“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
“Medicaid Is the Real Target”: Mitt Romney’s Priorities, Aid For The Rich, Paid For By The Poor
Since August, when Mitt Romney chose Paul Ryan as his running mate, the two campaigns have fought a fierce battle over who is the most stalwart protector of Medicare. In the first presidential debate, Romney assailed President Obama for his $716 billion in Medicare cuts, and Ryan did the same in last week’s vice presidential face-off. Likewise, the Obama campaign has hit Team Romney for the Ryan plan and its Medicare “premium support”—which, if implemented, would gradually replace traditional Medicare with subsidized, regulated private insurance.
The irony is that—in the short term, at least—Medicare will stay unchanged, regardless of who wins the election. Seniors are among the most mobilized voters in the electorate, and there’s too much political risk involved in making big, immediate changes to Medicare. For that reason, Medicare reform plans on both sides are backloaded and will take time to unfold.
The same isn’t true of Medicaid, the other major federal health-care program. The primary constituency for Medicaid—poor and working-class families—lacks the clout and influence of seniors. And while the Obama administration expanded the program in the Affordable Care Act, it has also made Medicaid a ripe target for conservative cuts to social insurance.
This means that, as Mother Jones’ Kevin Drum pointed out last week, Medicaid, not Medicare, is the actual flashpoint in this election. Romney has promised to “block grant” the program, giving states more flexibility in dealing with eligibility and benefits. Some states would use this as an opportunity to innovate. But as Drum notes, just as many would use it as an excuse to drop health coverage for poor people:
Lots of states, especially poor states in the South, don’t have much interest in experimenting. They just want to slash eligibility for Medicaid. Given the freedom to do it, they’d adopt what Ed Kilgore calls the “Mississippi model,” cutting off coverage for a family of three earning anything over $8,200. For all the talk of fresh thinking and new solutions, what they really want to do is simple: They want to stop providing medical care for poor people.
Admittedly, this is a little speculative. It’s possible—albeit, unlikely—that a future governor of South Carolina or Alabama might want to use the new flexibility to improve services for lower-income people. With that in mind, it’s also worth noting the extent to which Romney’s block-grant plan involves a massive cut to overall Medicaid spending. The Center on Budget and Policy Priorities finds that with a Paul Ryan-style block grant in place, overall Medicaid spending would decline by one-third over the next decade. When you put this in the context of Romney’s budget proposals—which include new defense spending and a promise to protect Medicare—and his promise to repeal the Affordable Care Act, the result is a $1.5 trillion reduction in Medicaid spending by 2022. These cuts would add an additional 14 to 19 million people to the ranks of the uninsured, on top of the 30 million people who would lose coverage as a result of full Obamacare repeal.
It’s his approach to Medicaid, more than anything else, that reveals Mitt Romney’s priorities—aid for the rich, paid for by taking relief from the poor.
By: Jamelle Bouie, The American Prospect, October 15, 2012
“Uncle Will At Your Service”: Marriott Is Mainstay For The Romney campaign
On the campaign trail, Mitt Romney incessantly talks about his “five points” to get the country moving again, but the only points anyone traveling with the GOP nominee is interested in are Marriott points.
The candidate has made the hotel chain the semi-official innkeeper of his presidential campaign. From Iowa to Ohio to New York City, Romney has wheeled his carry-on bag into Marriott lobbies and passed the omnipresent portrait of J. Willard Marriott and his son, John Willard “Bill” Marriott Jr. — a Romney contemporary, fellow Mormon scion and, along with his brother, a donor of more than $1 million to the Republican’s effort.
The Romneys and Marriotts go way back. J. Willard was a dear friend of Mitt’s father, George, with whom he sold tamales in Washington during the Depression Era. Forty years later, J. Willard Marriott asked his namesake Willard Mitt Romney, a young consultant with Bain & Co., to help with his Roy Rogers fast-food chain. But Bain prevented those at the firm from working for any client who employed their chief competitor, McKinsey & Co., which Marriott did. Or from working in a peripheral part of the business, which Roy Rogers was.
Romney had to call up “Uncle Will” — as he called him — to decline the work, according to Mike Farmer, who accompanied Romney on the sales trip.
But Romney, who once sat on the Marriott board, has stayed loyal to the Marriott empire. And now so has the phalanx of campaign operatives, television producers, camera operators and reporters, checking in behind the candidate with corporate cards in hand. (On Sunday, the Obama campaign press corp was also camped out at a Courtyard Marriott in Williamsburg.)
“It’s our home away from home,” said Rick Gorka, a spokesman for the Romney campaign. “We’ve converted a lot of press.”
To build brand loyalty and try to beat the competition, Marriott rewards guests with lodging’s version of frequent flyer miles for each stay. A steady accumulation of Marriott points bestows first silver, then gold and finally platinum status, each precious metal coming with its own precious perks.
