WASHINGTON — In the debate over deficits that is likely to dominate the capital for the next year, there are a few signs of common ground between President Obama and emboldened Republicans as each side tries to trim trillions of dollars from the federal budget.
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By Pablo Martinez Monsivais, AP
But not on Medicare.
The government’s health care program for seniors stands at the intersection between huge sums of money — 12% of the federal budget and rising — and a fundamental ideological divide over the role of government.
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That clash may define the political parties and help shape the 2012 elections.
“This is going to be at the centerpiece of our conversation with the American people,”Illinois Sen. Dick Durbin, a leading Democrat in the budget debate, told reporters at a breakfast Wednesday hosted by Bloomberg News.
“Let me be absolutely clear: I will preserve these health-care programs (Medicare and Medicaid) as a promise we make to each other in this society,” Obama declared in some of the most unyielding language he used in Wednesday’s speech at George Washington University. “I will not allow Medicare to become a voucher program that leaves seniors at the mercy of the insurance industry, with a shrinking benefit to pay for rising costs.”
Friday vote for GOP plan
Meanwhile, on Capitol Hill, House Republicans plan to vote Friday on a GOP budget blueprint that would cut $5.8 trillion over 10 years and overhaul Medicare. For those now under 55, the traditional fee-for-service program would be replaced by annual subsidies to individuals to buy health insurance coverage.
House Budget Chairman Paul Ryan, R-Wis., who watched Obama’s speech from a front-row seat, says the proposal would give seniors more choices, impose the discipline of free markets on health-care costs, and produce a long-term solution for a budget dilemma that threatens to spiral out of control.
Medicare expenditures totaled about $509 billion in 2010 — nearly one-fourth of all health-care spending — and are projected to rise to $929 billion in 2020.
“I think it demonstrates that we are really trying to be honest with the people that put us here, and the math doesn’t lie,” House Majority Leader Eric Cantor told reporters, defending the GOP blueprint. “I think that this is what America wants us to do right now.”
Obama’s plan offers more modest steps. It would strengthen the powers of an oversight board, created in the new health care law, to hold down the rise in Medicare costs below a designated cap. The White House also promises savings in prescription drug costs for total savings of $200 billion over a decade.
The 2012 elections may test the Republicans’ thesis that voters are so concerned about out-of-control deficits that they are willing to support dramatic changes in such programs asMedicare that once seemed unthinkable.
That is a debate Democrats are eager to have.
In part, it will be payback for GOP attacks last year. Republicans hammered Democrats for curbing a program called Medicare Advantage and described end-of-life counseling for seniors in the health care law as “death panels.” (The Ryan plan would leave almost all the curbs on Medicare Advantage, and their savings,in place.)
Broad support for Medicare
A USA TODAY/Gallup Poll taken Monday shows just how popular Medicare is. Six in 10 said they wanted the government to make no changes or only minor ones to save money in the program. A solid majority of every major demographic subgroup agreed: Men and women, liberals and conservatives, Democrats and Republicans.
Medicare gets wide support
Percentage who said in a USA TODAY/Gallup Poll taken Monday that the government should make only minor changes in Medicare or none at all to control costs.
• Men - 54%
• Women - 68%
• 18-29 year olds - 63%
• 65 years old and up - 69%
• Income below $2,000 a month - 69%
• Income $7,500 a month and up - 59%
• Married - 58%
• Not married - 65%
• Democrats - 67%
• Independents - 58%
• Republicans - 62%
• Moderates - 68%
• Conservatives - 53%
Source: USA TODAY/Gallup Poll of 1,004 adults; margin of error +/-4 percentage points.
In fact, 33% of Republicans said they didn’t want the program changed at all.
“The approach reflected in Congressman Ryan’s budget is, I think, politically perilous almost beyond compare,” Democratic pollster Geoffrey Garin says. He notes that even some Tea Party favorites such as freshman Rep. Sean Duffy of Wisconsin, elected on promises to slash spending, are raising questions about the Medicare plan.
The politics are delicate for Obama, too, facing protests from Democrats. A liberal group called the Progressive Change Campaign Committee says it collected 92,000 pledges in 24 hours from liberals who promised not to give money or volunteer time to Obama’s re-election effort if he made cuts to Medicare and Medicaid. “He needs to take Social Security, Medicaid, and Medicare benefit cuts completely off the table,” the group warned after Obama spoke.
The president directed some of his remarks to them.
“To those in my own party, I say that if we truly believe in a progressive vision of our society, we have the obligation to prove that we can afford our commitments,” he said. “If we believe that government can make a difference in people’s lives, we have the obligation to prove that it works — by making government smarter, leaner and more effective.”
Robert Reischauer, a trustee for Medicare and Social Security and a former director of the nonpartisan Congressional Budget Office, doesn’t see a grand compromise on Medicare anytime soon.
“With an election coming up and the Republicans rallying around a plan that the Democrats feel might be their ticket to majority status in the House, it’s unlikely that we’re going to have serious debate about these issue over the course of the next year,” he says.
Gail Wilensky, who oversaw the Medicare and Medicaid programs in the first Bush administration, says that’s unfortunate: “The longer it takes to do this, the harder it is.”
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