Monday, April 18, 2011

GOP expected to back Medicare shift

By CQ Staff

House Republicans appeared likely Friday to adopt a budget resolution that calls for changing Medicare into a voucher program for future seniors — a step many consider political dynamite.

Bucking conventional wisdom, GOP lawmakers are betting voters concerned about the nation’s debt may be willing to entertain changes to the popular social insurance program, especially if those affect only the next generation. Many say that by supporting House Budget Chairman Paul D. Ryan’s framework for the fiscal 2012 budget, they are showing they are serious about making the decisions necessary to put the nation’s fiscal house in order.

“I think the country’s ripe for looking at renegotiating the Medicare promises for folks under 55,” said K. Michael Conaway, R-Texas.

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But analysts say voting for the measure (H Con Res 34), which is as good as dead in the Democratic Senate, is a risky move for Republicans. Polls consistently show that Americans do not support transforming Medicare, and a USA Today/Gallup poll on April 11 found that two-thirds of Republicans oppose the governmemt making major changes to the program.

“The Republicans are betting the whole store on that even though people don’t like particular changes, they want something big done about the deficit — and that they’re going to stick with them even though they don’t like the cuts and changes,” said Robert Blendon, professor of health policy and political analysis in the Harvard University School of Public Health.

Democrats, meanwhile, see the Ryan plan as a political opportunity. They note that voters have rejected past GOP attempts to re-envision entitlement programs, including President George W. Bush’s attempt to change Social Security to a personal account system. And they are pledging to protect Medicare.

“No plan to end Medicare as we know it will ever pass the Senate,” said Sen. Charles E. Schumer, D-N.Y. “The debate is a debate we welcome. We’ve been waiting for it. It is a debate we will win.”

Sen. Patty Murray, D-Wash., painted Ryan’s entire proposal as a way to end the program that provides health care for seniors.

“It’s a smoke screen about balancing the budget. The real goal is to kill Medicare,” Murray said.

A major part of the Republican 2010 campaign was hammering seniors with the message that Democrats were cutting Medicare and proposing “death panels” that might ration care through the health care overhaul (PL 111-148, PL 111-152).

Observers say Republicans are vulnerable to a similar line of attack in the next election. The Democratic Congressional Campaign Committee (DCCC) already has announced plans to target potentially vulnerable House GOP members. A Roll Call rating shows that more than a third of House GOP freshmen are from toss-up or Democratic-leaning districts

“If you supported that, you can expect a blizzard of mail and phone calls and emails into your district presenting you as somebody who wants to shut off the Medicare spigot,” said University of Virginia political analyst Larry Sabato.

Still, House Republicans said late Thursday they felt confident in voting for a budget framework that calls for changing Medicare from a defined-benefit to a defined contribution plan in 2022. The GOP resolution calls for giving seniors and the disabled an annual stipend that would be used to buy private insurance plans of their choice and would increase over time based on the rate of inflation. Critics say the plan would shift a greater share of health care costs to seniors over time.

Some Republicans think they can sell that as a way to preserve the program for future generations and to keep the country fiscally sound.

GOP freshman Lou Barletta said seniors in his district “were more upset about their grandchildren and the debt we were leaving them than the fact of the assistance for themselves.”

“They’re tough and they’ll handle the consequences to themselves, but don’t mess with their grandchildren,” added Barletta, who said his district has one of the biggest senior populations in Pennsylvania. Barletta is one of the Republicans on the DCCC’s list.

Analysts said the crucial, and most challenging, step for Republicans would be convincing voters that the current path would lead to ruin. “They have to paint the picture of a troubled status quo that is no longer sustainable. . . . The status quo is like something on a fault line and we’re having all these earthquakes, and the big one’s going to come,” said Mike Franc, vice president of government studies at the conservative Heritage Foundation.

Franc said that Republicans also must convince voters that there would be negative consequences for future generations if they do not act.

“If they can paint that picture successfully, then they can win this,” Franc said.

Republicans also must also underscore that Ryan’s plan would not change access to fee-for-service Medicare for existing seniors, only those born in 1957 or after.

“If you say, ‘we are going to change the Medicare program to ensure its survival, but none of those changes will affect you,’ that’s a pretty powerful message,” said Republican pollster Whit Ayers.

Of course President Obama refuted many of those arguments on April 13 when he argued the nation could honor its commitments at the same time it controls costs by taking steps to wring additional savings from Medicare.

And some question whether voters will even entertain the idea of putting Medicare on the table, predicting Republicans might vote for the Ryan proposal but then walk away from some of its more far-reaching changes.

“The whole idea of converting Medicare into a kind of voucher system is highly controversial with older voters,” Sabato said. “And it’s not a group you want to take lightly, especially if you’re a Republican.”

Observers were divided on whether Obama’s defense of Medicare hurt or helped Republicans.

Blendon argued the president offered a potentially more palatable proposal. “He gave them something that sounds like a big reduction in the deficit without those kinds of changes or cuts.”

But Ayers contended Obama punted on the big issues.

“The president’s complete unwillingness to address an obvious problem comes across as a blatant lack of leadership,” the GOP pollster said.

Those on both sides agree that Ryan’s proposal all but ensures entitlements will be an important issue during the 2012 presidential campaign.

“It’s going to be difficult for a Republican nominee not to have his or her own plan to address entitlements after the Ryan initiative,” Ayers said.


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