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“Kaiser Foundation Report Backs The Critics”: 60% Of Seniors Would Pay More For Medicare Under Romney-Ryan Voucher Plan

A new study out today by the non-partisan Kaiser Family Foundation confirms what many have been saying for a very long time—the Romney-Ryan Medicare plan would result in six out of ten seniors paying substantially more for the same Medicare benefits they receive today.

The premium support approach to Medicare involves the government providing seniors with a set amount of money each year—pegged to the second lowest priced private health care plan available—in an effort to turn over health care for seniors to the private insurance market. While proponents of the approach believe that this will generate more competition in health care, make seniors more responsible for how they spend their health care dollars and result in less spending on seniors by the federal government, critics have argued that the sum of money the government would pay would be insufficient to cover the rising costs of health care, leaving seniors exposed to having to pay an ever growing portion of their health insurance coverage.

The Kaiser report backs up the critics.

According to Kaiser, the premium support approach (often referred to as a voucher plan) to Medicare—the hallmark of the Paul Ryan Medicare plan that has been endorsed and adopted by Governor Romney—would mean higher premium costs for more than half of beneficiaries currently enrolled in traditional Medicare—if such a program were in place today—while raising the costs for nearly all of those who participate in a Medicare Advantage program.

The study further found that the additional costs to seniors would vary from region to region, with areas of high per-capita Medicare spending seeing a cost boost for 80 percent of Medicare recipients.

While the Obama campaign was quick to trumpet the results of the study as further proof that the Romney-Ryan plan would mean dramatically higher costs to seniors when it comes to their healthcare, the Romney campaign fired back, noting that the Kaiser report says that it is not intended to model any specific proposal of either campaign.

The Romney troops are right to a point—but they somehow failed to fully quote what the Kaiser Family Foundation had to say, no doubt an inadvertent error that we shall seek to correct here—

“The analysis does not attempt to model any specific proposal, but is generally based on an approach included in House Budget Chairman Paul Ryan’s fiscal year 2013 budget plan (emphasis added), the proposal Chairman Ryan co-sponsored with Senator Ron Wyden of Oregon, and; in the plan put forward by former Senator Pete Domenici and Dr. Alice Rivlin. In the first two proposals, people who are at least 55 years old, including current beneficiaries, would be exempt from the new system. Republican presidential nominee Gov. Mitt Romney has supported a premium-support system along these lines. (emphasis added.)”

Here are the bullet points of the study results, including how you might be affected based on where you live:

  • Nearly six in 10 Medicare beneficiaries nationally could face higher premiums for Medicare benefits, assuming current plan preferences, including more than half of beneficiaries enrolled in traditional Medicare and almost nine in 10 Medicare Advantage enrollees. Even if as many as one-quarter of all beneficiaries moved into a low-cost plan offered in their area, the new system would still result in more than a third of all beneficiaries facing higher premiums.
  • Premiums for traditional Medicare would vary widely based on geography under the proposed premium support system, with no increase for beneficiaries living in Alaska, Delaware, Hawaii, Wyoming and the District of Columbia, but an average increase of at least $100 per month in California, Florida, Michigan, New Jersey, Nevada and New York. Such variations would exist even within a state, with traditional Medicare premiums remaining unchanged in California’s San Francisco and Sacramento counties and rising by more than $200 per month in Los Angeles and Orange counties.
  • At least nine in 10 Medicare beneficiaries in Connecticut, Florida, Massachusetts and New Jersey would face higher premiums in their current plan. Many counties in those states have relatively high per-beneficiary Medicare spending, which would make it more costly to enroll in traditional Medicare rather than one of the low-bidding private plans in those counties. In contrast, in areas with relatively low Medicare per-capita spending, it could be more costly to enroll in a private plan.

For those who may not follow health care policy closely, the Kaiser Family Foundation is one of the few independent think tanks that neither side of the political aisle is likely to criticize for being partisan as the organization’s record for impartiality is so well established. This would explain why the Romney campaign has chosen to attempt to distinguish the report from their plan (although there is little to distinguish the Romney-Ryan Medicare plan from the model studied by Kaiser) rather than attack the findings of the Kaiser Family Foundation report.