“I’m platinum,” Gorka said proudly as he swirled a large glass of bourbon on the back of the press plane. Having spent at least 150 nights in Marriott hotels since January and racked up a half-million points, he spoke reverentially about the “Taste of Platinum” program. He became almost misty discussing the time the West Palm Beach Marriott upgraded him to a two-bedroom condo with balcony, hot tub, washer and dryer. He said he daydreamed about a prolonged, free stay in a perhaps tropical destination with his girlfriend, who eagerly monitored his point total back home. “Points,” he said, “are gold for us.”
On his way back toward the front of the plane, Gorka hovered over the aqua-blue screen of a reporter’s laptop. She was gazing at the crystalline waters surrounding Marriott’s Scrub Island Resort, Spa & Marina in the Virgin Islands. “It’s a new Marriott, autograph collection” she explained to Gorka. “It’s on a private island, 52 rooms on the marina. It looks amazing.”
“Let me know if you go,” Gorka said.
The day had started, as so many of them do, with Romney staffers and Romney press corps members climbing out of their Marriott mattresses and picking at eggs in a private breakfast room off the lobby, this time of the Columbus Airport Marriott. One of the camera crew interrupted the breakfast of one of the embedded television reporters to ask, “Are you triple platinum now?”
“Oh, yeah,” she responded matter of factly. “I, like, lived in the Marriott New Hampshire. I have 200 free nights.”
It came time to board the bus, and a circle of cameramen discussed the finer points of Marriott points, saying things like “mega bonus.”
“Have you enrolled in the platinum challenge?” one asked this reporter, who had a lowly silver status. He described an alchemy by which every two-night stay results in a free night in another Marriott. As long as it isn’t too high end, interjected a colleague, “Only category three or four, not five.”
The press then loaded onto the bus, following Romney as he campaigned around the state. Then they boarded the plane, flew with him to Boston and boarded another bus to bring them to their hotels. As the coach rolled toward the entrance of the Courtyard Marriott in Waltham, one of the embedded network producers shouted to no one in particular: “Why don’t we stay at the Westin out here? Why does the Marriott own our souls?”
By: Jason Horowitz, The Washington Post, October 14, 2012
“Mitt Romney The Product”: A New Romney Appears On A Monthly, Weekly And Sometimes Daily Basis
As he tries to engineer a comeback in this week’s presidential debate, President Obama needs to recognize two things. First, when it comes to politics, Mitt Romney treats himself as a product, not a person. Second, Republicans cannot defend their proposals in terms that are acceptable to a majority of voters.
You can imagine Romney someday saying: “Politicians are products, my friend.” There’s no other way to explain why a candidate would seem to believe he can alter what he stands for at will. His campaign has been an exercise in identifying which piece of the electorate he needs at any given moment and adjusting his views, sometimes radically, to suit this requirement.
In that respect, Romney does Richard Nixon one better. When Nixon was looking to revive his career in the 1968 campaign, the terribly scarred veteran of so many political wars realized his old persona wouldn’t sell. And so he created what came to be known as the “New Nixon” — thoughtful, statesmanlike and tempered. The operation worked until Nixon’s old self got him into trouble.
But manufacturing the New Nixon took years of painstaking effort. New Romneys appear on a monthly, weekly and sometimes daily basis. Thus did Romney move far to the right on immigration last year because he needed to dispatch nomination rival Rick Perry, a moderate on that one issue. Since then, Romney has been trying to backtrack to appease Latino voters.
During the same nomination battle, Romney abruptly changed his tax policy to placate the supply-side-Wall-Street-Journal-Grover-Norquist axis in the GOP. Romney’s initial tax proposal was relatively modest. The right wasn’t happy. No problem, said Romney, and out came his new tax plan that included a 20 percent cut in income tax rates, “rate cuts” being a term of near-religious significance to supply-siders.
Romney pointedly asserted (again, in the primaries) that he wanted the tax cut to go to everyone, “including the top 1 percent.” But this doesn’t sell to swing voters now, especially after the leaked video in which Romney wrote off 47 percent of Americans as incorrigibly dependent. So in the first debate, Romney tried to pretend that he didn’t want to cut rich people’s taxes. He reassured us that “I’m not going to reduce the share of taxes paid by high-income people.” (By the way, he could cut taxes for the rich a lot and still keep their “share” of the government’s overall tax take the same.)
And then there’s abortion, an issue about which you have to wonder if Romney cares at all. Without much effort, you can find video online in which Romney declares with passion and conviction that he is absolutely committed to a woman’s right to choose — and video in which he declares with equal passion and conviction that he is absolutely opposed to abortion and committed to the right to life. Just recently, Romney moved again, offering this shameless gem of obfuscation to the Des Moines Register editorial board: “There’s no legislation with regards to abortion that I’m familiar with that would become part of my agenda.” There is no candidate I am familiar with who has tried to have as many positions on abortion in one lifetime as Mitt Romney.
But there’s an underlying reason for Romney’s shape-shifting. It’s the same reason Rep. Paul Ryan always resorts to impressive-sounding budget speak and mathematical gobbledygook to evade explaining the impact of his budgets on actual human beings.
Romney, Ryan and the entire right know that their most deeply held belief — the one on which they won’t compromise — is rejected by the vast majority of Americans. That’s their faith that every problem in the economy and in society can be solved by throwing more money at rich people through tax cuts.
