It’s time for the Republican Congress to start the long, tortured process of creating a budget, and as Alexander Bolton of The Hill reports, now that Paul Ryan has moved from chairing the Budget Committee to running Ways and Means, this version is going to be a little different from recent ones. Specifically, the transformation of Medicare is out:
Senate Republicans will not include detailed plans to overhaul entitlement programs when they unveil their first budget in nearly a decade this week, according to GOP sources.
The decision would break from Rep. Paul Ryan’s (R-Wis.) House budgets from recent years, which Democrats used to pound Republican candidates in the 2012 and 2014 elections.
Democrats repeatedly accused Republicans of wanting to “end Medicare as we know it.” In breaking with Ryan, Senate Republicans want to avoid giving their opponents the same ammunition — especially with a slim majority and in danger of losing their majority in 2016.
The GOP budget would balance in 10 years, according to GOP lawmakers familiar with the document, but it will only propose savings to be achieved in Medicare and Medicaid, without spelling out specific reforms as Ryan and House Republicans did in recent budgets.
Ryan always got a lot of credit from the chattering class for the wonky forthrightness of his budgets, which did indeed contain many numbers (though they also had plenty of smoke and mirrors). When it came to Medicare in particular, there was a certain courage in Ryan’s proposal, at least in so far as it admitted that what he sought was a radical change in the program. Instead of what it is now — an insurance program — Ryan would change Medicare to essentially a voucher program, where seniors would get a certain amount of money from the government with which they could buy private insurance.
We don’t have to go into all the dubious assumptions and projections that went into it, but the point is that Ryan’s proposal made seniors very unhappy, because they love their Medicare. And it made Democrats happy, because they could say, quite accurately, that Republicans wanted to end Medicare as we know it and replace it with something that would still bear the name “Medicare” but wouldn’t be the same thing. The potency of this argument can be seen every two years, when Republicans air one ad after another proclaiming their fervent commitment to Medicare, despite the fact that in reality they fought against it when it was created in 1965 and have sought to undermine it ever since. The fact that it’s one of the most successful social programs in American history, works exceedingly well and is tremendously popular only deepens the degree to which they consider it an ideological affront.
So if Republicans no longer want to talk about voucherizing Medicare (or “premium support,” as they would have it), does that mean they’ve given up the idea? I actually think it does. This doesn’t mean they wouldn’t do it if they could. But they know they can’t, and this is a concession to that reality.
One of the main reasons Ryan put his voucher proposal down on paper was to start a debate that over time could move opinions and make change possible. But it didn’t work. Maybe he didn’t have enough time, or maybe altering Medicare in this way is just politically impossible and always will be. Either way, once you stop talking about it, you have no chance at all to build support for your position, and that affects your range of options in the future. It isn’t as though a Republican president could get elected, then Congress could just spring an overhaul of Medicare on the public. “Oh, by the way, while we’re cutting taxes and increasing defense spending, we’re also going to turn Medicare into a voucher program.” Not a chance.
It takes years to prepare the ground for that kind of change. Republicans may still want to do it someday, but if they’ve stopped putting it in their budgets, it’s a sure sign they’ve given up on trying to enact it any time soon.