William E. Gibson / Sun Sentinel (Fla.)

WASHINGTON — Should well-to-do senior citizens pay more for Medicare? With little fanfare, that’s been happening since 2007. Single recipients who make more than $85,000 and couples who make more than $170,000 a year now pay $146.90 a month — $42 more than the basic premium for doctor care. Those at the highest range — singles making more than $214,000 and couples making more than $428,000 — are paying $335.70 a month.

Something similar is true for Part D, which covers prescription drugs. Higher-income patients are paying an extra cost ranging from $11.60 to $66.60 a month.

Today, only 5 percent of Medicare recipients pay that surcharge for doctor care and 3 percent for drug coverage. But President Barack Obama and many in Congress are proposing to expand that number — to one of every four of those covered, by 2035.

The president’s budget plan would accomplish that by adding more income brackets and then freezing them so they don’t rise with inflation. If approved by Congress — and it’s not clear if or when that might happen — that would gradually squeeze more and more middle-class households as their incomes rise, health care analysts said last week.

“They are saying this hits wealthier people. We think that it’s really reaching down into the middle class and some people who can’t really afford to pay higher premiums, given all their other out-of-pocket health-care costs,” said Diane Lifsey, senior legislative representative for the National Committee to Preserve Social Security and Medicare.

Obama is proposing other charges as well, regardless of income. Patients who receive home health care would face $100 co-pays for every 60-day period of service unless they came from a hospital. New Medicare enrollees would pay an additional $25-per-year deductible for Part B, which covers doctor care, in 2017 and again in 2019 and 2021. And those who hold many Medigap insurance policies, which cover costs not paid by Medicare, would face a surcharge of roughly $35 a month.

Obama is proposing to make higher-income patients pay more — known as “means testing” — as part of a compromise with Republicans that also would include raising taxes on the wealthy. His $3.8 trillion budget for next fiscal year also calls for trimming Social Security cost-of-living raises by changing the way inflation is figured.

Administration officials say their proposals would spare those who can least afford higher costs.

The Medicare plans have been overshadowed by the president’s Social Security proposal, but AARP and other advocates are sounding alarms about what they consider another attempt to shift costs onto the elderly.

As they learn more about these plans, some recipients say they oppose hikes in out-of-pocket costs, even if they mostly target the wealthy.

“If you contributed to Medicare, whether you are rich or poor or whatever, when you become eligible for benefits you should get them,” said Bette Jolly, 70, of Fort Lauderdale, Fla.