Posts Tagged ‘Federal budget’

Medicare Likely Safe From GOP Budget Cutters

Tuesday, May 24th, 2011

America’s senior citizens can breathe a sigh of relief.  Even as the majority Republicans in the House of Representatives wield a surgeon’s scalpel to slash spending from the federal budget, they are unlikely to succeed at making significant changes to the extremely popular Medicare program. The Democratic-controlled Senate rejected serious cuts in the proposed legislation, which also included an attempt to block implementation of the Patient Protection and Affordable Care Act.  Congressional Democrats and the Obama Administration pointed out that the Republican budget measure’s block on implementation funding would endanger short-term funding for Medicare.

The legislation would create “significant disruptions in services” to Medicare recipients, Department of Health and Human Services (HHS) Secretary Kathleen Sebelius wrote to Senator Max Baucus (D-MT).  The payment delays, Sebelius wrote, would halt the need to undertake a lengthy process to issue new regulations governing Medicare Advantage payment rates since the Patient Protection and Affordable Care Act (ACA) put in place its own set of payment rate rules.  The Congressional Budget Office’s (CBO) analysis questioned that claim because it believes that the Republican bill will reduce spending by $1.6 billion through the rest of 2011.  Democrats maintain that the CBO’s review of Medicare spending is a separate issue from HHS’s lawful authority to fund the program.

Despite the Senate Democrats’ united front, House Budget Committee Chairman Paul Ryan (R-WI) is “ready to take on health programs” as legislators on both sides of the aisle struggle with long-term spending concerns.  Lawmakers continue talks regarding the current year spending measure still under consideration.  A new continuing resolution that would fund government operations until April 8 has emerged.  Though it includes deeper spending cuts, it is free of controversial riders such as language to restrict ACA implementation funds.  Meanwhile, the CBO issued a report that legislation designed to further the defunding goal would add $5.7 billion to the deficit.

Democratic leaders insisted that some form of compromise by the House GOP members is now needed. “We’re looking for some give on the Republican side,” said Sen. Charles Schumer (D-NY).  Speaker of the House John Boehner (R-OH), he said, “needs something to bring his freshmen into the real world.”  Boehner, referencing the Democrats and the White House, said “I hope the talks are going to continue, but we are not going to get very far if they don’t get serious about doing what the American people expect of us.  “This is not going to be easy.  Our goal, as I’ve said many times, is to cut spending and keep the government open.”

Will Proposed Medicare Reform Leave Seniors Out in the Cold?

Monday, April 11th, 2011

A Congressional proposal to reform Medicare will transfer a significant share of the cost to the nation’s senior citizens – a constituency that is known for high voter turnout in elections.  The Congressional Budget Office (CBO) added fodder for critics, concluding that the majority of future retirees would pay considerably more for healthcare under the “Path to Prosperity” approach — which turns Medicare into a voucher-like plan for Americans who are currently 54 and younger.  Representative Paul Ryan

(R-WI), who introduced the plan, said “We don’t want to turn the safety net into a hammock that lulls people to lives of complacencies and dependencies, into a permanent condition where they never get on their feet.”  Instead of coverage for a set of prescribed benefits, Americans in their mid-50s and younger would receive a federal payment to purchase private insurance from a choice of government-regulated plans.  If the proposal becomes law, beginning in 2022, Americans would have a vastly different experience when they became eligible for Medicare.  The age for eligibility would rise from 65 to 67, according to the CBO.

Ryan’s proposal slashes $1.4 trillion from Medicaid over the next decade.  He proposes to cut $630 billion off the budget by more or less repealing the Patient Protection and Affordable Care Act’s provisions that extend coverage to include anyone living on less than 133 percent of the poverty rate — just under $30,000 for a family of four.  Additionally, Ryan’s plan eliminates subsidies for private insurance premiums for those just above the poverty line.  According to CBO estimates, nearly 17 million people without insurance would have been covered by the Medicaid expansion.

Representative Chris Van Hollen (D-MD), the ranking Budget Committee Democrat, said Republicans are protecting tax breaks for corporations and the wealthy to the detriment of the middle class and the poor.  “It doesn’t reform Medicare, it deforms and dismantles it,” Van Hollen said.  As for Medicaid, Ryan’s proposal “rips apart the safety net” for poor and older people.  “A typical beneficiary would spend more for healthcare under the proposal,” according to the CBO analysis.  “Although the uncertainty in future federal spending on healthcare would decrease under the proposal, that uncertainty would be transferred to future beneficiaries,” the CBO analysis said.  “If the volume, complexity, and costs of medical services turned out to be greater than expected, future beneficiaries would pay higher premiums and cost-sharing amount than are currently projected.”

Ryan’s budget resolution would improve the nation’s overall fiscal health, cutting projected deficits in President Obama‘s budget and moving the federal government towards a surplus by 2040, according to the non-partisan CBO.  Ryan believes that the cuts are necessary to save the programs.  “This is not a budget.  This is a cause,” he said.  “The social safety net is fraying at the seams.”  Chip Kahn, president of the Federation of American Hospitals, said that Ryan’s proposal would “result in the loss of health coverage for millions of low-income Americans, reduce critical benefits for others, and make it more difficult for hospitals, clinicians and other healthcare providers to deliver the care so many need.”  Other critics maintain that Ryan’s approach will shift the higher costs to individuals, much as the change from defined-benefit pensions to 401(k) plans has increased retirement risk.  Senior citizens, the disabled and the poor likely will pay more for healthcare, even as Washington pays less.  Additionally, Ryan’s plan would permanently extend George W. Bush’s tax cuts.

