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“Are These People On Drugs”: House GOP Apparently Wants To Be Even More Unpopular Than It Already Is

With the July 4 holiday behind them, House members might be expected to take up work on the immigration reform bill passed by the Senate. But they won’t. They’re looking at piecemeal reforms that will be heavier on border enforcement than the Senate bill – which doubled the number of border control agents, after the border control budget already doubled in size in the last decade — and even nuttier ideas.

Instead the House GOP is apparently making big plans for another debt ceiling hostage-taking, and this time they’ve got a strategy to demand big budget cuts from President Obama and the Democrats. According to the National Journal, House leaders are working on a “menu” of budget-slashing offers to Obama in exchange for lifting the debt ceiling for a short, medium or long period of time. Their template is Rep. Paul Ryan’s budget – the budget so unjust and biased against the poor that the U.S. Conference of Catholic Bishops took time out from restricting women’s rights to criticize the Ryan plan.

House members reluctantly voted to raise the debt ceiling in January promising to come back with a strengthened hand on behalf of budget cuts next time around (which will probably be the end of this year). So House Speaker John Boehner is reportedly meeting with Ryan and other conservatives like Louisiana Rep. Steve Scalise, who boasted about their talks to the National Journal. The key points:

For a long-term deal, one that gives Treasury borrowing authority for three-and-a-half years, Obama would have to agree to premium support. The plan to privatize Medicare, perhaps the most controversial aspect of the Ryan budget, is the holy grail for conservatives who say major deficit-reduction can only be achieved by making this type of cut to mandatory spending. “If the president wants to go big, there’s a big idea,” said Rep. Steve Scalise, chairman of the Republican Study Committee.

For a medium-sized increase in the debt-limit, Republicans want Obama to agree to cut spending in the SNAP food stamp program, block-grant Medicaid, or tinker with chained CPI.

For a smaller increase, there is talk of means-testing Social Security, for example, or ending certain agricultural subsidies.

…Even at the smallest end of the spectrum — another months-long extension of debt-limit — there is talk of pushing back the eligibility age for Social Security by an equal number of months.

Are these people on drugs? These are wildly unpopular ideas that have no chance of passing the Senate. (“Republicans are eager to look like they are giving the White House plenty of options, convinced that it is in their interest to appear engaged and flexible at the negotiating table,” the NJ’s Tim Alberta reports, apparently unironically.) Unfortunately, the president himself has come out behind the chained CPI, but given the enormousness of House GOP demands and delusion, he’s unlikely to get much for that concession. So one cheer for House GOP delusion.

Scalise seems to be the main source for the National Journal story, and you can imagine other members wincing at his clueless bluster. Not surprisingly, Scalise starred in another story today about the Obama team’s belief it will see some congressional movement on both immigration reform and the economy this summer. Not so fast, Scalise told the Washington Post: “We’re going to continue to be very aggressive in serving as a check and balance against the Obama administration. That’s what the country said in November. We’re very far apart.”

It’s interesting to note that Paul Ryan is key to these debt-ceiling strategy talks, according to the National Journal, when he’s also supposed to be key to comprehensive immigration reform. To his credit, Ryan has come out for something along the lines of the Senate bill, but the question is whether he’ll expend any political capital getting other members to join him. So far, he hasn’t. It looks like another round of debt-ceiling hostage taking is a higher priority for him.

Ironically, the fact that the deficit is falling faster than at any time since World War II is helping drive the House GOP’s extremism – they have to go for big, slashing cuts, because the deficit is already shrinking. Here’s hoping the extremism of the House GOP’s opening salvo will remind the Obama administration not to waste its time on another attempt at a “grand bargain” on deficit reduction.


