GOP Planning Medicare/Medicaid Cuts

In an interview with The Associated Press, Republican Rep. Paul Ryan says that the GOP will “lead with their chin” and soon propose cuts to Medicare and Medicaid in an effort to balance the budget:

In a wide-ranging interview with The Associated Press, the Wisconsin lawmaker and chairman of the House Budget Committee said the House Republicans’ budget proposal for the 2012 fiscal year that begins Oct. 1 will propose fundamental changes to Medicare and Medicaid, the giant health care programs that cover 100 million Americans and whose combined costs rival the defense budget.

Ryan offered no specifics, saying details are still being hashed out…

…Endorsing reduced Social Security checks for future seniors or raising the retirement age is viewed by many Republicans as well as Democrats as political suicide without cover from President Barack Obama. And some see the effort as futile when Republicans control only the House and a presidential election just over the horizon.

Whether or not you agree with the idea that Medicare and Medicaid need to be cut, you have to give some kudos to Ryan for acknowledging that any serious attempts to balance the budget are going to require more than just soundbytes about “cutting government waste.” With that said, the political reality of what Ryan is saying can only lead to disaster for the GOP in 2012.

We’ve talked for months about how the GOP has painted itself into a corner by promising a massive budget cuts to the Tea Party. Republicans are in a no-win situation of their own creation, because following up on that promise can only be done by really angering the vast majority of voters who most certainly do not want to see cuts to Medicare, Medicaid and Social Security. And as The Huffington Post notes, any such proposal by House Republicans will almost certainly be stopped cold in the Senate, allowing Democrats to say that they saved the popular programs.

Republicans can do what they promised, making the Tea Party happy but giving Democrats an incredible message and likely ensuring defeat in a general election…or they can stay away from unpopular cuts, thus defaulting on campaign promises and risking Primary challenges from the right. Hence the old saying that “leading with your chin” is a good way to get knocked out.

26 Community Comments, Facebook Comments

  1. rocco says:

    The republicans are targeting the very demographic that won them the House in November.

    The elderly entitlement receiving teabag nation will balk when they realize that the repubs are targeting THEIR entitlements.

    Before, it was the “lazy minorities sucking off the government teet” that was the enemy.

    Teabaggers are for cuts everywhere with the exception of their entitlements.

    Then, it’s different.  

  2. Senator McConnell is now pledging that there will be no debt limit increase without cuts to Social Security, Medicare, and Medicaid.

    I almost don’t want to tell them this, but the third rail is still carrying a heck of a current.

  3. ohwilleke says:

    it has been growing dramatically, putting pressure on both state and federal budgets, and unlike Social Security, it isn’t paid for entirely with a dedicated tax and trust fund.

    Ironically, they also want to repeal health care reform, which was the biggest step to control these parts of the budget in a decade or two, and Republicans voted to expand Medicare under George W. Bush by creating Medicare Part D not long ago at all.

    The devil, of course, is that “the details are still being hashed out.”  

    These aren’t easy details at all.  I am a hard core policy wonk who understands most of the federal budget intimately, but these huge line items are virtually black boxes as far as I am concerned, and as far as most politicians are concerned, which is why the usual approach to cuts is an across the board reduction in provider rates.  

    • dwyer says:

      Let me say I don’t know what the answer is.  I receive Medicare and pay around $225 a month per person for Medicare and an absolute necessary private auxiliary policy.

      That may not seem like much, but when one is on limited income.  It is substantial….could pay more for medicare, but not much more.

      The real cost to medicaid is nursing home costs and that really becomes a middle class benefit.  Nursing homes run around $70,000 a year. If a senior exhausts all his/her assets, then Medicaid picks up that costs.  With a married couple, the non-nursing home partner gets to keep part of the couple’s assets.  

      I don’t have answers.  Long-term care insurance costs a fortune to obtain, if you are in the age range which needs to be thinking of it.

      Social Security should be taken out of the mix.  It is funded differently and is not in danger of deficit for two decades or more.

      • ohwilleke says:

        another huge problem with Medicaid is that its provider rates are much lower than those paid by private insurers or by Medicare, which makes the supply of providers willing to take on new Medicaid patients small.

  4. reubenesp says:


    As for fixing our out of control health care spending, the public will probably come around, hopefully sooner rather than later, to a realization that a single-payer system, with its massive purchasing power, is the most economical approach to cutting costs (as is now practiced throughout the developed world, except the U.S.)

    As the benefits under the President’s new health care plan gain new converts and believers, it is only a matter of time before the public will recognize that the health insurance industry model is an extraordinarily expensive and irrelevant

    player.  The system would self-insure, and therefore cut costs to protect its members, you and me.

    • BlueCat says:

      about raising the cap even though it’s the simplest thing to do and something that wouldn’t cause anyone real hardship.

      Of course Rs would oppose it but I’m getting pretty tired of Dems conceding before they even get to the bargaining table.  This idea of starting straight off by taking off the table anything they know Rs won’t like, the Obama handbook, doesn’t win and friends on the R side, ticks off the D side and sends the message that weak Dems (even when they had the trifecta, both houses and the White House) feel they have to go begging  before all powerful (even when in the minority) Rs.  No wonder Rs won’t give an inch on anything they care about no matter what polls say. They know that they can count on Dems to fold even with the public on their side in polls.

      Wisconsin Dems are teaching us that we can challenge R message hegemony by keeping media on a story for more than 15 minutes.  With extended time and pressure, more of  the public can be educated as to what is really going on.

