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From the category archives: privatization

Paul Ryan Peddles Dangerous Fictions on "60 Minutes"

House Speaker Paul Ryan perpetuated dangerous falsehoods about Medicare on CBS “60 Minutes” Sunday night.  In an interview with correspondent Scott Pelley, Ryan hauled out the myth that “Medicare goes bankrupt in about 10 years.”  He continued, “The trust fund runs out of money.  So we have to make sure that we shore this program up.”  Really? 

To Ryan, “shoring up” Medicare means privatizing it, creating what we at the National Committee call “coupon care.”  Seniors would have to fend for themselves in the private insurance market with government-provided vouchers that wouldn’t fully cover their premiums or out-of-pocket costs.  Traditional Medicare would be left to wither and die.

Ryan’s plan is based on a fake crisis.  Contrary to the Speaker’s claims on “60 Minutes,” Medicare does not go bankrupt in 10 years.  It’s true that – without increasing payroll taxes – the Medicare Hospital Trust fund (which finances Medicare Part A) will become depleted in 2028.  However, as the Center for Budget and Policy Priorities (CBPP) points out, “incoming payroll taxes and other revenue will still cover 87% of Medicare hospital insurance costs.”  That’s a far cry from bankruptcy, Mr. Ryan.

Any shortfalls, CBPP notes, could be covered by “raising revenues, slowing the growth in costs, or most likely both,” without wrecking traditional Medicare - options that Ryan doesn’t seem inclined to consider.

The other fiction that Ryan perpetrates in his “60 Minutes” appearance is that his Medicare “reforms” wouldn’t “change the benefit” for anybody who is in or near retirement – only Gen X’ers (like Ryan himself) and subsequent generations. This is simply untrue.  Our own analysis at NCPSSM indicates that privatizing Medicare could adversely impact anyone 55 and older (including people currently enrolled in traditional Medicare) because of potentially higher premiums, benefit cuts, and higher out-of-pockets.  Neither seniors nor their children and grandchildren should believe Ryan’s false assurances.  There is simply too much at stake.

Medicare Privatization Tops the GOP Agenda

Well, that didn’t take long.  Just days after the election and already the GOP has confirmed, what we’ve been warning for months.  Destroying traditional Medicare in favor of a privatized CouponCare system is at the top of the Republican agenda.  In fact, they want it to happen as soon as next year.

“Below is a transcript of what Ryan said on Fox's Special Report, along with a flat out false statement suggesting that Obamacare has weakened Medicare's finances.

BRET BAIER: Your solution has always been to put things together including entitlement reform. That is Paul Ryan's plan. That's not Donald Trump's plan.

PAUL RYAN: Well, you have to remember, when Obamacare became Obamacare, Obamacare rewrote Medicare, rewrote Medicaid. If you are going to repeal and replace Obamacare, you have to address those issues as well. What a lot of folks don't realize is this 21-person board called the ipap is about to kick in with price controls on Medicare. What people don't realize is because of Obamacare, Medicare is going broke, Medicare is going to have price controls because of Obamacare, Medicaid is in fiscal straits. You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare. Those are part of our plan.” ...Talking Points Memo

Let’s be crystal clear about this – without Obamacare, Medicare’s Part A trust fund would have faced insolvency now.  Instead, because of the cost savings in the Affordable Care Act, including; trimming the billions in government subsidies going to the insurance industry in Medicare Advantage and productivity adjustments to how Medicare pays providers the program gained more than a decade of solvency.

“The net result was that the “insolvency” date was extended by 12 years. Before the law was passed, the trustees said in 2009, the fund was going to be depleted in 2017. “The short-range financial outlook for the HI [hospital insurance] trust fund is substantially more favorable than projected in last year’s annual report, primarily as a result of the Affordable Care Act,” the Medicare trustees said in their 2010 report, saying the fund would last until 2029.”...Washington Post

Fact checkers appropriately gave Speaker Ryan Four Pinnochios for this obvious lie:

“Medicare certainly faces financial stress as the baby-boom generation begins to retire in full force, but it’s important to get the facts straight. It’s bad enough that Ryan, like many politicians, uses imprecise rhetoric such as “broke”; that’s a Two-Pinocchio violation. But the House speaker really went off the rails when he said on national television that Obamacare is making the program go broke. That’s the exact opposite of what happened.”

