In This Fantasy Budget Deficit And Debt Fight, the Tea Party Refuses To Take ‘Yes’ For An Answer
Suppose I told you that I knew of a simple way to alleviate the budget deficit problem, and that it would require Congress not to do anything at all. You’d conclude that this was the poor start to a late April Fools’ column.
But unhappily the April Fools’ joke unfolding in the nation’s capital is the fantasy budget and spending debate itself. It’s rooted in an unreality that is about to crash into an unyielding real world, possibly in the form of a government shutdown.
The Congressional Budget Office, a nonpartisan fiscal scorekeeper, projects the budget deficit will be $1.5 trillion this year, or 9.8 percent of gross domestic product. In order to achieve budget stability and sustainability, according to economists, that figure should be around 3 percent of GDP. But here’s the good news: The CBO projects that the deficit will “drop markedly over the next few years as a share of output and average 3.1 percent of GDP from 2014 to 2021.” We’re saved! And it gets better: “Those projections . . . are based on the assumption that tax and spending policies unfold as specified in current law.”
In other words, all Congress has to do is what they seem ideally suited to these days—nothing. Ah, but there’s the rub. CBO continues that its projections “understate the budget deficits that would occur if many policies currently in place were continued, rather than allowed to expire as scheduled under current law.” Those policies include the Bush tax cuts. They also include annual spending punts that enjoy broad bipartisan support, like preventing the Alternative Minimum Tax’s bracket creep from snagging the middle class, and the “doc fix,” which pushes back a scheduled cut in Medicare payments.
So the solution isn’t so simple. But lawmakers wishing to do more than talk about dealing with the deficit could demand offsets for these policy changes. Instead, we’re reminded of the reality that even the toughest self-styled budget hawks–including Budget Committee Chairman Paul Ryan, who describes dealing with the deficit as a “moral imperative” but advocates extending the Bush tax cuts in full in perpetuity at a cost of nearly $4 trillion–are actually strutting budget peacocks more concerned with perception than results, or fiscal results anyway.
Take, for example, the Republican Study Committee, the hawkiest of the GOP budgetary birds of prey and enforcers of the party’s economic dogma. Going by reputation, they should be able to proffer a budget plan to bring the deficit into line. But the Concord Coalition, a group focused on eliminating the deficit, last month used CBO numbers to examine a scenario under which the Study Committee got its tax-and-spending wish list, which includes an extension of the Bush tax cuts, repeal of the Obama healthcare law (which CBO scores as a money-saver, meaning that repeal adds to the deficit), and $2.7 trillion saved in a spending freeze and cuts. The result? “Under this scenario, the resulting deficits would be $2.1 trillion larger over 10 years,” according to Concord, which concludes, “A budget that uses honest numbers and reflects Republicans’ current policy preferences will result in large continuing deficits.”
But nevertheless, and in the face of six recent years of GOP control over both the White House and Congress, Republicans have won the budget perception battle, and soundly. A poll released last week by Democracy Corps, a group of prominent liberal pollsters including Stan Greenberg and James Carville, found that independent voters are “still hesitant to trust Democrats on spending.”
Meanwhile the debate in Washington has focused almost entirely on spending cuts, even though polls show that voters are more concerned about jobs and the economy than the budget and the deficit—and even though most economists agree that the GOP’s proposed spending cuts would set back the recovery.
But the clearest example of the GOP having the Democrats on the run can be found in the current negotiations aimed at averting a government shutdown in a week. House Republican leaders originally wanted $32 billion in spending cuts for this year; that figure prompted a conservative backlash that ended with the House passing $61 billion in cuts. Now, according to press reports, negotiators have settled on $33 billion in cuts. In other words, the GOP, which controls one of three players in this negotiation, has already achieved its original budgetary goal. In this regard, House Speaker John Boehner seems to have (intentionally or not) used his Tea Party wing as a perfect foil to pull the debate to the right.
But judging by last Thursday’s Tea Party demonstration on the Hill—aimed at the GOP, mind you—conservatives don’t seem capable of banking their win and moving on to the next fight. They see anything less than total victory as an abject surrender.
And in that sense reality is about to intrude upon their budgetary-political fantasy land. The reality is that while voters like spending cuts in the abstract, polls show they object to the particulars of the GOP agenda. That reality is already taking hold at the state level where, Politico reported last week, the wave of newly elected governors trying to get tough on budgets have seen their approval ratings collapse.