By: Joan Walsh, Editor at Large, Salon, July 8, 2013

July 10, 2013 Posted by | Debt Ceiling, GOP | , , , , , , , | 3 Comments

“The Obamacare Referendum”: Paul Ryan Is Using Shorthand Again In Selling Changes To Medicare

Did you know that on November 6, 2012, in conjunction with the national election, the United States also had a referendum on Obamacare that Republicans won? No, I didn’t, either, until Paul Ryan informed me of this, via this Think Progress report:

On Sunday morning, Rep. Paul Ryan (R-WI) stopped by Fox News Sunday to preview his new budget, which will be released in full on Tuesday. As it had the past two years, this year’s version will call for massive cuts to social service programs, including food stamps, job training, Medicaid, and Medicare. Host Chris Wallace challenged Ryan on the viability of his plan, pointing out that he wants to repeal and replace Obamacare, and, “that’s not going to happen.”

Still, Ryan insisted that he and then-running mate Mitt Romney won the election on this issue because they “won the senior vote.”

Now I think we all understand that Ryan is using some shorthand here: many Democrats hoped, and Republicans feared, that Ryan’s budget, by proposing to change Medicare from an entitlement to publicly-provided health insurance into a premium-support system, would make his party vulnerable to losses it could not manage in its old-white-folks electoral base. Instead, by a variety of means (including over two years of insanely mendacious “death-panel” demagoguery about the impact of Obamacare on Medicare, and the systematic “grandfathering” of seniors from Ryan’s proposed Medicare changes), the GOP ticket managed to promote a health care message that nicely meshed with its overall pitch to old white folks that those people along with their atheist hippie allies were threatening to take away everything good virtuous retirees had worked so hard to secure for themselves, including Medicare (which they tend to regard as an earned benefit as opposed to Obamacare’s “welfare”).

I suppose it’s understandable that Ryan would view any success in selling big changes in Medicare to old folks would represent a political ten-strike, even if he’s now having to incorporate into his budget the same Medicare savings he implicitly attacked during the campaign as a token of Obamacare’s ultimate goal of sending seniors off to euthanasia camps. But it’s still bizarre that he’s touting an incumbent president’s re-election victory as a repudiation of his most important legislative accomplishment. It’s enough to give Dick Morris hope he can come back from ridicule and disgrace and claim he was right all along in predicting a big Romney-Ryan win.


By: Ed Kilgore, Contributing Writer, Washington Monthly Political Animal, March 11, 2013

March 11, 2013 Posted by | Medicare | , , , , , , , | Leave a comment

“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

PolitiFact’s Pants On Fire For Choosing “Ryan Will End Medicare” As “Lie Of The Year”

This morning, PolitiFact announcedthat the Democrats’ charge that Rep. Paul Ryan (R-WI) budget will end Medicare is the biggest lie of the year — even though it’s 100 percent true!

Here is why: Ryan’s plan ends traditional fee-for-service program and forces all future retirees to ultimately enroll in private coverage.

Under his proposal, beginning in 2022, people turning 65 will receive a pre-determined “premium support” payment to purchase private insurance. Insurers will offer a basic package of benefits, but traditional Medicare — the program that President Lyndon Johnson enacted in 1965 — will literally stop enrolling new beneficiaries. Rather than paying health care providers directly — and using its market clout to secure better bargains and other efficiencies for enrollees —  the government would now pay multiple private health insurers pre-determined amounts per beneficiary to act as middle men between patients and providers.

It will no longer guarantee seniors a defined package of benefits, but will instead only offer a defined contribution towards their health care costs. As the Congressional Budget Office (CBO) analysis of Ryan’s proposal explains, “the payment for 65-year-olds in 2022 is specified to be $8,000, on average, which is approximately the same dollar amount as projected net federal spending per capita for 65-year-olds in traditional Medicare.” However every subsequent year, as health care costs increase, the government’s contribution “would grow at a slower rate,” inflation, and the age of the enrollee. By 2030, under the proposal, the premium support would “only cover 32 percent of a typical 65-year-old’s total health care spending” and would decrease every subsequent year.

PolitiFact concedes that this is, in fact, “a huge change to the current program.” But it’s more than that. Capping costs to beneficiaries, closing the traditional fee-for-service program, and forcing seniors to enroll in new private coverage, ends Medicare by eliminating everything that has defined the program for the last 46 years.


By: Igor Volsky, Think Progress, December 20, 2011

December 20, 2011 Posted by | Health Care, Seniors | , , , , , | Leave a comment

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