“Lest We Forget”: Medicaid, Not Medicare Is Biggest Target For Conservatives
At the risk of sounding like a broken record on this subject, I devoutly hope that in their rush to tie Mitt Romney to Paul Ryan’s Medicare proposal, progressives don’t forget that there has never been much space between the two running-mates on the national health care program Ryan’s budget would really destroy: Medicaid. Wonkblog’s Suzy Khimm has a reminder today:
Paul Ryan’s Medicare overhaul may be the most controversial part of his budget.But the proposed cuts to the program are not the biggest cuts in the plan.
As Ezra notes, Ryan’s cuts to Medicare “are only 60 percent as large as the cuts to Medicaid and other health-care programs.” What’s more, his biggest change to Medicare wouldn’t kick in until 2023—the start date for his voucher-based premium support program. By comparison, Ryan’s cuts to Medicaid are more drastic, and they start sooner: Between 2013 and 2022, it would make nearly $1.4 trillion in cuts to Medicaid that “would almost inevitably result in dramatic reductions in coverage” as well as enrollment, according to the non-partisan Kaiser Family Foundation.
Over the next 10 years, the Ryan plan would cut Medicaid by $642 billion by repealing the Affordable Care Act and by $750 billion through new caps on federal spending—a 34 percent cut to Medicaid spending over the next decade, according to Edwin Park of the Center and Budget and Policy Priorities.
Who would that impact? First, by overturning the ACA, the Ryan plan would prevent 11 million people from gaining Medicaid coverage by 2022, according to the Congressional Budget Office’s latest estimates….
If states maintained their current level of spending for each Medicaid patient, 19 million more people would have to be cut from the program in 2021 because of Ryan’s block-grant reform, according to the Kaiser Family Foundation. If states managed to curb health-care spending growth in Medicaid, 14 million beneficiaries would still lose Medicaid coverage under the Ryan plan. And that’s on top of the 11 million Americans who would lose Medicaid coverage because the Ryan plan would repeal Obamacare. So all in all, Ryan’s cuts could mean as many as 30 million Medicaid beneficiaries lose their coverage.
Yeah, yeah, I know, old folks vote and in the last two cycles a majority have voted Republican, and po’ folks don’t vote so much, and far more already vote Democratic. But Lord a-mighty: 30 million people potentially losing their health insurance because Romney and Ryan think they need to show more moral fiber. Given Romney’s support for the entire Ryan Budget, that doesn’t even get into the damage wreaked on efforts to help the poor escape from total dependence on cash assistance or private charity by the combined cuts to Medicaid, food stamps, and the earned income tax credit that budget contemplates. And on top of all that, many millions of indigent seniors depend on Medicaid for nursing home care.
So before progressives decide to devote all their time to endless arguments over exactly which term to use for what the Ryan Budget proposes to do to Medicare—vouchers, cost-shifts, abandonment, abolition-of-Medicare-as-we-know it—don’t forget about Medicaid. That’s the Great Society safety net program with the biggest bullseye painted on it.
By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, August 13, 2012
“Phony Hawkery”: Paul Ryan Is A Conservative Ideologue Who Couches “Right Wing Social Engineering”
This is something that other people have mentioned, and Jamelle brings up in his extremely helpful post about Paul Ryan, but it really needs to be emphasized: Paul Ryan is not a “deficit hawk.” No matter how many times the news media tell us, it doesn’t make it true. As I’ve said before, you can’t call yourself a deficit hawk if the only programs you want to cut are the ones you don’t like anyway. Show me someone who’s willing to cut programs he favors (Ryan isn’t), and would actually take potentially painful measures to balance the budget (Ryan wouldn’t), and that’s a deficit hawk. Ryan, on the other hand, is a conservative ideologue who couches what Newt Gingrich appropriately called “right-wing social engineering” in a lot of talk about making tough choices. But I’ve never actually seen Paul Ryan make a “tough” choice, at least one that was tough for him. There’s nothing “tough” about a conservative Republican who tells you he wants to slash Medicare and Medicaid, increase defense spending, and cut taxes for the wealthy. That’s like Homer Simpson telling you he’s making the tough choice to skip the salad and eat three dozen donuts instead.
