Sigh. Paul Ryan et al.

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I really didn’t want to spend my last week before the school maelstrom starts writing about Paul Ryan. But, it is what it is. Yesterday was a veritable freeforall high school food fight of posts on the guy. It’s not as though I could really add anything you couldn’t find someplace else, but there are a couple of aspects I found peculiar yesterday.

One was the back and forth on Ryan’s involvement with Democrat Ron Wyden (Senator, Oregon) and how this somehow disqualifies non-conservative criticism on Ryan’s plans for Medicare. First, though, some backstory. Remember that Ryan’s 2012 budget involved changing Medicare from it’s current defined-benefit structure to a voucher-like defined-contribution program that would have seen increased costs for future seniors. Despite intentionally excluding current and near Medicare recipients, the plan enjoyed a whopping 16 percent support among Americans. Cue the involvement with sometime-renegage Ron Wyden, who decided to release a plan with Paul Ryan on how Medicare reform could be done using a premium support (the voucher-like part from earlier) structure that was a little bit more realistic. There were huge differences between the Ryan/Wyden plan and that 2012 budget, the most notable being that the traditional fee-for-service Medicare would still exist as an option. Then comes the 2013 budget, which included a plan to change Medicare similar to what was seen in Ryan/Wyden.

So what is all the fuss about over Wyden’s involvement? Well, it’s now being used to burnish Ryan’s bipartisan credentials and legitimize the Republican image as (positive) Medicare reformers. From the Washington Post, Romney name-dropping Wyden (emphasis mine):

Speaking about the Ryan-Wyden proposal at a Saturday rally at Randolph-Macon College in Ashland, Va., Romney said that Ryan “found a Democrat to co-lead a piece of legislation to make sure we can save Medicare.”

In Manassas, Romney explicitly name-checked Wyden to argue that Ryan actually wanted to save Medicare where President Obama and Democrats wanted to slash it. “Paul Ryan and Senator Wyden said, ‘No, we need to restore, retain and protect Medicare,’ ” Romney said. “That’s what our party will do.”

I suppose this sort of visible support for Ryan/Wyden might lead some folks to continue on down Romney’s (il)logic train on Republicans and Medicare. Here’s where the attempt to disqualify non-conservative criticism comes into play, via Timothy P. Carney in the Washington Examiner (emphasis mine):

Obama campaign manager Jim Messina wrote that Ryan’s “plan also would end Medicare as we know it by turning it into a voucher system, shifting thousands of dollars in health care costs to seniors.”

The “end Medicare as we know it” mantra highlights two ways in which it is the Democratic Party that is deeply unserious.

First, it echoes Obama’s mendacity. Second, it reflects the party’s irresponsible insistence on looking the other way while driving our government full speed toward the cliff of insolvency.

Ryan’s budget would not change anything about Medicare for people over age 54 or anyone younger who wants to go onto traditional Medicare. Ryan’s plan, crafted with Democratic Sen. Ron Wyden — who earns gushing praise from self-styled wonks on the Left as a serious legislator (which he is) — merely allows some people to opt instead for a voucherized version of Medicare.

So Democrats assert that Ryan-Wyden would “end Medicare as we know it,” because any modification of any existing policy would “end” that policy “as we know it.”

Hence the sigh in the title of this post. Where to begin? Notice in the fourth paragraph where Carney refers to “Ryan’s budget” and then “Ryan’s plan, crafted with…Wyden?” Yeah, as I outlined in the backstory above those are actually two separate things. The slick transition is meant to imply that the Medicare changes in “Ryan’s budget” is the same as the plan produced with Wyden. It’s not. But don’t just take my word for it, here’s Democratic Senator Ron Wyden in his own words on Romney’s association (and Carney’s implied association):

“Gov. Romney is talking nonsense. Bipartisanship requires that you not make up the facts. I did not ‘co-lead a piece of legislation.'” Wyden said. “I wrote a policy paper on options for Medicare. Several months after the paper came out, I spoke and voted against the Medicare provisions in the Ryan budget.”

Thus when Carney then writes in the last paragraph above that the attacks on Ryan’s Medicare plans are really attacks on the Ryan/Wyden plan, he’s practicing the same off-base attack he accuses Democrats of committing (which, if the Democrats are referring to the 2012 budget only, is truly off-base). In other words, he’s purposely chosen to conflate two different things (the Ryan 2013 budget – the Ryan/Wyden plan) in order to accuse Ryan’s criticizers of…conflating two different things (the Ryan 2012 budget – the Ryan 2013 budget). It is any wonder how some find politics so disingenuous?

To be fair, as was pointed out to me on Twitter, the Ryan/Wyden plan (pdf) does have more in common with Ryan’s 2013 budget than the 2012 budget has to either. That being said, what is the difference between Wyden’s plan and what Ryan included in the 2013 budget that caused the Democratic Senator to reject? For that I’ll outsource to Jeff Spross from ThinkProgress (emphasis mine):

For one thing, the Wyden-Ryan plan would cap the growth rate of this new version of Medicare at the growth of the economy plus one percent, while Ryan’s budget would cap it at economic growth plus 0.5 percent.

[…]More important, however, is understanding Wyden’s support for these Medicare reforms within the context of his stances on broader health care reform. Wyden voted for President Obama’s Affordable Care Act — the health reform bill that used a similar exchange structure to cover all Americans not already ensured by their employers, Medicare, or Medicaid. […]

[…] Meanwhile, the latest House GOP budget — which Wyden pointedly refused to support — repeals the ACA, casting everyone who isn’t a senior back into the country’s prior dysfunctional system, with severe cuts to Medicaid to boot.

