Last week twelve senators expressed their misgivings over the proposed Medicare buy-in for Americans aged 55-64 in a strongly worded letter to Senate Majority Leader Harry Reid.  In part, they state, “Creating a Medicare buy-in program that reimburses providers at current Medicare rates and according to today’s payment structure will exacerbate the existing funding inequity.  Medicare is spending over one-third more for each Medicare beneficiary in some states compared to ours.  The combination of an antiquated payment forumla that tends to penalize rural providers and greater medical efficiency in our states has forced many physicians to stop accepting Medicare patients or limit the number of Medicare patients they serve.  Increasing the number of Medicare patients under a buy-in proposal without fixing the Medicare reimbursement rate will further exacerbate this problem.”