And the experience of state governments also provides an insight into the possible winners and losers in a government shutdown. A pair of political scientists published a paper last year looking at the effects of such budgetary breakdowns (167 of them since 1988) at the state level, reports the Washington Post’s Ezra Klein. The study found that voters tend to punish legislators while rewarding the executive. So a shutdown would benefit President Obama while hurting lawmakers in both parties.
So if members of Congress let the government shut down on Friday, they will be the real April fools.
By: Robert Schlesinger, U.S. News and World Report, April 6, 2011
Congressional Budget Office Looks At “RyanCare” Rationing And It Ain’t Pretty
The Congressional Budget Office has released its preliminary analysis (PDF) of House Budget Committee Chairman Paul Ryan’s budget, and I wouldn’t say it’s pretty. According to the CBO, Medicare beneficiaries will be left paying more for less. The CBO goes about this in a bit of a confusing way, setting a “benchmark” that corresponds to the cost of purchasing a private plan equivalent to Medicare, and then seeing how much more that plan would cost than Medicare under two different scenarios. Compared with either scenario, RyanCare costs a lot more than Medicare:
Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system. For a typical 65-year-old with average health spending enrolled in a plan with benefits similar to those currently provided by Medicare, the CBO estimated the beneficiary’s spending on premiums and out-of-pocket expenditures as a share of a benchmark: what total health-care spending would be if a private insurer covered the beneficiary. By 2030, the beneficiary’s spending would be 68 percent of that benchmark under the proposal, 25 percent under the extended-baseline scenario, and 30 percent under the alternative fiscal scenario.
If Medicare’s beneficiaries are getting less for more, Medicaid’s are simply getting less, period:
Federal payments for Medicaid under the proposal would be substantially smaller than currently projected amounts. States would have additional flexibility to design and manage their Medicaid programs, and they might achieve greater efficiencies in the delivery of care than under current law. Even with additional flexibility, however, the large projected reduction in payments would probably require states to decrease payments to Medicaid providers, reduce eligibility for Medicaid, provide less extensive coverage to beneficiaries, or pay more themselves than would be the case under current law.
As the CBO recognizes, a lot of what Ryan is doing isn’t saving money so much as shifting costs. Poor people and seniors don’t need less health care because Medicare and Medicaid are providing less health care. They just have to pay for more of it on their own. And as the CBO says, it’s hard to imagine Congress simply ignoring their pleas for help:
Under the proposal analyzed here, debt would eventually shrink relative to the size of the economy — but the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the current program; payments to physicians and other providers for services provided under the traditional Medicare program would be restrained (as under the two scenarios); states would have to pay substantially more for their Medicaid programs or tightly constrain spending for those programs; and spending for federal programs other than Social Security and the major health care programs would be reduced far below historical levels relative to GDP. It is unclear whether and how future lawmakers would address the pressures resulting from the long-term scenarios or the proposal analyzed here.
By: Ezra Klein, The Washington Post, April 5, 2011
Wisconsin Waterloo: Where The GOP Sees Demons To Attack, Voters See Themselves
Wisconsin Democrats are filing recall petitions that could result in the Wisconsin Senate being controlled by Democrats. Summer 2011 will bring white-hot midterm elections and a potential Wisconsin Waterloo for the GOP that is spreading to other states and could shift the tectonic plate of American politics.
In Wisconsin, Ohio and other states a powerful backlash is brewing from giant swaths of voters who failed to turn out for Democrats or regret their votes for Republicans in 2010. They feel demonized by GOP attacks and financially threatened by GOP policies. They will be highly motivated to vote.
Wisconsin Democrats could win the three state Senate seats necessary to turn control of the Wisconsin Senate to the Dems, because voters do not want political holy wars against teachers, public workers or anyone else. They do not want fanatics in politics, fiats by government, incendiary partisanship or crusades against collective bargaining, which voters widely believe is a valued part of the American system.
Recently the Polish trade union Solidarity, one of the great voices for freedom in modern history, endorsed the Wisconsin workers and condemned the attacks on them by GOP Gov. Scott Walker. More voters agree with Solidarity than with Wisconsin Republicans.
