The story I covered on Sunday about how the Romney-Ryan campaign would have to cut current Medicare benefits because of the box they’ve shoved themselves into by promising to “restore $716 billion in Medicare cuts” finally gets picked up by the New York Times in a front-page story. If the story gets a bigger platform, all the better. But I don’t think Jackie Calmes did a complete job of explaining this, so let me try again.
The “$716 billion in Medicare cuts” are actually savings in the form of reduced payments to Medicare providers and subsidies to insurance companies. If you “restore” those savings, it means that Medicare will pay out higher subsidies to Medicare Advantage and higher reimbursement rates to providers. This does two things. First, because Medicare beneficiaries pay a share of all costs in Medicare, it means higher out-of-pocket costs and premiums for them. That’s what Calmes focuses on.
Second, the Romney proposal accelerates the insolvency of the Medicare trust fund. By cutting costs, ACA savings extended the Trust Fund another 8 years, according to the CBO; so repealing ACA and eliminating those savings just ensures that insolvency could still happen by 2016, the last year of a Romney Administration’s first term. By law, once the Medicare Trust Fund is insolvent, you would have to initiate immediate cuts to the program, to get it within the Trust Fund’s spending authority.
All this has been established about a week ago. What’s new is that Romney campaign advisor Ed Gillespie was asked about this on Fox News Sunday and responded, when asked how they would deal with an insolvent Medicare Trust Fund in 2016, that Romney supports increasing the Medicare eligibility age, in addition to more means-testing (Medicare is already means-tested). Those are cuts to near current beneficiaries, and that’s what would have to happen. So Romney-Ryan cannot preserve Medicare for current seniors, claiming to shield those over 55, under their plan. They would have to make cuts. And the bargain that Romney-Ryan are making is that they will force Medicare to pay higher rates to providers and higher subsidies to private insurance companies, and in turn cut senior benefits.
This is an extremely important point. The President is an imperfect messenger for it, because he too proposed an increase in the Medicare eligibility age in 2011 during his grand bargaining. But under his plan, the Trust Fund solvency gets pushed out to 2024. Under the Romney-Ryan plan, they would have to make cuts in the first term, by law. It’s a big difference.
The Romney campaign either doesn’t understand this or is being deliberately obtuse.
The Romney campaign adamantly disputes the critics’ assertions.
“The idea that restoring funding to Medicare could somehow hasten its bankruptcy is on its face absurd,” said Andrea Saul, a spokeswoman for the Romney campaign. She added, “Governor Romney’s plan is to repeal Obamacare and replace it with patient-centered reforms that control cost throughout the health care system and extend the solvency of Medicare.”
That reflects a total ignorance of trust fund accounting and the implications of the Romney-Ryan plan. They cannot keep up the fiction that current beneficiaries would see no cuts. One group – 65 and 66 year-olds, or wealthier seniors – would see immediate cuts, plus everyone would see across-the-board higher costs on their out-of-pocket expenses. Not to mention the fact that the Medicare drug donut hole would be opened up again, free preventive care would be lost, etc., by a repeal of the Affordable Care Act.
The Obama campaign hasn’t really pursued this full line of attack, but now that it’s made its way into the Grey Lady, I’d expect to see it coming.




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Congratulations, Dday. Now, if the Times would just give credit for your scoops ….
The Times typesetters forgot the scare quotes around the word “restore”.
Looks like your key point — that current beneficiaries will suffer higher costs or cuts in benefits from Rmoney’s plan –
was included in the Times story, but not as fact. Instead, they used a Van Hollen quote to end the story, which turns the fact back into the “he said she said:”
Sigh. Two links:
http://www.ft.com/intl/cms/s/0/21d103cc-e6c3-11e1-af33-00144feab49a.html#axzz24DX7cuQr
Also:
http://www.maniacworld.com/illusion-of-free-choice.jpg
Let’s get real. ACA will cut benefits. ACA subsidizes private industry without really controlling cost. Ryan would cut benefits. Romney would delay cuts. There is no plan in the arena today that is not doomed to failure.
yep, your .jpg sums it up nicely tho the “right path” would be slightly longer. That’s why obama will probably be “elected.” He’s the TPP guy; rMoney would not get it passed.
see NAFTA, FISA, PANAMA-COLUMBIA-SKOREA,NDAA,Genetically-Engineered food & trees, expanded surveillence, data storage and contractor data-mining, etc.,etc,etc.
So the Obama cuts aren’t cuts to Medicare at all. They are cuts to doctors and insurance companies. Of course that means doctors and insurance companies will no longer provide services to seniors, but that’s not part of the official plan.
Of course if your doctor won’t take Medicare, you’ll have to pay 100% out of pocket costs.
You know what won’t accelerate the insolvency of the Medicare trust fund, Obamas solution of paying doctors and insurance companies so little that they won’t take Medicare patients. Why not just reduce payments to providers to a flat rate of $5 for doctor visits, 10$ for hospital stays and $15 for any type of surgery. We wouldn’t have to worry about the trust fund ever running out of money.
I know FDL focuses on the middle class ,but DD don;t you think the far more important story is the pubs promising to murder infants with barbaric cuts to child nutrition .Other cuts to medicare ,food stamps and housing must kill people .This isn’t speculation ,it is an existential given .Ezra did a solid job covering the issue .As ,usual ,this pure fascistic evil is ensconced in faux christianity by Ryan and other spiritual goblins and moral perverts of puritanical fundamentalism while Obama is silenced for fear of being tagged the food stamp prez or a socialist .Is there a rainbow militia ?
Thats not quite right. The 716m is roughly in thirds. One third is reimbursements to hospitals, which they agreed to since they will be getting more paying customers under the ACA. Another third is made up of a bunch of savings, which escape me at the moment. Another third is to Medicare Advantage providrs, I.e. insurance companies. The reduction in any of this does not reduce the base Medicare fee for service plan. At present people without a plan are subsidizing those with a plan. At least this is how I understand it. Medicare advantage is similar to Obamacare except Medicare pays the bills. The premiums to the plans cover parts not paid by Medicare. There are no cuts,to doctors. Most doctors take Medicare. I haven’t found one,yet who did not, but…… BTW I also believe the 716m is over ten years, so not a hell of a lot to worry about. Just more bullshit to plow through.
Oops that’s billions of dollars. I’m not good with those zeros. Also note DD said these savings extend the trust fund from 2016 out to 2024.
Badges! We don’t need no stinkin” badges!
Medicare! We. don’t need no stinkin’ Medicare!
(Apologies to last line in Treasure of the Sierra Madre.)
Among many other schemes deep in the bill is the payment for providers that incentivises less treatment especially for sicker patients. There is also The U.S. Preventive Services Task Force which sets guidelines for what benefits will be provided. In practice this prevents the providers and patients from determining individualized best care.
http://www.ahrq.gov/clinic/uspstfix.htm
Lots of links to follow depending on the depth you want to go into as far as just how these guidelines are developed and promoted/enforced.
You sound like you know what you’re talking about.
From the Trustees Report:
Note – the most important of which are the reductions in the payment rate updates for most categories of Medicare providers
If all the stars allign, we’re good. If not…