 

By: Rick Ungar, Contributor, Forbes, October 15, 2012

October 16, 2012 Posted by | Election 2012 | , , , , , , , , | Leave a comment

“Truth And Lies About Medicare”: Voters Can’t Believe Anything Republicans Say

Republican attacks on President Obama’s plans for Medicare are growing more heated and inaccurate by the day. Both Mitt Romney and Paul Ryan made statements last week implying that the Affordable Care Act would eviscerate Medicare when in fact the law should shore up the program’s finances.

Both men have also twisted themselves into knots to distance themselves from previous positions, so that voters can no longer believe anything they say. Last week, both insisted that they would save Medicare by pumping a huge amount of money into the program, a bizarre turnaround for supposed fiscal conservatives out to rein in federal spending.

The likelihood that they would stand by that irresponsible pledge after the election is close to zero. And the likelihood that they would be better able than Democrats to preserve Medicare for the future (through a risky voucher system that may not work well for many beneficiaries) is not much better. THE ALLEGED “RAID ON MEDICARE” A Republican attack ad says that the reform law has “cut” $716 billion from Medicare, with the money used to expand coverage to low-
income people who are currently uninsured. “So now the money you paid for your guaranteed health care is going to a massive new government program that’s not for you,” the ad warns.

What the Republicans fail to say is that the budget resolutions crafted by Paul Ryan and approved by the Republican-controlled House retained virtually the same cut in Medicare.

In reality, the $716 billion is not a “cut” in benefits but rather the savings in costs that the Congressional Budget Office projects over the next decade from wholly reasonable provisions in the reform law.

One big chunk of money will be saved by reducing unjustifiably high subsidies to private Medicare Advantage plans that enroll many beneficiaries at a higher average cost than traditional Medicare. Another will come from reducing the annual increases in federal reimbursements to health care providers — like hospitals, nursing homes and home health agencies — to force the notoriously inefficient system to find ways to improve productivity.

And a further chunk will come from fees or taxes imposed on drug makers, device makers and insurers — fees that they can surely afford since expanded coverage for the uninsured will increase their markets and their revenues.

NO HARM TO SENIORS The Republicans imply that the $716 billion in cuts will harm older Americans, but almost none of the savings come from reducing the benefits available for people already on Medicare. But if Mr. Romney and Mr. Ryan were able to repeal the reform law, as they have pledged to do, that would drive up costs for many seniors — namely those with high prescription drug costs, who are already receiving subsidies under the reform law, and those who are receiving preventive services, like colonoscopies, mammograms and immunizations, with no cost sharing.

Mr. Romney argued on Friday that the $716 billion in cuts will harm beneficiaries because those who get discounts or extra benefits in the heavily subsidized Medicare Advantage plans will lose them and because reduced payments to hospitals and other providers could cause some providers to stop accepting Medicare patients.

If he thinks that will be a major problem, Mr. Romney should leave the reform law in place: it has many provisions designed to make the delivery of health care more efficient and cheaper, so that hospitals and others will be better able to survive on smaller payments.

NO BANKRUPTCY LOOMING The Republicans also argue that the reform law will weaken Medicare and that by preventing the cuts and ultimately turning to vouchers they will enhance the program’s solvency. But Medicare is not in danger of going “bankrupt”; the issue is whether the trust fund that pays hospital bills will run out of money in 2024, as now projected, and require the program to live on the annual payroll tax revenues it receives.

The Affordable Care Act helped push back the insolvency date by eight years, so repealing the act would actually bring the trust fund closer to insolvency, perhaps in 2016.

DEFICIT REDUCTION Mr. Romney and Mr. Ryan said last week that they would restore the entire $716 billion in cuts by repealing the law. The Congressional Budget Office concluded that repealing the law would raise the deficit by $109 billion over 10 years.

The Republicans gave no clue about how they would pay for restoring the Medicare cuts without increasing the deficit. It is hard to believe that, if faced with the necessity of fashioning a realistic budget, keeping Medicare spending high would be a top priority with a Romney-Ryan administration that also wants to spend very large sums on the military and on tax cuts for wealthy Americans.

Regardless of who wins the election, Medicare spending has to be reined in lest it squeeze out other priorities, like education. It is utterly irresponsible for the Republicans to promise not to trim Medicare spending in their desperate bid for votes.

THE DANGER IN MEDICARE VOUCHERS The reform law would help working-age people on modest incomes buy private policies with government subsidies on new insurance exchanges, starting in 2014. Federal oversight will ensure a reasonably comprehensive benefit package, and competition among the insurers could help keep costs down.

