Why Mess With Medicare?

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Republican Paul Ryan’s budget mark proposes deep cuts to Medicare, the popular government program that funds health care for seniors. Polls show Americans are overwhelmingly against cuts to entitlement programs generally, and Medicare in particular, and Ryan himself admits that he is handing Democrats a potential weapon. So why would the GOP risk Medicare reform?

To quantify the risk Ryan and the Republicans are taking it’s important to understand just how unpopular Medicare cuts are. A recent Wall Street Journal/NBC News poll found less than a quarter of Americans supported significant cuts to Medicare or Social Security to tackle the deficit. Even self-identifying “Tea Party” members opposed such cuts by a nearly 2-to-1 margin.

Similarly a March 2011 poll by the Pew Research Center found 65% of Americans oppose cuts in Social Security or Medicare to bring down the deficit. Independents, the key voting block in national elections, opposed such cuts 61% to 35%. The GOP doesn’t get much help when the numbers are broken out by age: Pew found last fall that elderly Americans, who are more likely to vote than younger ones and are a key GOP voting block, oppose replacing Medicare with a voucher system, as proposed by Ryan, by 69% to 14%.

Ryan argues no plan for balancing the budget is credible without addressing Medicare and he’s right: if you want to bring down deficits and deal with the debt, you can’t get around the massive growth in the cost of Medicare. So in one sense Ryan is being honest and makinga  play for credibility. As one advisor to the House GOP leadership puts it, “Governing is hard.” Ryan hopes to get some cover by arguing that his voucher plan is built on one he worked up with Alice Rivlin, Bill Clinton’s OMB director. And he says his proposal is just a start: that he’s open to other ideas as his plan moves through committees in Congress.

But that still leaves the problem of trying to sell the cuts to the public. Republicans will try and explain what the country will get in exchange for the cuts, says David Winston, a top GOP pollster and veteran of the Newt Gingrich era in the House. “One reason the GOP could do as well as we did was because we asked the question where are the jobs,” Winston said. “This budget addresses that question.”

Ryan’s plan cites Heritage Foundation numbers to argue he will get unemployment down to 4% by 2015, Winston says. “This is not just a deficit hawk argument in this budget, this is a Reagan era plan for spending restraint and ultimately a plan for economic growth that can get us out of this mess,” he says.

How that argument overcomes the country’s deep opposition to Medicare cuts is unclear. But even if it does, will the GOP get much credit for what they accomplish? Bill Clinton came out of the budget battles of the 1990s as a clear winner and there’s no reason to think Americans won’t attribute any eventual budget success to the President, not Congress. Which makes it even harder to understand why Ryan and the GOP are taking the risk.

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