I asked him about the White House’s negative reaction, proclaiming the administration “concerned” about a bipartisan reform deal. Ryan described the White House response: “Predictable. It’s clear they’re in political mode.” He noted that the White House took to “trashing out of hand” the deal without much inquiry. “It’s unfortunate they’re going to quickly dismiss what is a bipartisan compromise,” he said.
He nevertheless remains optimistic on both tax and entitlement reform. ”I see a pretty good consensus on tax reform,” he said, referring to ideas from both sides of the aisle to lower rates and close loopholes. And now there is an emerging deal on a Medicare support plan. What about the Obama administration? He’s blunt: “They’re on the outside.”
He told me he received initial support from Blue Dog Democrats on the floor. “They are very encouraged [by the Ryan-Wyden plan]. Their party leaders beat them down,” He said. “They are tired of their side sitting on the sidelines and not engaging.”
I asked Ryan about a few of the more detailed aspects of the plan. Is his plan to have a congressional cap on Medicare spending (if his competitive market idea fails) any different than the 15-person Independent Payment Advisory Board? After all, both would cut outlays for Medicare. “They are very different,” he said. “First, this makes IPAB irrelevant and obsolete.” He explained that rather than an unelected body, Congress will be empowered, for example, by adjusting the means testing or cracking down on abuse of durable medical devices.” He said Wyden was very adamant on this point and he agreed. ”We wanted to give Congress the chance to clean up the system,” he explained.
What about the charge that his plan is like Obamacare. He laughed. “They are centralizing under-65 health care.” By contrast he and Wyden start with a centralized government system. “We are taking [power] away from the federal government. There is a difference in direction there.”
He also tried to correct the misimpression that this will preserve Medicare in its current form. He concedes that under any reform plan, “the Medicare system is going to be around” for those older Americans being grandfathered into it. But in the future, although the program remains an option, he stressed, “Medicare is going to be within the premium support system.” That means that a fixed amount will be given to beneficiaries, rather than an open-ended fee-for-service plan. That will impose discipline on Medicare, forcing it to reform and lower costs or lose patients who don’t want to pay the difference between what they receive under premium support and the actual cost of Medicare.”
As he told another blogger earlier in the day, “A traditional Medicare fee-for-service option would operate within a premium support framework. This Medicare fee-for-service plan would be forced to compete alongside private options within a fundamentally reformed program. Just like in the House-passed budget, seniors would receive a fixed amount and be allowed to chose from a select set of Medicare-approved plans. A difference with this bipartisan effort is that one of the Medicare-approved plans would be a Medicare fee-for-service option. The financing for all options is the core reform, maximizing the power of the senior and the benefits of choice and competition.” In short Medicare won’t be Medicare as we know it after the last grandfathered Medicare recipient.
I asked Ryan why he chose Wyden and why he released the plan now. He said he could not recall who contacted whom first. “I’ve know him a long time. He was always sympathetic to this [approach]. We got to talking.” And the result was a plan that adheres to conservative principles, avoids the tag that it is “destroying” Medicare and largely insulates the reformers against political attacks in 2012.
As for the timing, he is candid, “I wanted to plant a seed this year that we can reap in 2013 when we have better [executive] leadership.” He said he felt compelled to get it out this year because next year he’ll be tied up with the budget.
For now, however, Ryan and Wyden have thrown a very big rock in the pond. Their plan has rattled the White House and confirmed for many conservatives that there is no Republican more adept at crafting entitlement reform that can meet both policy and political demands. Perhaps, you can be the most influential Republican without being a presidential candidate.