Saturday, November 19, 2016

If you think Paul Ryan isn't serious about ending Medicare, think again


By Joan McCarter  Tuesday Nov 15, 2016 · 12:31 PM EST
170 Comments (170 New)

Last Friday, House Speaker Paul Ryan went on Fox, the very best place for Republicans to shop their lies, and told some whoppers about Medicare. Those whoppers are what he's using to justify the one big thing he thinks he's going to get out of president-popular vote loser-elect Donald Trump: the end of Medicare. Here's what he said in that interview:
What people don't realize is that Medicare is going broke, that Medicare is going to have price controls. Because of ObamaCare, Medicaid is in fiscal straits. So you have to deal with those issues if you're going to repeal and replace ObamaCare. Medicare has got some serious problems because of ObamaCare. Those things are part of our plan to replace ObamaCare.
First, it already has price controls. Second, it is not going broke. Third, it's not going broke in large part because of Obamacare. In fact, the Medicare controls in Obamacare have actually extended Medicare's solvency by 12 years. Even the fact-checkers say so. So the whole premise Ryan is shopping to explain why he wants to blow Medicare up is a big, fat lie. Which you probably already knew because Paul Ryan.

When Ryan says "those things are part of our plan to replace Obamacare," he's talking about his "Better [sic] Way" plan. Which includes repealing the Independent Payment Advisory Board, a body created under Obamacare that is tasked with recommending cuts in payments to providers who participate in Medicare, if necessary. Note the IPAB can't make those cuts, but recommends them to Congress. If Medicare is going broke, which it isn't. Because of the law IPAB is part of. His plan would also expand Medicare Advantage, the privatized part of Medicare. The big part of that plan, however, is his long-standing proposal to turn Medicare into a voucher program.

Ironically, sort of, is that his plan would give subsidies to seniors to buy private plans. Just like Obamacare—which he wants to repeal—does. What it really means is an end to the program seniors have been relying upon since 1965 for their health care. (He also will block grant Medicaid, allowing the states to take the chunk of Medicaid money they receive and do what they will with it. This is important for seniors because Medicaid is the program that provides funding for long-term, nursing home care for low-income seniors.)

Now, Ryan likes to stress that this change will only apply to future retirees. He's lying. These changes would undercut current financing for Medicare, and would throw current beneficiaries into chaos. But it would end one of the most popular and successful government programs ever created, and that's what Ryan is all about. It remains to be seen if that's what Trump is all about, and whether he's going to let Ryan call the shots.

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