“The idealized notion that older consumers would be making these annual choices may have some merit as an idea, but it doesn’t seem to be taking place in practice,” said Patricia Neuman, director of the Medicare Policy Project at the non-partisan Kaiser Family Foundation.  Picking the right health plan could become even more critical if premiums outpace federal subsidies.  In 2010, 50 percent of the nation’s Medicare recipients reported incomes of less than $21,000 a year, according to a Kaiser Family Foundation analysis.

In an opinion piece in the Seattle Post-Intelligencer, the “Monday Morning Economist” Stephen Herrington writes “The tax cut proposal is not getting the attention it deserves.  If it shapes up to be anything like was described in Ryan’s Road Map, it will create massive dislocations and disruptions in the economy.  Ryan’s plan was/is to cut the top tax bracket from 35 percent to 25 percent with the promise/expectation that this would not impact revenues.  In a departure from the standard ‘trickle down’ excuse for tax cuts, Ryan meant/means to offset the admitted loss in revenues by eliminating all manner of deductions.  The deductions in our current tax code, such as medical, mortgage and state income tax expense are there for a purpose.  Eliminating them will introduce wild distortions in markets and effectively push the tax cuts for the rich onto the other 98 percent of us.  Elimination of the medical expense deduction will intensify the impact of the Medicare/Medicaid part of the plan.  It is as if Ryan thinks the magic of the free market can absorb any shock in real time.  No more mortgage deduction?  No problem, I just won’t buy a house at all until the lack of the mortgage deduction causes prices to fall by half.”

Republicans Vow to Take on Healthcare Entitlement Programs

Wednesday, March 23rd, 2011

With the power shift in the House of Representatives, Medicare, Medicaid and Social Security are being targeted in proposed budget cuts designed to bring down the deficit. “It will likely be the first time you see a House have a prescription for Social Security, Medicare and Medicaid,” House Majority Leader Eric Cantor (R-VA) said at the Federation of American Hospitals’ annual public policy conference and business exposition in Washington.

Mississippi Governor Haley Barbour, a Republican, said that members of Mississippi’s Medicaid program saw its enrollment drop approximately 23 percent to 580,000 beneficiaries from 750,000 after the state started requiring beneficiaries to establish their eligibility in person.  Barbour began this practice in his first year as governor in 2004.  Senator Orrin Hatch (R-UT), the ranking Republican on the Senate Finance Committee, slammed the Patient Protection and Affordable Care Act (ACA), noting that its expansion of Medicaid will “bankrupt” the states, which already have strained budgets.  Hatch also cited Congressional Budget Office figures that say the ACA’s Medicaid expansion will cost taxpayers $435 billion over the next decade.

President Barack Obama said his proposed 2012 budget was a “down payment,” on cutting the federal budget deficit, and said that more work is needed to address “long term challenges”. Cantor said that on “individual items” there were “probably some areas of agreement” between the President and Republicans.  “But we can’t keep taking the savings and going to spend it,” he said.  “The object here is to cut.”  According to Cantor, the President’s plan “just misses the mark of living up to the expectations” Obama laid out in his State of the Union speech in January.  Asked if Cantor expected adjustments to Social Security and Medicare, Cantor said he was “hopeful that we can get some cooperation from [Senate Majority Leader] Harry Reid [D-NV] and the President, because these are programs that touch the lives of every American and we don’t want, nor can we, make these changes by ourselves.”

Writing on the Huffington Post, Richard Eskow took an alarmist tone, saying that “entitlement reform” is a euphemism for allowing the elderly to die if they become ill. “’The President’s budget punts on entitlement reform,’ reads a statement by House Republicans.  ‘Our budget will lead where the President has failed, and it will include real entitlement reforms.’  ‘You have to do entitlement reforms if you are serious about this budget,’ according to Representative Paul Ryan (R-WI).”  Eskow counters “Reality check: Nobody’s proposing ‘entitlement reform.’ That term is a cloaking device for some very ugly intentions.  It’s a meaningless manufactured phrase cooked up by some highly-paid consultant, and it diminishes the sum total of human understanding every time it’s used.  The phrase is a euphemism for deep cuts to programs that are vital and even life-saving for millions of elderly and poor people, but it’s politically unpalatable to say that.  So it became necessary to come up with yet another cognition-killing term designed to numb us from the human toll of our political actions.  ‘Entitlement reform’ is the new ‘collateral damage.’”

The Washington Post’s Ezra Klein is more diplomatic in his assessment of the possibility of entitlement reform. “We’ll see.  I wouldn’t be surprised if Obama has his name on a broader deficit-reduction bill at this time next year.  If he takes the deficit away from Republicans before 2012, his reelection campaign becomes considerably easier.  And on a less cynical level, his administration is stocked with deficit hawks — the same folks who actually balanced the budget under Bill Clinton.  And similarly, Republicans want to deliver on the deficit-reduction promises they’ve made to their base.  In theory, everyone’s incentives and ideologies are pointing in the same direction.  That’s a good sign for progress.”