But it is one thing to provide these “premium support” subsidies for uninsured people who cannot get affordable coverage in the costly, dysfunctional markets that serve individuals and their families. It is quite another thing to use a similar strategy for older Americans who have generous coverage through Medicare and who might well end up worse off if their vouchers failed to keep pace with the cost of decent coverage.

Mr. Romney and Mr. Ryan would allow beneficiaries to use vouchers to buy a version of traditional Medicare instead of a private plan, but it seems likely that the Medicare plan would attract the sickest patients, driving up Medicare premiums so that they would be unaffordable for many who wanted traditional coverage. Before disrupting the current Medicare program, it would be wise to see how well premium support worked in the new exchanges.

THE CHOICE This will be an election about big problems, and it will provide a clear choice between contrasting approaches to solve them. In the Medicare arena, the choice is between a Democratic approach that wants to retain Medicare as a guaranteed set of benefits with the government paying its share of the costs even if costs rise, and a Republican approach that wants to limit the government’s spending to a defined level, relying on untested market forces to drive down insurance costs.

The reform law is starting pilot programs to test ways to reduce Medicare costs without cutting benefits. Many health care experts have identified additional ways to shave hundreds of billions of dollars from projected spending over the next decade without harming beneficiaries.

It is much less likely that the Republicans, who have long wanted to privatize Medicare, can achieve these goals.

 

By: Editorial, The New York Times, August 18, 2012

August 20, 2012 Posted by | Election 2012 | , , , , , , , , | Leave a comment

“The Rising”: Return Of The Big GOP Medicare Lie

The participant’s in last night’s GOP presidential debate once again took the opportunity to pretend that the Affordable Care Act (“Obamacare”) put a massive dent in Medicare by cutting $500 billion from the program.

Michele Bachmann told us that “We know that President Obama stole over $500 billion out of Medicare to switch it over to Obamacare.” Mitt Romney intoned “He cut Medicare by $500 billion. This is a Democratic president the liberal, so to speak, cut Medicare.”

Yeah…except that nobody stole anything and Medicare was not cut by $500 billion.

Here are the facts:

For starters, nobody cut anything from the Medicare budget in the health care reform bill. The actions taken in the legislation are designed to slow the growth of Medicare spending without cutting benefits. Further, not one cent that would have gone to Medicare is somehow being shifted over to a program created by Obamacare (for first time readers, I readily use the term Obamacare because I believe that this name will ultimately stand as an honor to the President who made it happen.)

With respect to the infamous $500 billion, the non-partisan Congressional Budget Office has made it clear that the bulk of the projected savings will come from two primary sources—ending the subsidies to health insurance companies who offer Medicare Advantage programs and reining in the growth of payments to physicians. The remainder will, hopefully, come from cutting back on the waste and fraud that have long been rampant in the Medicare system.

Let’s begin with the Medicare Advantage program. Established via the Medicare Modernization  Act of 2003. the program—a Bush/GOP creation—was ostensibly invented to encourage Medicare beneficiaries to gravitate towards privately operated insurance programs pursuant to the theory that the private sector could do a better job of  delivering care to our seniors than the government.

I say ‘ostensibly’ because the true purpose was to create a windfall for the private insurance companies who have done so much for so long for so many Republican elected officials.

The way the script played out, the private  insurance companies said that they would only be able to paricipate in the program if, and only if, the government gave them a head start by agreeing to subsidize their “start up costs” until the year 2010.

As  a result of the deal, Medicare found itself paying, on average, an 11%  surcharge on medical services and procedures provided by Medicare Advantage plans. This was enough to guarantee the insurance providers  a tidy profit fully comprised of the government subsidies, creating one of the greatest examples of corporate welfare in the history of the nation.

Not surprisingly, the health insurers took advantage of the windfall to attract customers by offering very low premium charges, not  to mention free gym memberships, one pair of eyeglasses per year, spa treatments, zero co-pays and  assorted other benefits not available to those who opted to take their Medicare  directly from the government. And why not? The insurers don’t need to make a penny from those who were insured as each customer guarantees them an 11 percent return on any medical benefit receieved courtesy of the Medicare program. Thus, they are more than happy to offer a free toaster to anyone who agrees to sign up.

What Obamacare did was put an end to the subsidies, thereby reducing future costs to the program by billions while continuing to provide Medicare beneficiaries with the benefits promised.