Vice President Biden kept Ryan on the defensive during most of Thursday night’s debate precisely because he refused to let anything distract him from driving this central point home. Without pause and without mercy, Biden kept bringing viewers back to the obsession of the current Republican Party with “taking care of only the very wealthy.”
Obama doesn’t have to look angry or agitated in this week’s debate. He simply needs to invite voters to see that Romney, the product, will give them no clue as to what Romney, the person, might do as president. Romney keeps changing the packaging because he knows that the policies inside the box are not what voters are looking for.
By: E. J. Dionne, Jr., Opinion Writer, The Washington Post, October 14, 2012
“Pilfering The Federal Treasury”: Mitt Romney’s Medicaid Shell Game
Mitt Romney is lambasting federal aid in his campaign for the presidency, including derisive comments against those who receive government assistance. But he pulled all the stops to pursue federal aid as governor of Massachusetts, even hiring “revenue maximization” contractors to scour federal programs for every possible penny — and using financial schemes to maximize and then divert the aid from his needy constituents.
In his first budget proposal, Romney promised balancing the budget without tapping reserves, and “without the use of fiscal gimmicks.” However, buried in the details, he suggested tapping reserves such as taking $4 million from the Catastrophic Illness in Children Relief Fund, and he included fiscal gimmicks to maximize and divert federal aid into his general state coffers.
His strategies are akin to tax schemes using offshore bank accounts — but instead of avoiding federal taxes, seeking to pilfer the federal treasury. The Wall Street Journal labeled such financing mechanisms “Medicaid Money Laundering” and a “swindle.”
Medicaid is a matching grant program. If a state with a 50 percent match rate like Massachusetts spends $50 on qualifying services, the federal government will provide an additional $50 so there is $100 total for Medicaid services. The federal match payment is much higher in some states, such as Mississippi where its almost 75 percent.
Unfortunately, some states concocted budget shell games, often with private consultants, providing an illusion of state spending to claim federal matching funds, when no state spending has occurred. As governor of New Hampshire, Judd Gregg developed such a practice labeled “Mediscam.” Gregg taxed hospitals serving the poor, routed the money into an “uncompensated care fund” which he sent right back to the hospitals, and used the round-trip of money to claim federal matching funds. Then, the swindle gets worse, because he routed the federal Medicaid funds into his general coffers rather than for Medicaid services.
Romney’s schemes were similar to Gregg’s. Buried in his 2004 budget, Romney proposed maximizing federal aid by taxing hospitals, shifting the resulting tax payments in and out of an uncompensated care fund, back to hospitals as adjustment payments, and diverting resulting federal Medicaid funds to state general revenue. He also proposed using taxes on nursing homes and pharmacies in his efforts to maximize and divert federal aid.
In such strategies, health care facilities serving the poor are used to claim federal funds to help the poor. But the health care facilities and the poor may get nothing, as the state diverts the federal aid to general coffers — and revenue maximization contractors reap millions in contingency fees. Romney used such private companies to help carryout his strategies.
After a US General Accounting Office report responding to concerns of Republican Senator Charles Grassley, the Romney administration vigorously defended using contingency-fee revenue maximization consultants and revenue practices – that the GAO labeled illusory. The GAO responded that “hospitals should benefit from increased federal reimbursements and Massachusetts’s arrangement appeared to result in lower payments to hospitals, despite increased claims for federal reimbursement.” The Romney administration even defended double (if not quadruple) billing practices “of allowing multiple agencies to bill Medicaid” for “services for the same beneficiary.” The GAO concluded that the Romney administration “did not provide convincing evidence that the [Medicaid] services provided by the four state agencies were unique,” and the Bush administration agreed with the GAO’s conclusions.
The Bush administration implemented regulations trying to reduce such practices, and the Obama administration continues efforts to improve fiscal integrity in the Medicaid program. However, Romney would virtually end federal oversight by block-granting federal Medicaid funds to states.
It’s not hard to imagine how a governor — one that employs complex shell games to find loopholes in federal rules in order to maximize and divert federal aid — would use the federal funds if handed to the state without any federal oversight. The answer to state misuse of federal aid is not to give those states even more discretion to do whatever they wish – but to simplify the claiming process, reduce loopholes allowing the revenue schemes, and improve oversight to ensure Medicaid funds are used as intended.
Romney has undergone dramatic and hard to follow shifts in his apparent views of government aid. Romney2004 proposed cutting healthcare while simultaneously proposing illusory schemes to maximize and divert federal Medicaid funds. Romney2006 changed course with the first nearly universal healthcare plan. Now Romney2012 is turning back to cuts, denouncing federal aid he once schemed to maximize and divert, condemning those who need government aid, and seeking repeal of national health care reform that is nearly identical to the plan he signed into law. And now he proposes giving all the federal money from the Medicaid program to states without federal control.
Romney2004 would have a field day with Romney2012’s plan.
By: Daniel L. Hatcher, Law Professor, University of Baltimore, Published in The Boston Globe, October 12, 2012
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