GOP split on Paul Ryan's Medicare overhaul

Greenbeard · Apr 19, 2015

Sounds like the GOP House may still be ready to charge ahead with Paul Ryan's controversial Medicare plan but antsy Republicans in the GOP-controlled Senate are demurring. Understandable, given that it's not a particularly easy sell.

GOP split on Medicare overhaul

Congressional Republicans are divided on whether to push forward with an overhaul of Medicare long championed by Rep. Paul Ryan (R-Wis.).

The House budget includes Ryan’s proposal to convert Medicare into a premium support system in 2024, giving new beneficiaries the option of enrolling in private insurance.

Republicans have long seen Medicare reform as a key ingredient in getting Washington’s spending under control, and are under pressure now that they control both chambers of Congress to put their beliefs to the test.

The problem is that Senate Republicans must defend 24 seats in 2016 to keep their majority, and they are not excited about jumping into a battle with Democrats over a sensitive entitlement program ahead of the election, particularly when President Obama might veto the proposal in the first place.

Sen. Lindsey Graham (R-S.C.) insisted he’s “up for” reforming Medicare, but said Senate Republicans are unlikely to embrace the House’s plan.

“I think that might be difficult to get through our conference,” said Graham, a possible presidential candidate next year. “Probably some people disagree with the concept [and] some people are up for reelection.”

Sen. Rob Portman (R-Ohio), who could face a difficult re-election race against former Gov. Ted Strickland (D-Ohio) next year, also deferred on the Ryan plan.

He said he wants to stick with the Senate’s budget proposal, which would find $430 billion in Medicare savings requested by Obama, but leave the traditional program intact.

“My sense is the Senate approach — which takes the president’s number on Medicare and then provides flexibility to the authorizing committees of jurisdiction — is the way the Senate would like to go,” Portman said.

“That’s the way I would prefer to go because I think that enables the committees to be able to do their work, hopefully on a bipartisan basis.”

fmw · Apr 19, 2015

Greenbeard said:
Sounds like the GOP House may still be ready to charge ahead with Paul Ryan's controversial Medicare plan but antsy Republicans in the GOP-controlled Senate are demurring. Understandable, given that it's not a particularly easy sell.

GOP split on Medicare overhaul

Politics will win out over common sense. Nothing will happen.

reinoe · Apr 19, 2015

Republicans are cowards. If it really needs to be done they'll do it and face the consequences because they'll be vidicated over time. That's the difference between Dems and Reps...

Dems passed the ACA, and though it wasn't perfect they did it and faced the consequences. They'll be vindicated over time because at least they tried to fix a problem.

Reps back down from reforming Social Security because they're two faced cowards and would rather maintain power than push anything controversial. Even if the Medicare reforms aren't perfect at least they could stand up and say they made a difference.

Objective Voice · Apr 20, 2015

reinoe said:
Republicans are cowards. If it really needs to be done they'll do it and face the consequences because they'll be vidicated over time. That's the difference between Dems and Reps...

Dems passed the ACA, and though it wasn't perfect they did it and faced the consequences. They'll be vindicated over time because at least they tried to fix a problem.

Reps back down from reforming Social Security because they're two faced cowards and would rather maintain power than push anything controversial. Even if the Medicare reforms aren't perfect at least they could stand up and say they made a difference.

I share your opinion here.

I'll give Paul Ryan credit. At least he's brave enough - not to mention persistent - to try and tackle one of this country's long-term liability issues head-on. I think if given the option more people would opt to enroll in a private health insurance plan rather than stay with Medicare provided the health benefits they receive will be less costly. I'm talking prescription medications, routine examines including blood test and annual checkups, surgeries and long-term hospital stays. Right now, the cost of all the routine stuff tends to increase while patients are being gouged for their long-term care. Without price constraints, no reforms to Medicare will be effective.

Still, Paul Ryan gets an "A" for effort, bravery and persistence for at least putting forward a plan of some sort and not being afraid that his political clout will suffer.

Greenbeard · Apr 20, 2015

Objective Voice said:
I'll give Paul Ryan credit. At least he's brave enough - not to mention persistent - to try and tackle one of this country's long-term liability issues head-on.

I don't think there's any great political risk for him to advance this concept; quite the opposite. The only time it might've been a liability (when he was on the presidential ticket) he distanced himself from it.

And he still refuses to admit the obvious: the design is borrowed from the ACA, as are the Medicare savings needed to bridge the present and the implementation date a decade from now. Because that would offend his patrons on the right. Hardly a model of political bravery.

Objective Voice · Apr 20, 2015

Greenbeard said:
He [Paul Ryan] still refuses to admit the obvious: the design is borrowed from the ACA, as are the Medicare savings needed to bridge the present and the implementation date a decade from now. Because that would offend his patrons on the right. Hardly a model of political bravery.

Explain...which ACA provision mirrors Ryan's Medicare reform proposal? (Not doubting you, just curious. I've read a good portion of the ACA; maybe I missed something.) Also, any idea where I can read a draft of his bill?

Greenbeard · Apr 20, 2015

Objective Voice said:
Explain...which ACA provision mirrors Ryan's Medicare reform proposal? (Not doubting you, just curious. I've read a good portion of the ACA; maybe I missed something.) Also, any idea where I can read a draft of his bill?

Ryan supports the creation of a Medicare exchange--a regulated marketplace in which competing plans are subject to a set of common rules of the road--and a market-determined defined premium contribution provided by the federal government that a beneficiary can apply to the private plan of her choice.

The Medicare recipient of the future would choose, from a list of guaranteed-coverage options, a health plan that best suits his or her needs. This is not a voucher program. A Medicare premium-support payment would be paid, by Medicare, directly to the plan or the fee-for-service program to subsidize its cost.

Moreover, it would set up a carefully monitored exchange for Medicare plans. Health plans that chose to participate in the Medicare Exchange would agree to offer insurance to all Medicare beneficiaries, to avoid cherry-picking, and to ensure that Medicare’s sickest and highest-cost beneficiaries receive coverage.

The structure is that established for private insurance markets under the ACA. The difference is that Ryan's Medicare exchanges have a public option (traditional fee-for-service Medicare) competing with private plans. Other than they're conceptually the same thing.

Hatuey · Apr 20, 2015

Republicans aren't going to mess with Medicare. It's their bread and butter with Florida's geriatric population and election season is right around the corner.

Objective Voice · Apr 20, 2015

Greenbeard said:
Ryan supports the creation of a Medicare exchange--a regulated marketplace in which competing plans are subject to a set of common rules of the road--and a market-determined defined premium contribution provided by the federal government that a beneficiary can apply to the private plan of her choice.

The structure is that established for private insurance markets under the ACA. The difference is that Ryan's Medicare exchanges have a public option (traditional fee-for-service Medicare) competing with private plans. Other than they're conceptually the same thing.

He'd been better off picking up the CLASS Act that the former Sec., HHS threw out and tweaking it alittle. His plan would pretty much do the same thing except his would set a date far out in the future where those who eligible for Medicare would be given a choice - stay with the government supported health care or switch to a private health plan. At least under the CLASS Act, participants could start using their health benefits after paying into the system for the first five years. That in itself was a big drawback, but allowing those 18-26 yrs old to remain on their parents health insurance policy was the killer. Dust off the CLASS Act and tweak it alittle and you'd have a decent Medicare reform package.

GOP split on Paul Ryan's Medicare overhaul

Rule of Two