By any standards, this was a no-brainer in terms of reigning in the growing costs of Medicare and creating a system that is fair to all beneficiaries.

Now, the doctors.

This gets a bit tricky and, to be honest, I don’t really believe that these savings will ever materialize.

At the heart of the discussion is a formula that was designed during the Clinton Administration called the Medicare Sustainable Growth Rate, or SGR. The approach was created in an attempt to control Medicare spending for physician services with the idea being that the yearly increase in the expense per Medicare beneficiary should be tied to the growth in GDP. Thus, when actual Medicare spending exceeds the annual target in a given year, the SGR requires that physicians, and other system providers, must take a cut in order to bring the spending back in line with the annual spending targets.

The docs, understandably, do not like the idea of taking less in their Medicare payments. As a result, Congress has been delaying the cuts for years, constantly rolling them over into the next year at which time they roll them over again and again. Were Congress to ever stop delaying the SGR cuts, the physicians would find themselves feeling the cumulative pain of the delays with a one time Medicare rate reduction in excess of 20 percent.

These cuts are factored into the Medicare savings projections, along with hoped for savings to come by encouraging physicians to try some different approaches to practicing medicine.

Will this ever happen? Probably not.

So, while a skeptic can argue that these projected savings may never materialize, one cannot argue that this is, somehow, a cut to the Medicare program.

The bottom line is that there is nothing in the ACA that takes anything away from Medicare beneficiaries, now or in the future. Yet, the GOP continues to do its best to scare the hell out of seniors, the most reliable voter block in the nation.

We need to take this very seriously.

If the 2010 elections taught us anything, it is that a frightened voter  population will do some crazy things. So, it’s on us to make sure that our grandparents and parents understand that Repubican fear peddlers are selling nothing but lies and that falling for the lies could result in the end of Medicare as we know it if the Republicans are permitted to gain full control of the government.

If you would like more information on this to share with family and friends, just let me know. The effort to mislead our senior citizens worked well in 2010. We simply cannot permit it to work again in 2012.

 

By: Rick Ungar, Mother Jones, September 13, 2011

September 13, 2011 Posted by | Affordable Care Act, Class Warfare, Congress, Conservatives, Consumers, Democrats, Elections, GOP, Health Care Costs, Health Reform, Ideologues, Ideology, Medicare, Middle Class, Politics, Public, Republicans, Right Wing, Tea Party, Uninsured, Voters | , , , , , , , , | Leave a comment

Medicare Saves Money: Ensuring Health Care At A Cost The Nation Can Afford

Every once in a while a politician comes up with an idea that’s so bad, so wrongheaded, that you’re almost grateful. For really bad ideas can help illustrate the extent to which policy discourse has gone off the rails.

And so it was with Senator Joseph Lieberman’s proposal, released last week, to raise the age for Medicare eligibility from 65 to 67.

Like Republicans who want to end Medicare as we know it and replace it with (grossly inadequate) insurance vouchers, Mr. Lieberman describes his proposal as a way to save Medicare. It wouldn’t actually do that. But more to the point, our goal shouldn’t be to “save Medicare,” whatever that means. It should be to ensure that Americans get the health care they need, at a cost the nation can afford.

And here’s what you need to know: Medicare actually saves money — a lot of money — compared with relying on private insurance companies. And this in turn means that pushing people out of Medicare, in addition to depriving many Americans of needed care, would almost surely end up increasing total health care costs.

The idea of Medicare as a money-saving program may seem hard to grasp. After all, hasn’t Medicare spending risen dramatically over time? Yes, it has: adjusting for overall inflation, Medicare spending per beneficiary rose more than 400 percent from 1969 to 2009.

But inflation-adjusted premiums on private health insurance rose more than 700 percent over the same period. So while it’s true that Medicare has done an inadequate job of controlling costs, the private sector has done much worse. And if we deny Medicare to 65- and 66-year-olds, we’ll be forcing them to get private insurance — if they can — that will cost much more than it would have cost to provide the same coverage through Medicare.

By the way, we have direct evidence about the higher costs of private insurance via the Medicare Advantage program, which allows Medicare beneficiaries to get their coverage through the private sector. This was supposed to save money; in fact, the program costs taxpayers substantially more per beneficiary than traditional Medicare.