 

 

As we’ve said here before, repeal of the ACA will have an immediate impact on seniors. While Republicans continue their cynical promise that “reforms” won’t touch current seniors (because they believe America’s “greedy geezers” only care about their own benefits and don’t care about what happens to their children and grandchildren) the truth is, repealing Obamacare hits millions of American seniors immediately and robs the Part A trust fund of more than a decade of solvency:  

“Medicare’s financing challenges would be much greater without the health reform law (the Affordable Care Act, or ACA), which substantially improved the program’s financial outlook.  Repealing the ACA, a course of action promoted by some who simultaneously claim that the program is approaching “bankruptcy,” would worsen Medicare’s financial situation.”... Center on Budget and Policy Priorities.

“The Affordable Care Act strengthens Medicare's financing by increasing efforts to reduce waste, fraud and abuse; slowing the rate of increase in payments to providers; improving quality of care and phasing out overpayments to private Medicare Advantage plans, plans that are continuing to increase their enrollments each year.  The impact of these provisions has already resulted in extending the solvency of the Medicare Part A Trust Fund by more than a decade and lowering Part B out-of-pocket costs for beneficiaries.

In addition to Medicare beneficiaries, the Affordable Care Act is very important to millions of adults ages 50-64 who are uninsured because they do not have access to affordable private insurance.  Many of these individuals are now able to purchase private insurance even if they have pre-existing medical conditions, and costs are more affordable due to the law's limits on age rating and the subsidies available for lower-income beneficiaries.

The number of uninsured “young seniors,” aged 50-64, would increase, leaving them in poorer health by the time they are eligible for Medicare – thereby increasing Medicare’s costs.”...NCPSSM, 2015 ACA Repeal Letter to Congress

And all of this only addresses the clearly false assertion made by Speaker Ryan that Medicare is going “bankrupt” and that Obamacare is the reason.  What is equally important for seniors to understand is what Ryan’s CouponCare plan actually means for them. We’ll address that more completely in a future post but as a reminder:  the Ryan plan will end traditional Medicare, privatizing it, while raising seniors’ costs.  Under CouponCare seniors pay more for less coverage.

The GOP’s voucher plan works this way:

•           Rather than you going to your doctor and Medicare pays the bill, under CouponCare the federal government will give you a voucher each year that you will then use to go out and buy private insurance out in the open market or to pay for Medicare.

•           However, those coupons’ values are based on the cost of Medicare in a particular community or the second lowest private health insurance plan, whichever is cheaper.  So if, you choose to stay in traditional Medicare, and it costs more than virtually the cheapest plan out there, you’ll pay more.  Let’s be really clear, vouchers are designed to shift costs to seniors.  That’s how the government saves money. 

The Kaiser Family Foundation estimates 59% of seniors would have to pay higher premiums in order to receive the same Medicare plans they now have, with the average premium increase coming in at $107 per month, they didn’t even look at co-pays and out-of-pocket costs. 

The Congressional Budget Office looked at this in 2011 and said it would double beneficiaries’ costs.

After George Bush won re-election in 2004 and the Republicans controlled Congress, privatizing Social Security was the first order of business.  Here were go again -- but this time your Medicare is the target. The American people don’t support privatizing Medicare; however, it has long been the goal of conservatives who believe seniors should be forced back into a private insurance marketplace which history has proven, over and over again, they simply can’t afford. 

The Trump Conundrum: He Can’t Keep His Promise to Seniors While Also Repealing Obamacare

Donald Trump made a lot of promises to the American people during the Presidential campaign.  For seniors, who supported him overwhelmingly, none was more important that his promise “not to touch” middle-class benefits in Social Security and Medicare.  There’s no doubt his political calculus during this campaign accurately tapped in to a core middle-class value: 

"As Republicans, if you think you are going to change very substantially for the worse Medicare, Medicaid and Social Security in any substantial way, and at the same time you think you are going to win elections, it just really is not going to happen."...Donald Trump, 2013 CPAC speech, Washington Times

The problem for President-elect Trump is that the American people fully expect his administration to now keep that campaign promise. Unfortunately, preserving Medicare and Social Security benefits could be among the first of his promises to go. Trump and Republican leaders in Congress have vowed the repeal of the Affordable Care Act will be one of their first acts. For seniors, that means billions in lost Medicare benefits, the return of the Part D prescription drug donut hole and years of solvency taken from Medicare. Millions of seniors will immediately feel the effects of these Medicare cuts which will weaken the program itself.