But oh boy, have the media ever bought into the idea of Ryan as the courageous budget-cutter. “A Beltway Budget Hawk Gets a Chance to Sell Vision” says The Wall Street Journal. “Paul Ryan: Hawk on Budget and Tea Party Darling” says the Philadelphia Inquirer. “We know Paul Ryan is a budget hawk. But what about other issues?” says the Christian Science Monitor. And that’s just a few headlines; there are hundreds of stories referring to Ryan as a “fiscal hawk,” a “budget hawk,” and a “deficit hawk.”
So why does he get described this way so often? I think it’s because the establishment media have become devoted to a particular narrative, which says that the country is deeply threatened by the future growth of Social Security and Medicare, and anyone who has the “courage” to propose cuts to those programs is a hero (Time‘s Michael Grunwald did an excellent examination last year of all kinds of people weirdly praising Ryan’s courage). And even if, like Ryan, you also want to slash taxes and increase the deficit, you’re still a hero.
It’s strange how you never see the members of the congressional Progressive Caucus, who want to cut defense spending and bring in more tax revenues than Ryan does, described as “deficit hawks,” or, heaven forbid, “courageous.” Representative Jan Schakowsky, for instance, put out a plan that balances the budget in a much shorter amount of time than Paul Ryan’s plan, but does so primarily through a combination of tax increases and defense cuts. Nobody calls Schakowsky a “deficit hawk” or praises her “courage” on fiscal issues, even though her proposal is far more realistic and less cruel than Ryan’s. Could it have something to do with the fact that your average Washington 1 percenter actually thinks slashing programs for the poor and cutting taxes for the wealthy is a smashing idea?
By: Paul Waldman, Contributing Editor, The American Prospect, August 13, 2012
“A Suspension Of Intellectual Honesty”: Mitt Romney And Paul Ryan’s Medicare Hypocrisy
On the matter of Medicare, Mitt Romney’s campaign seems to have adopted the approach that the best defense is a good offense. And while it should come as no surprise that their attacks require a degree of shamelessness and a suspension of intellectual honesty, the scope of it is breathtaking.
When the former Massachusetts governor tapped House Budget Committee Chairman Paul Ryan as his running mate, he immediately took ownership of Ryan’s biggest liability, that he proposed to replace Medicare, the Great Society-era program which guaranteed health coverage for senior citizens, with a voucher-based program of the same name. The vouchers would cover a diminishing portion of seniors’ healthcare costs and they’d be on the hook for the balance. The fundamental promise of Medicare would be gone.
Understandably, this proposal is unpopular, especially among senior citizens (though he exempts current Medicare beneficiaries from his proposal). So how has the Romney campaign elected to deal with this political problem? Going on offense, of course.
Obama, Romney and the GOP has started charging, “robbed” Medicare to pay for his health reform program. It’s true that Obamacare cut Medicare reimbursements (not benefits). That would be a clean political hit attack but for one small problem the Romney-Ryan team has: Ryan’s budget keeps those $700 billion in cuts. Oh, and Romney has endorsed Ryan’s budget.
If that sounds confusing, here it is more simply: Romney and Ryan are condemning Obama for Medicare cuts that they both endorse. Like I said, it’s pretty breathtaking.
But wait, there’s more.
As The New Republic’s Jonathan Cohn writes:
The most significant difference between the two sides, at least for the short- to medium-term, is how they handle the savings these cuts generate. Obamacare puts the money back into the pockets of people who need help with their medical bills. A portion of the money is earmarked for children and non-elderly Americans, who, starting in 2014, will become eligible for Medicaid or receive tax credits to offset the cost of private insurance. A smaller, but still significant, portion of the money is for seniors. It helps them pay for prescription drugs, by filling the “donut hole” in Medicare Part D coverage. It also eliminates out-of-pocket costs for annual wellness visits, some cancer screenings, and other preventative services.