You might not thing that half a percent would make much of a difference. Yet a slower growth rate could also increase the chance of cost-shifting to seniors under such a premium-support model. It was enough of a difference for Wyden to reject, something that is (not so) curiously missing from Carney’s piece and Romney’s stump speech.

Another peculiar aspect from yesterday’s run-around was the preemptive rhetorical strikes on Medicare cuts in the Affordable Care Act. Now this isn’t something entirely new – remember Michelle Bachman’s screed about “stealing 500 billion from Medicare?” Well now it’s projected to be around 700 billion, but the political usage is still the same. In order to counter Dem attacks that Ryan, and now by implication Romney, wanted to “end Medicare as we know it,” Republicans will point out that Obama has already “gutted Medicare.” Romney has already said as much. For a more colorful example, here’s RNC Chair Reince Priebus on Meet the Press:

“This president stole, he didn’t cut Medicare, he stole $700 billion from Medicare to fund Obamacare,” Priebus said. “If any person in this entire debate has blood on their hands in regard to Medicare, it’s Barack Obama. He’s the one that’s destroying Medicare.”

This would be all bloody well and fine, I suppose, and a bit of justice for all those years of Democratic accusations that Republicans wanted to “take away your Medicare.” Except that the 700 billion or so in projected savings taken from Medicare’s future growth is kept in Paul Ryan’s budget. Once more, with feeling: Romney chose a vice-presidential candidate whose two signature budgets repeal the ACA but keep the 700 billion in savings “that’s destroying Medicare.” From John E. McDonough (again, emphasis mine):

In the spring of 2011, the new Republican House majority votes overwhelmingly in favor of the budget proposal advanced by the new House Budget Chairman Paul Ryan. Ryan proposes a controversial restructuring of Medicare to move it in a premium support/voucher direction beginning in 2023, a proposal that gets lots and lots of attention, pro and con. Ryan’s budget proposal also includes complete repeal of the ACA, with one little-noticed exception, the $500 billion in ACA Medicare reductions.


Nearly every House and Senate Republican votes for the Ryan proposal. In the spring of 2012, Ryan again releases the plan, and includes the same repeal of the ACA, minus the Medicare reductions, now approaching $700B. And, again, nearly every House Republican votes for the plan.

Of course the irony can’t end there. Ryan also used a similar growth-cap for his projected Medicare savings. Dave Weigel calls this a “version of the sophisticated parlor game I’m Rubber and You’re Glue” (my emphasis):

Remember, Obamacare is supposed to save $700 billion by capping the rise in Medicare spending from GDP growth plus 0.5 percent. The Ryan budgets in 2012 and 2013 don’t alter Medicare for anyone entering it before 2022—a buffer that lets current retirees breathe easy. After 2022, it turns all of Medicare into a premium support plan like Medicare Advantage. At that point, “an annual competitive bidding process” is supposed to push providers to provide lower rates. “The per capita cost of this reformed program for seniors reaching eligibility after 2023,” explains Ryan in his budget guide, “could not exceed nominal GDP growth plus 0.5 percent.” So, if it works, it’s got the exact same Medicare cap as the Obama plan.

The hard truth of the matter, from Romney’s perspective, is that on Medicare he’s got to hit the president from all angles. Why? Because his various proposals, vague as they are, would require massive cuts (excluding, as he says, defense and Social Security) in spending:

Assuming that such cuts were spread proportionally, Romney’s plan would necessarily entail cutting Medicare (and everything else) by 29 percent in 2016, and 40 percent in 2022. So Romney really needs to have his cake and eat it too in this race, and this is the reason for such (myth-based) opposing messages coming from Romney and Ryan.

Thus, Obama and the Democrats don’t have a serious plan for Medicare. Of course if President Obama is, according to Romney, the “only one president that I know of in history that robbed Medicare, $716 billion to pay for a new risky program of his own that we call Obamacare,” then he also is necessarily the only one in the race that has actually implemented legislation attempting to reform Medicare cost growth. One might think it’s a terrible idea, sure, but at least its a serious idea. Serious enough for some to liken it as blood on Obama’s hands. And given that Ryan intentionally keeps those cuts (while Romney cuts even further) and adds to them it’s serious enough for the Republicans to get their hands bloody too.

Yet maybe it isn’t as bad as it sounds. Indeed, as Carney writes, “The Democratic alternative to Ryan’s Medicare reform, meanwhile is, well, nothing.” If that’s the case, then, whew. Yeah, have your cake and eat it too.

*Update – Well, the Romney response was quick:

“A Romney-Ryan Administration will restore the funding to Medicare, ensure that no changes are made to the program for those 55 or older, and implement the reforms that they have proposed to strengthen it for future generations.” 

Everything’s kosher then, right? Maybe not so much (my emphasis):

Consider what the Romney campaign, then, is saying: If Romney is elected, then by his third year in office, every single federal program that is not Medicare, Social Security, or defense, will be cut, on average, by 40 percent. That means Medicaid, infrastructure, education, food safety, road safety, the postal service, basic research, foreign aid, housing subsidies, food stamps — all of it has to be cut by, on average, 40 percent. If Romney tried to protect any particular priority, it would mean all the others have to be cut by more than 40 percent.

That’s not even remotely plausible. The consequences would be catastrophic. The outcry would be deafening. And Romney has shown no stomach for selling such severe cuts.

I’m sorry but the deeper the Romney campaign goes into the “budget rabbit hole” the more, as Ezra Klein describes, it clearly becomes a fantasy. Or if you prefer my analogy, it’s even more of a wishful plan to own that cake and consume it too.


One response to “Sigh. Paul Ryan et al.

  1. Pingback: A small note on Ryan, Romney, and Medicaid | Punditocracy·

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