Sen­ate GOP shies from fight over Medi­care

57 mil­lion could be af­fected

Kuwait Times - - HEALTH & SCIENCE -

WASH­ING­TON: Con­gres­sional Democrats are warn­ing that Speaker Paul Ryan and Pres­i­den­t­elect Don­ald Trump are gun­ning for Medi­care and they are rub­bing their hands with glee at the prospect of an epic politi­cal bat­tle over the gov­ern­ment’s flag­ship health pro­gram that cov­ers 57 mil­lion Amer­i­cans.

It turns out that Repub­li­cans, es­pe­cially in the Sen­ate, are not spoil­ing for a fight. “We are not in­clined to lead with our chin,” said No. 2 Sen­ate Repub­li­can John Cornyn of Texas. “And right now, we’ve got a lot on our plate.”

Ryan, R-Wis., is the most pow­er­ful ad­vo­cate in Wash­ing­ton for a pre­mium-sup­port ap­proach that would, over time, re­make Medi­care into a voucher-like pro­gram that could force some se­niors en­ter­ing the pro­gram to buy health in­surance on the open mar­ket in­stead of get­ting cov­er­age through the tra­di­tional open-ended pro­gram. Crit­ics say such cov­er­age would take away a Medi­care guar­an­tee and give se­niors sub­si­dies whose value won’t keep up with in­fla­tion.

Medi­care cov­ers 48 mil­lion se­niors and nine mil­lion dis­abled peo­ple. Ryan, just days af­ter the elec­tion, said any leg­is­la­tion to re­place Pres­i­dent Barack Obama’s sig­na­ture Af­ford­able Care Act law would nec­es­sar­ily in­clude cuts to Medi­care and Med­i­caid. “Oba­macare rewrote Medi­care, rewrote Med­i­caid, so if you’re go­ing to re­peal and re­place Oba­macare, you have to ad­dress those is­sues as well,” Ryan told Fox News. “Those things are part of our plan to re­place Oba­macare.”

Ryan’s com­ments set off alarm bells, as did re­cent re­marks by Rep. Tom Price, R-Ga. - made be­fore be­com­ing Trump’s nom­i­nee to head the De­part­ment of Health and Hu­man Ser­vices sug­gest­ing that House Repub­li­cans are eye­ing ma­jor Medi­care cuts as early as the sum­mer. “Speaker Ryan has pushed to pri­va­tize Medi­care for years and the Pres­i­dent-elect has nom­i­nated a cham­pion of that ef­fort,” said in­com­ing Sen­ate Demo­cratic leader Charles Schumer of New York. “The peo­ple who are gen­uinely and rightly scared are mil­lions of Amer­i­can se­niors who don’t be­lieve pri­va­ti­za­tion of Medi­care will be in their in­ter­est.”

Schumer on Fri­day an­nounced a news con­fer­ence next week with lib­eral groups to de­liver more than 1 mil­lion sig­na­tures de­mand­ing that Repub­li­cans “keep their hands off” Medi­care. Over the last cou­ple of weeks, how­ever, it’s be­come clear that even House Repub­li­cans aren’t gun­ning for a big fight on Medi­care this year. “I en­vi­sion 2017 as tak­ing steps, small, in pre­par­ing for larger steps to save Medi­care for the long term,” House Ways and Means Com­mit­tee Chair­man Kevin Brady, R-Texas, said in an in­ter­view with The As­so­ci­ated Press on Thurs­day.

Re­ac­tion among Sen­ate Repub­li­cans at the prospect of ma­jor Medi­care cuts, mean­while, was al­most one of be­muse­ment. “When you take a look at the menu, that’s prob­a­bly one of the last cour­ses,” said Sen. Ron John­son, R-Wis.

Medi­care is ex­cep­tion­ally pop­u­lar, but faces ma­jor fis­cal prob­lems from an in­com­ing wave of baby boomers. While there is wide­spread agree­ment that changes are needed to shore up the pro­gram, Medi­care has an out­sized rep­u­ta­tion as a “third rail” politi­cal is­sue - touch it and you die.

Medi­care cuts were used by Democrats to help fi­nance the Af­ford­able Care Act and they are a big part of GOP prom­ises to bal­ance the bud­get. But House Repub­li­cans have never pushed Medi­care pri­va­ti­za­tion be­yond as­sum­ing it in their an­nual - but mostly sym­bolic - bal­anced bud­get plan. Sen­ate Repub­li­cans have never shown much en­thu­si­asm for the idea and it’s not even clear that the House could ac­tu­ally pass it.

“Paul Ryan, who I ad­mire tremen­dously, he’s a big thinker. He’s a big idea guy. I’m ac­tu­ally try­ing to fig­ure out, ‘How do we get it passed?’” added Cornyn, the top GOP vote counter. “The first test would be, ‘Can it pass the House?’”

Ryan’s post-elec­tion com­ments were es­pe­cially strik­ing be­cause Trump made clear in the cam­paign that he wasn’t in­ter­ested in cut­ting Medi­care. And Ryan said on Thurs­day that he hasn’t dis­cussed Medi­care with Trump him­self.

“As far as what our plans are with re­form­ing and pre­serv­ing (Medi­care), that’s just some­thing we haven’t dis­cussed yet with the ad­min­is­tra­tion and we’ll do it as the year goes on,” Ryan told re­porters. “I think it would de­pend en­tirely on how com­mit­ted the ad­min­is­tra­tion was to push­ing some sort of re­forms,” added Sen. John Thune, R-S.D. “I do think there are re­forms that you could get north of 50 (votes) on here. But I don’t know if what’s be­ing talked about (vouch­ers) is among those.”

WASH­ING­TON: In this June 7, 2016, file photo, Sen. John Cornyn, R-Texas speaks on Capi­tol Hill. —AP

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