KHN Morning Briefing

Summaries of health policy coverage from major news organizations

Politics Heat Up In Response To GOP Budget’s Medicare, Medicaid Proposals

The blueprint advanced by House Budget Committee Chairman Paul Ryan, R-Wis., would attempt to rein in the long-term costs of Medicare and Medicaid while squeezing $6.2 trillion dollars from the nation's deficit over the next 10 years.

Kaiser Health News provides excerpts from the GOP "Path To Prosperity" regarding its Medicare and Medicaid provisions, as well as links to the complete GOP budget document, summary information, comparison tables and President Obama's 2012 budget for the Department of Health and Human Services. KHN also has a resource page with proposals and other information on curbing Medicare cost growth.

Reuters: "U.S. Republicans on Tuesday proposed $6 trillion in spending cuts over a decade, including a politically risky overhaul of government-run health programs, while also slashing tax rates as part of their 2012 budget blueprint. The budget proposal comes as Congress and President Barack Obama are arguing over the 2011 budget -- six months into the fiscal year -- and trying to avoid a government shutdown Friday when money runs out" (Sullivan, 4/5).

The Wall Street Journal: "The budget proposal stands little chance of becoming law, since it would have to be approved by the Democratic-controlled Senate and signed by Mr. Obama, and, among other things, it would repeal Mr. Obama's signature health-care law. It would make fundamental changes to Medicare and Medicaid and reduce spending on the government health-insurance programs. ... Democrats, based on early reports of the budget's contents, portrayed it as an extreme document, dedicated to dismantling the protections government has provided the lower- and middle-class for decades, while declining to make businesses pay their fair share" (Bendavid, 4/5).

Kaiser Health News: "House Budget Committee Chairman Paul Ryan, R-Wis., left many details to Congress when he unveiled Tuesday his plan to make major changes to Medicare as part of a fiscal 2012 budget resolution. He says his overall objective is to convert Medicare into a premium support program for which the government will spend a specific amount for beneficiaries' care, a fundamental shift from the current fee-for-service program. Backers of premium support say it is similar to the health insurance program for federal workers but others say it may not meet seniors' needs. Insurers are eager for the additional business but wonder if payments will be adequate to cover the cost of care" (4/4).

MSNBC: "Over age 54? You needn't worry about the proposal [Ryan] unveiled Tuesday for a redesign of Medicare. Under age 54? You'll need to pay a bigger share of the cost of your medical care once you're retired. Ryan's remake of Medicare would save as much as $285 billion a year by 2030, and would mean less federal spending on medical care in future decades for today's workers and their children" (Curry, 4/5).

The New York Times: "Congress and the White House veered toward a fiscal collision on Tuesday as the Obama administration rejected a short-term House Republican demand to cut $12 billion now in exchange for keeping the government open for one more week. At the same time, the Republicans' budget chairman set forth a longer-range blueprint defining a new era of profoundly smaller government. ... Republicans made clear they had no intention of backing down on more cuts in current year spending and would frame the fight over next year's budget in similar terms. Their long-term proposal also included changes in mandatory entitlement programs like Medicare and Medicaid. ... Representative Chris Van Hollen, ranking Democrat on the House Budget Committee, called it a 'rigid ideological agenda that extends tax cuts to the rich and powerful at the expense of the rest of America'" (Steinhauer and Hulse, 4/5).

MarketWatch: "By presenting a plan to lock in spending cuts, replace Obama's health-care law and allow new Medicare beneficiaries to choose private plans, Republicans say they're leading where the president has failed... Democrats attacked the Ryan plan in a preview of the policy tug-of-wars to come. 'The American people won't be fooled by your rhetoric, Mr. Chairman. The GOP budget eliminates guaranteed benefits for seniors under Medicare and slashes support for seniors, children, and Americans with disabilities on Medicaid,' said a statement from House Democratic Leader Nancy Pelosi's office" (Schroeder, 4/5).

Los Angeles Times: "The budget outlined by budget committee chairman Rep. Paul Ryan (R-Wis.) takes considerable political risks -- particularly in its proposal to remake Medicare and Medicaid, the core of the social safety net for the poor and elderly. But Ryan also passes on other politically dicey solutions to reducing deficits and debt. His plan all but dodges changes to Social Security, an area Ryan acknowledged Tuesday was more ripe for bipartisan agreement. ...  Ryan freely admits he's taking a sizable gamble - and dragging his party along with him - by going after entitlements, a proven American political minefield" (Hennessey and Oliphant, 4/5).

CBS News Political Hotsheet: Ryan "is knowingly taking a big political gamble by introducing a 2012 federal budget today that proposes to dramatically transform Medicare and Medicaid. ... It's a risky proposal politically, given Medicare's overwhelming popularity, but Ryan and the GOP are prepared to argue the changes are necessary. ... [He] says his budget 'fixes the flaws in Medicare and Medicaid that have made rising costs nearly impossible to check.' [But] liberal economists like Dean Baker argue that Ryan's plan 'does nothing to address our broken health care system while virtually guaranteeing that most seniors will not be able to afford decent health care'" (Condon, 4/5).

The Washington Post: Democrats responded. "'Behind the sunny rhetoric of reform,' Rep. Chris Van Hollen (D-Md.), the senior Democrat on the House Budget Committee, said in a statement, 'the Republican budget represents the rigid ideological agenda that extends tax cuts to the rich and powerful at the expense of the rest of America.' ... However, Republicans emerging from a morning meeting with House leaders Tuesday said they were united behind the Ryan plan. They argued that voters sent Republicans to Washington to rein in spending, even if that means cutting cherished programs for the poor and the elderly" (Montgomery and Rucker, 4/5).

McClatchy/Miami Herald: "[Ryan's] committee will begin writing legislation Wednesday to incorporate his ideas, and the full House is expected to consider his proposal next week. But its prospects are dim in the Democratic-controlled Senate, and as details have trickled out, Democrats and liberal interest groups have blasted the blueprint" (Douglas and Lightman, 4/5).

USA Today On Politics: " [I]n an e-mail this morning, House Minority Leader Nancy Pelosi's office says the GOP's 'rhetoric doesn't match reality.' The Democratic leader contends the 'paths' as outlined by Ryan will eliminate guaranteed benefits for seniors on Medicare, reduce support for low-income people and those with disabilities on Medicaid, and cut education benefits (Camia, 4/5).

Politico: "Republicans are betting ... that there is finally enough public support for general deficit reduction - thanks to voters' alarm over the surge in federal spending of the last few years - that they'll be able to shield themselves from any backlash over cuts in the major federal health programs" Nather, 4/5).


In addition, here's a summary of news coverage prior to the official announcement:

The Wall Street Journal: Ryan's Plan For Medicare Is Huge Bet By GOP (Weisman, 4/4).

The New York Times: GOP Blueprint Would Remake Health Policy (Pear, 4/4).

The Associated Press: Obama, Boehner To Talk Budget Cuts At White House  (Taylor, 4/5).

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