Ryan’s budget—which, again, Romney has repeatedly embraced and said he would sign—actually takes those new benefits away. The Part D donut hole would open back up. Access to free preventative care would vanish. And where would Ryan and Romney put the money instead? They say it’s for deficit reduction. I’d say it’s really for their big new tax cuts, which disproportionately benefit the wealthy.
If nothing else, the Romney-Ryan campaign has an impressive level of chutzpah.
BY” Robert Schlesinger, Washington Whispers, U. S. News and World Report, August 13, 2012
“Hallmark Doublespeak”: With VP Selection, Romney Now Won’t Take A Stand On Paul Ryan’s Budget
It’s only been a few hours since Mitt Romney announced House Budget Chair Paul Ryan as his running mate, but the Republican presidential candidate is already distancing himself from Ryan’s signature policy achievement.
In what appears to be an early attempt to deflect criticism about Ryan’s controversial budget plans, Romney’s aides circulated an internal memo to reporters this morning that lays out talking points for how the campaign plans to address the Ryan budget.
The whole memo is worth a read, but here is the part that addresses the budget (emphasis added):
1) Does this mean Mitt Romney is adopting the Paul Ryan plan?
- Gov. Romney applauds Paul Ryan for going in the right direction with his budget, and as president he will be putting together his own plan for cutting the deficit and putting the budget on a path to balance.
- Romney’s administration will go through the budget line by line and ask two questions: Can we afford it? And, if not, should we borrow money from China to pay for it?
- Mitt Romney will start with the easiest cut of all: Obamacare, a trillion-dollar entitlement we don’t want and can’t afford.
- Mitt Romney also laid out commonsense reforms that will make good on our promises to today’s seniors and save Social Security and Medicare for future generations.
2) Mitt Romney and Paul Ryan have different views on some policy areas – like Medicare spending, entitlement reform, labor, etc. – do you think those differences are going to hurt or help?
- Of course they aren’t going to have the same view on every issue. But they both share the view that this election is a choice about two fundamentally different paths for this country. President Obama has taken America down a path of debt and decline. Romney and Ryan believe in a path for America that leads to more jobs, less debt and smaller government. So, while you might find an issue or two where they might not agree, they are in complete agreement on the direction that they want to lead America
On the surface, this just looks like a feeble effort to mitigate the political risk of being associated with Ryan’s budget, which proposes drastic cuts in federal spending and a dramatic overhaul of popular entitlement programs, including Medicare.
But these proposals are the reason why conservatives and Democrats are both psyched about the Ryan V.P. pick. So Romney’s attempt to simultaneously embrace Ryan’s fiscal policy record and disavow his signature fiscal policy just sounds like more of his campaign’s hallmark doublespeak.
In reality, however, this is really the only position that Romney could or should be expected to take on Ryan’s budget proposals. As we have pointed out before, no one has ever thought the Ryan Budget was going to become a law. It has always been a political document, laying out a new ideological framework for the Republican Party, which, in the wake of the 2008 financial crisis, found that it had lost its way on fiscal policy.
It would be unreasonable to ask Romney to rigidly adhere to someone else’s budget manifesto, and it makes sense that he would want to form his own plan, consistent with his own ideas about the economy and fiscal policy.
The problem is that we have no clue what those ideas are. So in the absence of details about Romney’s own budget plan, it seems fair to tie him to the only proposal available — that of his V.P.
