Ryan strikes Democrats with 3rd plan for Medi­care

House GOP faces up to sticky elec­tion is­sue

The Washington Times Daily - - Front Page - BY PAIGE WIN­FIELD CUN­NING­HAM

A year af­ter House Repub­li­cans mis­fired on their plan to over­haul Medi­care, they’re go­ing right back at it in the bud­get they pro­posed Tues­day, tweak­ing the de­tails but sig­nal­ing their will­ing­ness to en­gage in a po­lit­i­cal bat­tle over en­ti­tle­ment re­form — even in an elec­tion year.

It’s the third such GOP plan in the past month to try to change Medi­care, and it runs smack into the White House and con­gres­sional Democrats, who say the GOP is tan­gling with an is­sue that will cost them votes in Novem­ber.

The plan in­tro­duced Tues­day came from House Bud­get Com­mit­tee Chair­man Paul Ryan, who re­vised key el­e­ments of his Medi­care plan from last year, but still pro­poses hav­ing the fed­eral pro­gram com­pete with pri­vate plans and giv­ing se­niors a voucher to choose the plan they like.

“If we al­low en­ti­tle­ment pol­i­tics — fear that your ad­ver­saries will turn your re­forms into a po­lit­i­cal

weapon used against you, and we cow to that — then Amer­ica is go­ing to have a debt cri­sis,” the Wis­con­sin Re­pub­li­can said.

Medi­care is the fastest-grow­ing large en­ti­tle­ment pro­gram and could eclipse So­cial Se­cu­rity spend­ing by 2040, far out­strip­ping the fund­ing sources Congress has ded­i­cated to it.

All sides agree that it needs changes — a task that de­mands rais­ing taxes, cut­ting ben­e­fits or some com­bi­na­tion of the two. But Repub­li­cans and Democrats are strug­gling to find any com­mon ground over how to make it sus­tain­able.

In­stead of do­ing away en­tirely with fee-for-ser­vice Medi­care, as his plan sug­gested last year, Mr. Ryan pro­poses main­tain­ing the tra­di­tional plan while al­low­ing pri­vate plans to com­pete in an ex­change where se­niors could use vouch­ers to se­lect from a num­ber of op­tions. Those cur­rently younger than 55 would par­tic­i­pate in the sys­tem start­ing in 2023, while the plan wouldn’t change things for cur­rent se­niors.

Mr. Ryan un­veiled the plan in De­cem­ber along with Sen. Ron Wy­den, Ore­gon Demo­crat, and on Tues­day he in­cluded it in his 2013 bud­get pro­posal, on which he will ask his House col­leagues to vote.

Other Repub­li­cans also have tried to tackle the is­sue, though those plans — one led by Sen. Tom Coburn of Ok­la­homa, and an­other last week by four Re­pub­li­can sen­a­tors, led by Sen. Rand Paul of Ken­tucky — have yet to win any Demo­cratic back­ing.

A ma­jor dif­fer­ence is over how much to cut Medi­care spend­ing, with Mr. Ryan propos­ing spend­ing $205 bil­lion less on the en­ti­tle­ment pro­gram over 10 years than what Pres­i­dent Obama had sug­gested. Mr. Ryan’s plan would hold Medi­care spend­ing to 4.75 per­cent of gross do­mes­tic prod­uct by 2050, down from the likely sce­nario of 7.25 per­cent pro­jected by the Con­gres­sional Bud­get Of­fice.

Mr. Obama, in his 2013 bud­get, pro­posed cut­ting $ 267 bil­lion from Medi­care over a decade.

An­other key stick­ing point is how to curb Medi­care costs. Repub­li­cans ar­gue that they have a bet­ter strat­egy than Democrats.

In Mr. Ryan’s vi­sion, plans in the new ex­change would com­pete an­nu­ally to de­ter­mine the dol­lar amount of the sub­sidy se­niors could use to pur­chase cov­er­age, with the sec­ond least ex­pen­sive pri­vate plan or fee-for-ser­vice Medi­care — which­ever is cheaper — to be used as a bench­mark.

If se­niors chose a more ex­pen­sive plan, they would be re­spon­si­ble for pay­ing the dif­fer­ence, while those se­lect­ing a less-ex­pen­sive plan would be awarded a re­bate. Growth would be capped at GDP plus 0.5 per­cent in case the bid­ding failed to con­tain costs.

Democrats blasted the plan, say­ing it would shift costs to se­niors.

“In­stead of strength­en­ing Medi­care, the House bud­get would end Medi­care as we know it, turn­ing the guar­an­tee of re­tire­ment se­cu­rity into a voucher that will shift higher and higher costs to se­niors over time,” White House spokesman Dan Pfeif­fer said.

House Mi­nor­ity Leader Nancy Pelosi, Cal­i­for­nia Demo­crat, said Mr. Ryan’s plan would let Medi­care “wither on the vine” and vowed that Democrats would de­feat it.

“The Amer­i­can peo­ple have al­ready re­jected this plan be­fore, and this year will be no dif­fer­ent,” Mrs. Pelosi said. “Amer­i­cans’ pri­or­i­ties are clear: Repub­li­cans must work with Democrats to pre­serve and strengthen Medi­care, not dis­man­tle it.”

But Repub­li­cans pre­dict that the ap­proach taken un­der Mr. Obama’s health care law will se­verely un­der­cut the pro­gram, push­ing doc­tors out of Medi­care by cut­ting their pay­ments. Un­der the law, ap­pointed mem­bers of the In­de­pen­dent Pay­ment Ad­vi­sory Board will rec­om­mend cuts to keep costs in check — an ap­proach Repub­li­cans say gives un­elected ap­pointees too much power.

“It doesn’t make any dif­fer­ence what you call it, the fact of the mat­ter is, the board is in place that will deny pay­ment for ser­vices to se­niors,” said Rep. Tom Price, Ge­or­gia Re­pub­li­can. “Se­niors know that’s wrong.”

Tremors also have been com­ing from the Se­nate in re­cent weeks, in­di­cat­ing that Repub­li­cans in­tend to put Medi­care front and cen­ter this year.

Sens. Richard Burr, North Carolina Re­pub­li­can, and Tom Coburn, Ok­la­homa Re­pub­li­can, in­tro­duced Medi­care re­form in Fe­bru­ary that is sim­i­lar to the Ryan plan, although it would speed up im­ple­ment­ing the com­pet­i­tive bid­ding and pre­mium sup­ports to 2016.

Last week, Mr. Paul, along with fel­low Re­pub­li­can Sens. Mike Lee of Utah and Jim Demint and Lind­sey Gra­ham, both of South Carolina, in­tro­duced a plan to end the tra­di­tional feefor-ser­vice and en­roll se­niors in the same health care pro­gram used by fed­eral em­ploy­ees while grad­u­ally rais­ing the el­i­gi­bil­ity age. De­pend­ing on their in­come lev­els, se­niors would re­ceive sub­si­dies cov­er­ing up to 75 per­cent of their plans.

AS­SO­CI­ATED PRESS

House Bud­get Com­mit­tee Chair­man Paul Ryan, Wis­con­sin Re­pub­li­can, in­tro­duced a plan Tues­day to over­haul Medi­care that pro­poses hav­ing the fed­eral pro­gram com­pete with pri­vate plans.

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