      Without Wiscinsin Dems fighting even  though they know how to count votes (Reid’s favorite excuse for caving) nobody would know what governors in  Ohio, Michigan and Indiana were trying to do.  We wouldn’t have had the R Wisconsin majority leader on Fox admitting what the protesters have been saying all along:  It’s not about the budget. It’s about taking out unions as a political player that supports Dems, making sure Dems have less union money to spend on getting elected and reelecting Obama.  We have it now, straight from the horse’s mouth and in context.  

      The result?  Tens of thousands keeping the heat on, continuing to demonstrate for weeks, the media actually covering something other than the rightie press release, huge swings in opinion polls.  Could it be the right doesn’t have to win every message war if we don’t just roll over and let them? Dems should start talking about raising the cap and welcome the debate.  

  5. Ralphie says:

    The GOP has been trying to roll back the New Deal and the Great Society for decades.

    Yet people keep voting for them.

    Figure out that little problem and we’ll all know how to fix the big problem.  But we can’t figure it out until we figure out which button they press that gets people to repeatedly vote against their own economic self interest.

    I have a theory, but it’s reserved for future diaries.

  6. DavidThi808 says:

    We have to limit medical spending. We all have various suggestions about how to best do so, but the bottom line is the growth has to be ended. It’s not that medical inflation will become unsustainable, it has become unsustainable.

    I think this could (repeat could) turn out well for the Repubs if the country comes to understand that medical inflation has to be ended. And kudos for stepping up to address the key deficit issue.

    • davebarnes says:

      Tackle the big ones and not the silly little ones.

      Touch that 3rd rail and enjoy the charge.

      Raise co-pay.

      Reduce payments.

      No pay for anyone over the age of 100.

    • You reduce Medicare and Medicaid payments and what?  Kick people who exceed those costs out on the streets?  Back to emergency care?  Just tell them to go get private insurance?

      The Republicans aren’t offering solutions here, David, they’re offering dictates.

      Not that Democrats are stepping up and saying “fine – you want Medicare and Medicaid cuts?  Here’s a Medicare-for-all and Federal drug price negotiation powers…”, but you’ve got to be daft if you think just dictating a spending cut is going to solve the problem.

      • DavidThi808 says:

        Yes we need to figure out how to reduce medical costs. But we’ve hit the point where we can no longer keep increasing what we spend while we figure it out. We have to say we’ve hit the limit and we now must adjust based on that limit.

        Otherwise medical costs will continue to outpace inflation and destroy the economy. We’ve tried for 20 years to reduce medical inflation and it’s kept growing. I don’t see any other way to tame the beast.

        • ajb says:

          I wonder what they’ll call them?

          • DavidThi808 says:

            The bottom line is limiting spending will kill people. The present system where many are uninsured or under insured kills people. The incentives to maximize profits which leads to less effective or unnecessary treatment kills people.

            One of the big things we need to face up to is just as with everything else in life there are limits here and those limits mean you get less than the max. What makes this so touchy for healthcare is that less can directly mean a shorter life.

        • And you should know it.  I’ve provided two; there are probably dozens more on the table from Dems over the years.  You propose that we listen to the Republicans and just screw the Medicare and Medicaid patients who have paid in to the system and have no other recourse, just because we can’t get Republicans to compromise and actually reform the system?

          • DavidThi808 says:

            1. Holds medical inflation to the rate of general inflation. And

            2. Has some prayer of getting passed.

            I’m all for it. My point is I think the only way we may be able to force the tough decisions required to stop the unending growth of medical costs is to say that it is what we are paying now – and no more.

            I’m not saying the GOP approach is perfect, or even great. But I do think it’s something worth considering. Because everything else we’ve tried has not been able to control the rate of medical inflation.

            • I agree with your first point – we need to reign in costs.

              But I believe it is more valid to force Congress to come to terms with the escalating costs of these programs by keeping them intact until they’re forced to face them than it is to simply cut them and pray that we don’t kill anyone who needs a transplant a la Arizona.

        • ohwilleke says:

          to not cover some forms of medical care that have been covered entirely, rather than simply capping costs, have proven somewhat palatable politically where attempted.

          But, ultimately, no matter how much administrative cost and insurance company profit and marketing costs are trimmed, and no matter how many marginal non-core procedures are shifted out of the system, and no matter how much excess “defensive medicine” is reduced, the big issue with health care cost in the United States is that we pay our health care providers far more than any other country in the world, even relevative to per capita GDP.

          Paying nurses and doctors and drug companies and medical equipment makers, etc. less is going to be a politically explosive step, however.

    • Is there something that happens to people who do interviews on a regular basis that causes their brains to turn to mush and just blindly accept that anyone they might potentially interview must not be offended or questioned?

      If so, count me out of any job as a reporter.

      • DavidThi808 says:

        Doesn’t mean I agree with anyone I talk to. But I do try to understand their point and the logic behind it. And more often than not what I think is the best approach takes elements from every side.

        As to not offending those I interview, trust me I think everyone I’ve interviewed has been unhappy with some things I’ve said about them. Many with quite a few things 🙂

  7. Ray Springfield says:

    They don’t invest the money in the USA, anyway. It goes overseas to cheaper labor markets. We had a balanced budged and surplus under Pres.Clinton.

    We will have no infrastucture and further deaths caused by collapsing roads. We will have a less educated work force with the progression of cuts in education.

    The “reform” on Wall St still permits oil speculators to derail any recovery.

    Meanwhile the Republicans will simply blame the poor, and the Democrats will sugar coat the fact that they are just as responsible.

    Colorado is dependent on jailing people. The USA as a whole incarcerates more per capita than any other nation.

    This doesn’t sound like the land of the free.

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