Ryan tar­gets Medi­care, but GOP un­sure

The Denver Post - - NEWS - By Mike DeBonis

House Speaker Paul D. Ryan made clear Thurs­day that he is will­ing to pur­sue a ma­jor over­haul of Medi­care, in­clud­ing changes that could even­tu­ally put pri­vate com­pa­nies in charge of the health care for tens of mil­lions of Amer­i­can se­niors. But talk of whole­sale changes to the pop­u­lar fed­eral pro­grams has key GOP law­mak­ers ner­vous about over­shoot­ing their elec­toral man­date.

“Save Medi­care for another day,” said Sen. La­mar Alexan­der, R-Tenn., chair­man of the Se­nate Com­mit­tee on Health, Ed­u­ca­tion, La­bor and Pen­sions. “We want to be­gin im­me­di­ately to re­peal Oba­macare . ... Try­ing to deal with the sol­vency is­sues with Medi­care at the same time falls into the cat­e­gory of bit­ing off more than you can chew. It’s an im­por­tant is­sue, it’s one I’m ready to ad­dress, but a lit­tle hu­mil­ity here would be in or­der. We can’t do ev­ery­thing at once, and we shouldn’t try.”

Ryan has long ad­vo­cated for a ma­jor Medi­care over­haul, one that would con­vert the 50-year-old pub­lic health in­sur­ance pro­gram for se­niors and the dis­abled into a sys­tem that would help ben­e­fi­cia­ries pur­chase pri­vate in­sur­ance. Repub­li­cans tend to call such a model “pre­mium sup­port,” say­ing it is the best way to con­trol Medi­care’s costs, while Democrats re­fer to it as “voucher­iza­tion” or pri­va­ti­za­tion and ar­gue that it would mean less com­pre­hen­sive cov­er­age for vul­ner­a­ble Amer­i­cans.

On Thurs­day, Ryan re­peated com­ments he made shortly af­ter the elec­tion in­di­cat­ing that changes to Medi­care would have to ac­com­pany any ef­fort to re­peal and re­place Pres­i­dent Obama’s Pa­tient Pro­tec­tion and Af­ford­able Care Act. He spoke care­fully about how far those ef­forts might go, but he did not rule out pur­su­ing a pre­mium sup­port model for fu­ture re­tirees — a stance Ryan has held for years, dat­ing back to his days chair­ing the House Bud­get Com­mit­tee, and one that was in­cluded in his re­cent “Bet­ter Way” pol­icy agenda.

“We are go­ing to have to do things to pre­serve and shore up this pro­gram,” he said Thurs­day. “The re­forms that we’ve been talk­ing about here in the House Repub­li­cans for many years are re­forms that do not af­fect the ben­e­fits for any­one in or near re­tire­ment. But for those of us who are in the younger gen­er­a­tions, the X Gen­er­a­tion on down, it won’t be there for us if we stay on the cur­rent path. So we have to do things to fix this pro­gram so we can guar­an­tee that it’s there in­tact for cur­rent se­niors but also that there’s some­thing there for us when we re­tire.”

Those fixes, he said, “are noth­ing dif­fer­ent than what fed­eral em­ploy­ees have: You get to choose among plans that are com­pre­hen­sive and guar­an­teed to meet your ben­e­fits. Or if you want to stick with the cur­rent tra­di­tional pro­gram, you can do that as well.” Ryan com­pared his plan to Medi­care Ad­van­tage — an op­tion for se­niors where the fed­eral gov­ern­ment pays a pri­vate in­surer a flat rate for each ben­e­fi­ciary rather than di­rectly pay­ing a health care provider for ser­vices ren­dered.

Ryan also re­peated a fre­quent talk­ing point, that “Medi­care it­self is on a path to go­ing bank­rupt,” although he did not specif­i­cally blame the Af­ford­able Care Act as he has in the past. The Wash­ing­ton Post Fact Checker has con­cluded it is mis­lead­ing to say that Medi­care would go bank­rupt and flat-out in­cor­rect to blame Oba­macare, which has ex­tended the sol­vency of the key Medi­care Part A trust fund by nine years.

Newspapers in English

Newspapers from USA

© PressReader. All rights reserved.