By: Grace Wyler, Business Insider, August 11, 2012
“Mitt Is Not His Own Man”: Romney’s Stunning Terrible Choice Of Paul Ryan
Paul Ryan? Really? It’s a stunning choice. A terrible one too. By making it, Mitt Romney tells America that he is not his own man and hasn’t even the remotest fleeting desire to be his own man. He is owned by the right wing. Did I write a couple of weeks ago that Romney was insecure? Well—Q.E.D.
Ryan will immediately become the flashpoint of this campaign. Yes, he’ll get the usual soft-focus biographical rollout. Expect Republicans to talk endlessly about his authenticity, his blue-collar roots, the fact that he once drove an Oscar Mayer weiner truck—and, certainly, his Catholicism. Also, his brains. He’s a smart guy, no doubt of that, although as I’ve written many times, it says something deeply pathetic about the GOP that Ryan has managed to become a star just because he’s bothered to learn policy.
So he’ll get some good press, and he’ll generate great enthusiasm among conservative intellectuals. But the introduction of him to the American people will inevitably involve some other things, too. It will involve explanations from the media that he is the GOP’s archconservative theoretician. It will involve explaining who Ayn Rand is. It will involve going into detail on his budget, and in particular his plans for Medicare. Learn that now, folks, if you don’t know it already. It will involve endless interpretations exactly like mine, about Romney sending a signal that he is running an ultraconservative campaign. The Ryan controversy will overtake the campaign. Romney will become in some senses the running mate—the ticket’s No. 2.
Think of it: The candidate will be running on his vice president’s ideas! It’s a staggering thought. Ryan might as well debate Obama this October, and Romney can square off against Biden.
And in this light, it’s what this choice says about Romney that is most interesting. Romney had to know all this. He had to accept, privately and internally, the arguments one hears that he’s a boring white guy who excites no one. And he had to accept the reality that he still, after flip-flopping on a half-dozen key issues and doing so much pandering, hasn’t koshered himself up with the right.
So, you’re Mitt Romney. You’re sitting there in your hotel suite alone at midnight. You’re thinking about this choice. After plowing through the angles about this state and that state and each person’s plusses and minuses, you think to yourself, “But I have to make the choice that I want to make, a choice that says something about me.” And yet, at the crucial moment, you recoil from it. You’re afraid to do that. Doing that might upset The Wall Street Journal’s editorial page or Bill Kristol, and goodness, that can’t be. It’s deeply craven.
Democrats are celebrating. Are they overdoing it? Ryan is smart. He’ll hold his own on the trail. He’ll talk about the fiscal cliff coming at the end of the year, and he’ll probably make as credible a case as any conservative can make that Obama won’t make the “tough choices” and Republicans will. And don’t forget that he has a grudge against Obama personally, ever since that George Washington University speech of Obama’s in April 2011 when he invited Ryan—and made the guy sit there and listen to the president of the United States trash him. That’s probably a motivator. And the Democrats might overplay their hand. That’s always a temptation when the target is as big and juicy as Ryan is.
So Democrats will have to be smart. They should show respect for Ryan for being a serious guy, but then just explain to people, urgently but not over-heatedly, what he’s proposed. It’s just very hard to imagine that middle-of-the-road voters want harsh future cuts to Medicare, massive tax cuts for the rich, and huge reductions to domestic programs that most swing voters really don’t hate. Does this choice work in Florida, with all those old people? If Romney just sacrificed Florida, he’s lost the election already.
And why? To placate a party that doesn’t even want him as its nominee anyway. It’s psycho-weird. But at least it will carry the benefit, if this ticket loses, of keeping conservatives from griping that they lost because their ticket was too moderate. Conservatism will share—will own—this loss.
Is all that “daring”? Well, Thelma and Louise were “daring” too, but they ended up at the bottom of a canyon. If the Democrats handle this situation properly, that’s where this ticket will end up too, and then the rest of us—the people who don’t want federal policy to be based on Atlas Shrugged—can finally and fully press the case to the right that America is not behind you, and please grow up.
By: Michael Tomasky, The Daily Beast, August 11, 2012
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