Ryan targets Medicare, but GOP unsure
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.