And then there’s the international evidence. The United States has the most privatized health care system in the advanced world; it also has, by far, the most expensive care, without gaining any clear advantage in quality for all that spending. Health is one area in which the public sector consistently does a better job than the private sector at controlling costs.

Indeed, as the economist (and former Reagan adviser) Bruce Bartlett points out, high U.S. private spending on health care, compared with spending in other advanced countries, just about wipes out any benefit we might receive from our relatively low tax burden. So where’s the gain from pushing seniors out of an admittedly expensive system, Medicare, into even more expensive private health insurance?

Wait, it gets worse. Not every 65- or 66-year-old denied Medicare would be able to get private coverage — in fact, many would find themselves uninsured. So what would these seniors do?

Well, as the health economists Austin Frakt and Aaron Carroll document, right now Americans in their early 60s without health insurance routinely delay needed care, only to become very expensive Medicare recipients once they reach 65. This pattern would be even stronger and more destructive if Medicare eligibility were delayed. As a result, Mr. Frakt and Mr. Carroll suggest, Medicare spending might actually go up, not down, under Mr. Lieberman’s proposal.

O.K., the obvious question: If Medicare is so much better than private insurance, why didn’t the Affordable Care Act simply extend Medicare to cover everyone? The answer, of course, was interest-group politics: realistically, given the insurance industry’s power, Medicare for all wasn’t going to pass, so advocates of universal coverage, myself included, were willing to settle for half a loaf. But the fact that it seemed politically necessary to accept a second-best solution for younger Americans is no reason to start dismantling the superior system we already have for those 65 and over.

Now, none of what I have said should be taken as a reason to be complacent about rising health care costs. Both Medicare and private insurance will be unsustainable unless there are major cost-control efforts — the kind of efforts that are actually in the Affordable Care Act, and which Republicans demagogued with cries of “death panels.”

The point, however, is that privatizing health insurance for seniors, which is what Mr. Lieberman is in effect proposing — and which is the essence of the G.O.P. plan — hurts rather than helps the cause of cost control. If we really want to hold down costs, we should be seeking to offer Medicare-type programs to as many Americans as possible.

By: Paul Krugman, Op-Ed Columnist, The New York Times, June 12, 2011

June 13, 2011 Posted by | Affordable Care Act, Congress, Conservatives, Consumers, Economy, GOP, Government, Health Care, Health Care Costs, Health Reform, Ideologues, Ideology, Insurance Companies, Lawmakers, Medicare, Politics, Public Health, Republicans, Right Wing, Seniors, Single Payer, Under Insured, Uninsured | , , , , , , , , , , , , , | 1 Comment

Seniors, Are You Paying Attention To Paul Ryan’s Medicare Plan?

Tea Party members who railed against health care reform because of the spin they were sold about how “Obamacare” would affect Medicare played a big role in returning the House of Representatives to Republican control.

I’m betting that many of them, if they’re paying attention to what Rep. Paul Ryan (R-Wisconsin), wants to do to the Medicare program, are having some serious buyer’s remorse. If Democrats are wise, they’re already drafting a strategy to remind Medicare beneficiaries, including card-carrying Tea Party members, just how fooled they were into thinking that Republicans were the protectors of the government-run program they hold so dear.

As a speaker at an especially contentious town hall meeting during the summer of 2009, I saw firsthand just how many senior citizens were snookered about how reform legislation would alter Medicare. Shortly after I testified before Congress about how the insurance industry was conducting a behind-the-scenes campaign to influence public opinion about reform, Rep. Bill Pascrell (D-New Jersey) invited me to share my perspective as a former insurance industry insider at his September 3, 2009, town hall meeting at Montclair State University.

More than 1,000 people had crammed into the school’s auditorium, not so much to hear the speakers as to express their opinions. Reform opponents were on one side of the auditorium, and reform advocates were on the other side. I had to shout just to be heard above the insults the groups were hurling at each other. Many of the reform opponents were carrying signs that read, “Hands Off My Medicare!” They clearly had bought the lie that the Democrats planned to dismantle the program.

There was no doubt in my mind that the insurance industry was the original source of that lie. While insurers liked the part of reform that would require all Americans not eligible for Medicare or Medicaid to buy coverage from them, they did not like the provision that would eliminate the overpayments the federal government has been paying private insurers for years to participate in the Medicare Advantage program, which was created when Republicans controlled both chambers of Congress in the late 1990s.

