London (CNSNews.com) – As U.S. presidential campaigns increasingly look to citizens overseas to win tight elections, Americans expatriates in turn are asking Washington to extend Medicare coverage to retired citizens living throughout the world.
 
Organizations representing Americans living outside the United States have long called for Medicare coverage for citizens who have paid in enough tax to be eligible but are retired and living abroad, where the program mostly does not operate.
 
With the November election approaching, Democrats Abroad earlier this year included a passage in its 2008 platform urging Congress and the next president to address the “hardship” caused by this situation.
 
A spokeswoman for Republicans Abroad, the worldwide organization for Republicans, said the group has never issued a statement on the Medicare issue. It has in the past lobbied strongly on issues such as voting from abroad and taxes affecting expatriates.
 
Andy Sundberg, director of American Citizens Abroad, said it would be relatively easy to include retired civilians in the military TRICARE system, which provides medical coverage for veterans and their dependents outside the U.S.
 
Estimates of the number of Americans living abroad vary widely, but the Geneva-based Sundberg said he believed 250,000-300,000 retirees overseas could benefit from such a change.
 
The biggest challenge would be getting the change through Congress, no matter who is elected president in November, he said.
 
In recent years, it has become easier for Americans living overseas to vote in local and national elections, with both major parties targeting them in get-out-the-vote and fundraising drives.
 
A small group of legislators has set up a bipartisan Americans Abroad caucus in the House of Representatives.
 
Sundberg said that despite these moves, Americans in foreign countries are still penalized in a number of areas – from collecting Social Security benefits to the difficulties faced in registering their children as U.S. citizens.
 
“We’ve been living with the illusion that having the right to vote overseas makes a difference,” he said.
 
Tom Rose, an expert with the Association of Americans Resident Overseas, said he did not  think it likely that Medicare would be extended internationally in the coming years.
 
Speaking from France, he said that the House of Representatives had voted once to extend the benefits – during the Carter administration – but the measure was shot down in the Senate.
 
Over the decades since then, attitudes towards the overseas community had only hardened, with a feeling in Congress that Americans who have “left the nest” were not entitled to the same privileges as other citizens.
 
Rose said the best chance of extending Medicare abroad may be a pilot program that has been proposed by academics at the University of Texas, to extend coverage to retirees in Mexico.
 
While he does not believe the healthcare situation stops many Americans from retiring abroad, Rose said that some risk going without insurance while living in foreign countries.
 
The Democrats Abroad platform, which was adopted by delegates at a global convention in Vancouver last April, will be submitted to the Democratic National Convention in Denver later this month for consideration.
 
The platform includes wide-ranging recommendations in other areas, among them a call for a foreign policy that “fosters engagement, rejects arrogance, and creates opportunities for dialogue rather than limits or shuts them down.”
 
It also supports passage of the Uniting American Families Act, a bill that would give American citizens with foreign same-sex partners the same rights to be reunited in the U.S. as married couples.
 
Conservative family groups have spoken out against the bill, which  Human Rights Watch estimates would benefit more than 36,000 binational same-sex couples living in America.