's worked hard and played by the rules. She's upheld her end of the bargain, and her children's and grandchildren's economic security depends on a strong, sustainable Medicare.
But, when the time comes, she's faced with a system that's changed and where the goal posts have moved because Republicans in Congress demanded that the eligibility age for Medicare rise. It was their trophy in the talks on the fiscal cliff -- the price they asked seniors to pay before they voted to ask the wealthiest to pay their fair share.
Americans have not had to deal with the reality of this scenario since the advent of Medicare more than 45 years ago. Yet in the talks to avert the fiscal cliff, the idea of raising the Medicare age is central to the Republican proposal. There's just one critical problem: It doesn't work. It doesn't have public support. It's unfair. And it doesn't lower health expenditures.
Such a proposal is a reflection of the broader Republican plan: an assault on the middle class, seniors -- and our future. Republicans like to talk about their ideas in terms of abstract numbers. However, we cannot ignore the adverse impacts of their policies on the American people.
Raising the Medicare eligibility age is a case in point. On paper, it appears to save money for the federal government. In practice, it simply shifts the cost of health care to newly uninsured 65- and 66-year-olds, forcing them to pay more for their care out of their own pockets. It makes older Medicare beneficiaries pay higher premiums.
Under the Republican plan, it shifts costs to employers who wish to do right by their workers and cover their retirees for two additional years. It adds costs to states, as low-income seniors find themselves forced to seek out coverage through Medicaid.
It raises premiums for younger Americans who don't receive insurance through their jobs and who are set to purchase coverage through new insurance exchanges. It asks them to foot the bill to cover the cost of insuring the many 65- and 66-year-olds who would enter the system at the same time.
As one expert, Paul N. Van de Water of the Center for Budget and Policy Priorities, has noted, taking this step "would not only fail to constrain health care costs across the economy; it would increase them." In fact, the Kaiser Family Foundation estimates that higher state and private sector costs would be twice as large as the total federal savings.
The overall impact, according to Van de Water, is that "total health care costs would rise, some seniors would end up uninsured, and many would face unaffordable out-of-pocket costs."
Put another way: raising the Medicare age asks the most vulnerable citizens to pay more with little to show for it in terms of long-term deficit reduction or more affordable care, for seniors or anyone else. It increases health spending across-the-board. It takes money out of the pockets of a small slice of Americans.
We can do better -- and we have. Democrats are the only ones who have enacted a plan that extends the solvency of Medicare without cutting benefits through the Affordable Care Act.
Make no mistake: Democrats are ready to discuss even more savings that extend the life of Medicare without hurting beneficiaries. We should reduce health expenditures and build on our work in the Affordable Care Act to slow the growth of health costs. We should be strengthening Medicare, not undermining it.
The Republican plan, which would be phased in over more than a decade, may sound simple enough. But remember: it is brought to you by the same people who think it's a good idea to end the Medicare guarantee and turn Medicare into a voucher system -- putting seniors at the mercy of insurance companies.
Raising the Medicare age represents more of the same. For seniors nearing retirement, it means less security for themselves and their families. It betrays the bedrock promise of Medicare: that Americans who work hard and take responsibility all their lives can know dignity in their later years.
For the sake of America's seniors and their families, our middle class, and our country, let's enact a plan that creates jobs, strengthens the middle class, grows the economy, and reduces the deficit in a balanced, responsible way.
Rep. Nancy Pelosi of California, the first female speaker of the House, is the current House Democratic leader.