In Ohio, the widely unpopular Republican governor, John Kasich, who was caught on tape verbally abusing a police officer who gave him a ticket, has now added both police and firefighters to the list of enemies he attacked in legislation. Most Americans view firefighters and police as heroes who risk their lives to save their neighbors, not as demons to attack or targets to have their financial security threatened.
In Washington, the GOP has added the venerable AARP to its enemies list. AARP has long represented tens of millions of seniors with honor. For Republicans to launch a Nixonian attack against them is an act of political stupidity that will not be well-received by senior voters.
Republicans wage holy war against National Public Radio, one of the fairest media in the nation, and one that provides vital service to small-town America and includes many Republicans among its fans.
Republicans threaten to shut down the government to pursue their war against Planned Parenthood, which is supported by many Republican women, while they attack a long list of programs important to mainstream American women. Many Republicans oppose efforts to achieve pay equity for women.
House Republicans even want to cut programs that help homeless veterans, cuts that Sens. Harry Reid (D-Nev.) and Sherrod Brown (D-Ohio) speak eloquently against.
The Texas GOP is likely to attempt to cheat Hispanics out of representation in Congress through a gerrymander similar to that once orchestrated by disgraced former House Republican Leader Tom DeLay. Many Republicans use tactics on immigration that are anathema to many Hispanics.
House Republicans will be widely blamed for any government shutdown or economic collapse from a failure to extend the debt ceiling if they pursue their partisan and ideological vendettas and refuse to accept 50-50 offers from Democrats.
A Wisconsin Waterloo is a real danger to Republicans. Where the GOP sees demons to attack, many voters see themselves.
By: Brent Budowsky, The Hill, April 4, 2011
Cutting Medicaid Means Cutting Care For The Poor, Sick And Elderly
The part of Paul Ryan’s budget that’s going to get the most attention is his proposal to privatize and voucherize Medicare. But the part that worries me the most is his effort to slash Medicaid, with no real theory as to how to make up the cuts.
Ryan’s op-ed introducing his budget lists Medicaid under “welfare reform,” reflecting the widespread belief that Medicaid is a program for the poor. That belief is wrong, or at least incomplete. A full two-thirds of Medicaid’s spending goes to seniors and people with disabilities — even though seniors and the disabled are only a quarter of Medicaid’s members. Sharply cutting Medicaid means sharply cutting their benefits, as that’s where the bulk of Medicaid’s money goes. This is not just about the free health care given to some hypothetical class of undeserving and unemployed Medicaid queens.
But perhaps cutting it wouldn’t be so bad if there were a lot of waste in Medicaid. But there isn’t. Medicaid is cheap. Arguably too cheap. Its reimbursements are so low many doctors won’t accept Medicaid patients. Its costs grew less quickly than those of private insurance over the past decade, and at this point, a Medicaid plan is about 20 percent cheaper than an equivalent private-insurance plan. As it happens, I don’t think Medicaid is a great program, and I’d be perfectly happy to see it moved onto the exchanges once health-care reform is up and running. But the reason that’s unlikely to happen isn’t ideology. It’s money. Giving Medicaid members private insurance would cost many billions of dollars.
That’s why it’s well understood that converting Medicaid into block grants means cutting people off from using it, or limiting what they can use it for. You can see CBO director Doug Elmendorf say exactly the same thing here. There’s just not another way to cut costs in the program. You can, of course, work to cut costs outside of the program, either by helping people avoid becoming disabled or making it cheaper to treat patients once they become disabled or sick, but those sorts of health-system reforms are beyond the ambitions of Ryan’s budget.
To get around some of this, Ryan’s op-ed talks about state flexibility, with the implication being that states have some secret Medicaid policies they’ve been dying to try but that the federal government simply hasn’t let them attempt. But the truth is there’s been a tremendous amount of experimentation in Medicaid over recent decades. Indiana converted its Medicaid program into health savings accounts. Tennessee based its program around managed care. Massachusetts folded its Medicaid money into Mitt Romney’s health-care reforms. Oregon tried to rank treatments by value. Some of these reforms have worked well and some haven’t worked at all, but none have solved the basic problem that covering the sick and disabled costs money, and you can’t get around that by trying to redesign their insurance packages. For that reason, block-granting Medicaid ultimately means cutting health-care coverage to the poor, the elderly and the disabled, even as it doesn’t actually address the factors driving costs throughout the health-care system.
By: Ezra Klein, The Washington Post, April 5, 2011
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