A little history: A provision of the Balanced Budget Act of 1997, written primarily by the insurance industry and backed by House Speaker Newt Gingrich and Senate Majority Leader Trent Lott, gave Medicare beneficiaries the option of getting their benefits through private insurers. Republicans envisioned this as the first step toward the total privatization of Medicare.

The Insurance Industry’s Government Favor

The problem was that insurers were reluctant to jump in unless they could be assured of a substantial profit. To get them to market Medicare Advantage plans, the government agreed to give them a big bonus. As a result, we the taxpayers now pay private insurers 14 percent more than the per-patient cost of the traditional Medicare program. These overpayments have contributed significantly to the record profits insurance companies have been posting in recent years, even though only 22 percent of people eligible for Medicare have bought what they’re selling.

The insurers were not able to keep the Democrat-controlled Congress of 2010 from eliminating those bonuses when they passed the Affordable Care Act. The law will indeed reduce future Medicare spending — not benefits — by an estimated $500 million over the next 10 years in a variety of ways, one of which is to stop overpaying insurers. This means that they will not get an extra $136 billion that they — and their shareholders — had been counting on, and they’re really bummed about that.

Knowing they fare much better when the GOP is running things on Capitol Hill, they devoted millions of the premium dollars we paid them to help elect more Republicans to Congress.

An Insurer-Funded Misinformation Campaign

The insurers funneled millions of dollars to their business allies and front groups in an effort to convince the American public that the Democrats wanted to cut Medicare benefits. Not only is that not true, but the new law actually adds an important new benefit and greatly improves another. For the first time, Medicare now pays for preventive care. And the law closes the hated “doughnut hole” in the Medicare prescription drug program.

But thanks to the success of the insurer-funded misinformation campaign, many seniors went to the polls last November convinced that the Democrats not only had created death panels in the Medicare program, they had also slashed their benefits.

The insurance industry funneled $86 million to the U.S. Chamber of Commerce to pay for TV ads that charged that the new law would “cut Medicare.” Also joining in on the campaign of lies was the 60 Plus Association, a group that, according to the Washington Post, AARP and other sources, has received the lion’s share of its funding over the years from the pharmaceutical industry and other special interests.

The 60 Plus Association ran TV ads in numerous congressional districts last fall against Democrats who had voted for the reform law. The ads were amazingly effective. Most of the Democrats they targeted lost.

The irony, of course, is that the GOP had no intention of preserving Medicare as seniors have known it since it was created more than 45 years ago. Ryan’s plan to reduce the deficit — which was approved by the House last week — would complete the privatization of Medicare that insurers and their Republican allies have been plotting for years.

The Republican Effort to Kill Medicare: a Losing Proposition

Ryan wants to give Medicare beneficiaries a voucher they can use to get coverage from a private insurance company. Initially, the vouchers would enable beneficiaries to get coverage comparable to what they have today. But the value of the vouchers would diminish over time. The Congressional Budget Office predicts that 65-year-olds would be paying 68 percent of their Medicare coverage costs by 2030, compared with 25 percent today.

What this means is that almost all Medicare beneficiaries would eventually be woefully underinsured, just as an estimated 25 million younger Americans already are and just as most of the nation’s elderly — the ones who could afford coverage at all — were before Medicare was enacted in 1965. (Most senior citizens had no health coverage before Medicare because insurance companies refused to sell it to them. That’s why it was so urgently needed.)

Ryan’s plan is a losing proposition for just about every American who lives long enough to qualify for Medicare benefits, but it is the business model that insurance firms have been dreaming of for years. It would enable them to reap profits that would make their earnings today pale by comparison.

If Democrats have any hope of keeping control of the Senate and regaining the House, they better be able to explain what’s really going on in ways that even the Tea Party seniors will understand. If I were a Democratic strategist, I would be ordering enough “Hands Off My Medicare” signs to blanket the country.

By: Wendell Potter, Center for Media and Democracy, April 18, 2011

April 18, 2011 Posted by | Affordable Care Act, Budget, Congress, Conservatives, Deficits, Democrats, Economy, Elections, GOP, Government, Health Care, Health Care Costs, Health Reform, Insurance Companies, Medicaid, Medicare, Pharmaceutical Companies, Politics, Public Opinion, Rep Paul Ryan, Republicans, Seniors, Tea Party, U.S. Chamber of Commerce | , , , , , , , | Leave a comment

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