Also read Jonathan Cohn’s take:
It is based on the Medicare (and Medicaid) proposal in the most recent Ryan budget, since Romney hasn’t provided sufficient details for making such estimates. The lead author is David Cutler, the Harvard University economist and advisor to Obama during the last presidential campaign. Along with Topher Spiro and Maura Calsyn from the Progress Fund, Cutler crunched the numbers and found that somebody turning 65 now would end up paying about $11,000 in extra retirement costs. Somebody who was still 54 now would pay an extra $59,500. (This chart has the full results.) The CAP Action Fund is a progressive advocacy organization, but Cutler is among the nation’s most respected health economists. And although I can’t vouch for these numbers, the general idea—that even current seniors would pay more in the next few years—seems self-evident.
I’ve had some time to peruse the report and I’d like to clarify something mentioned in the above quote from Cohn. This CAP report specifically refers to Paul Ryan’s FY2013 budget plan. While Mitt Romney had endorsed the house budget earlier this year, since choosing Ryan as his vice-presidential nominee he’s (sorta maybe kinda’) distanced himself from that plan. When asked if choosing Ryan meant a referendum on the House plans for Medicare, Romney responded “Well, I have my budget plan as you know that I’ve put out. And that’s the budget plan that we’re going to run on.” So there’s a easy objection hanging out there about whether any specific numbers based on a plan that the Romney campaign is not actually running on is fair game.
That being said, Romney’s actual plan is a glorified bullet-point political bucket list. Add to that the fact that there has been messaging that conflicts with Romney’s denial of the house budget — plus his generalized plan for block-granting Medicaid is no different. Given the conditions I don’t think it’s completely out of the question to use the FY2013 budget as an approximation for Romney’s intentions. It’s the closest antecedent without enough meat on the bones to suss out what would actually happen to seniors under a Romney administration.
One last point; the CAP report specifically refers to two aspects of the plan that would affect current seniors:
- Increased drug costs and higher Medicare premiums. By repealing the Affordable Care Act, the Romney-Ryan plan would raise health care costs in retirement by $11,000 for the average person who is 65 years old today.
- Increased long-term care costs, including increased costs for nursing home care, because of cuts to Medicaid. A substantial share of Medicaid spending pays for health care costs for Medicare beneficiaries. The Romney-Ryan Medicaid cuts mean a loss of over $2,500 annually for seniors currently on Medicare who also rely on Medicaid. Unlike the Medicare voucher system that would begin in 2023 the cuts to Medicaid would begin almost immediately.
To the first point there are easy rebuttals. I.e., “I’ll keep the ‘Donut Hole’ in prescription drug coverage closed” and “Competition among the private options in my Medicare plan will keep premiums down.” The counter argument to those statements would be; “How would you pay to keep the it closed (since everything in Romney’s plan would supposedly be ‘budget-neutral)” and “What evidence can you offer that such competition would keep premiums from increasing, given that the most relevant example in Medicare Advantage disproves your assumption?” Here’s hoping someone is willing to ask the Romney team these questions.
To the second point, well, I’ve already argued that block-granting Medicaid would affect current seniors. The only logical response would be to offer a credible alternative to the existing long term care structure in Medicaid — something that health care reformers of all political stripes are very much interested in pursuing. Unfortunately I don’t see that kind of credibility coming from the Romney campaign. Yet without any serious alternatives we’re left with very real cuts in programs that affect the health-vulnerable and vague promises to “not make it too bad.” That is not acceptable to me and it shouldn’t be for anyone else.