“The Affordable Care Act strengthens Medicare's financing by increasing efforts to reduce waste, fraud and abuse; slowing the rate of increase in payments to providers; improving quality of care and phasing out overpayments to private Medicare Advantage plans, plans that are continuing to increase their enrollments each year.  The impact of these provisions has already resulted in extending the solvency of the Medicare Part A Trust Fund by more than a decade and lowering Part B out-of-pocket costs for beneficiaries.

In addition to Medicare beneficiaries, the Affordable Care Act is very important to millions of adults ages 50-64 who are uninsured because they do not have access to affordable private insurance.  Many of these individuals are now able to purchase private insurance even if they have pre-existing medical conditions, and costs are more affordable due to the law's limits on age rating and the subsidies available for lower-income beneficiaries. 

The number of uninsured “young seniors,” aged 50-64, would increase, leaving them in poorer health by the time they are eligible for Medicare – thereby increasing Medicare’s costs.”...NCPSSM, 2015 ACA Repeal Letter to Congress

In addition to the immediate Medicare cuts that come with the repeal of Obamacare, the Republican Congress has made it clear another top priority is to turn Medicare into CouponCare.  In fact, the Medicare Payment Advisory Commission (MedPac), has already announced it will include analysis of the GOP’s Medicare privatization plan in its annual report next year. The Republican plans for Medicare, passed in GOP budgets over many years was most recently described in the “A Better Way” campaign led by House Speaker Paul Ryan.  It has already been embraced by Vice President-elect Mike Pence:

“What’s so inspiring to me is how much consistency there is between Donald Trump and the agenda House Republicans have put forward with a ‘Better Way.'”...Vice President-elect Mike Pence.

Again, President-elect Trump won’t be able to have it both ways on this issue.  If he wants to preserve seniors’ benefits in Medicare, as promised during the campaign, then adopting a voucher plan designed to shift costs to seniors fundamentally violates that pledge. Privatizing Medicare with a voucher plan, will leave seniors and people with disabilities – some of our most vulnerable Americans – hostage to the whims of private insurance companies and making it even harder for seniors to choose their own doctors. Beneficiaries will pay more money for less coverage because vouchers will not keep up with the increasing cost of health insurance. That is how the program saves money – at seniors’ expense. In fact, the Congressional Budget Office predicted the CouponCare proposal in the GOP’s 2011 budget would cost seniors $20,000 more each year. Over time, this proposal will create a death-spiral ending traditional Medicare. This scheme is, by definition, the antithesis of “not touching” seniors’ benefits.

This conundrum for the Trump administration doesn’t end there. On Social Security, unfortunately, the warning signs for seniors are just as alarming.  Trump advisors and the Republican platform have made it clear that “entitlements” will very likely be on the agenda of a Trump presidency.

“After the administration has been in place, then we will start to take a look at all of the programs, including entitlement programs like Social Security and Medicare. We’ll start taking a hard look at those to start seeing what we can do in a bipartisan way.”

“...I think that whoever [is] the next president is going to have a horrible time in dealing with this, because those entitlements will race to the front of all the economic issues we have in this country.”  Sam Clovis, Trump campaign Chief Policy Advisor, May 2016

"I think you're going to see him do it across the board on entitlements."

"He's not making the case because it's a political suicide to make this case. If you go up and start saying I'm going to attack Social Security, I'm going to attack Medicaid...there goes those votes. So no smart politician is going to step into this milieu."

"At the end of the day, somebody's gotta say you've got to move the retirement age up two years."...Tom Barrack, Trump Economic Advisor, August 2016

The American people have spoken.  They said they wanted change – they got it.  And yet...they’ve also made it clear they don’t support cutting middle-class benefits for millions of American families who depend on Social Security and Medicare. Time will tell whether President Trump will keep the promises candidate Trump has made and what this “change” election will actually mean to workers who’ve earned their Social Security and Medicare benefits and expect them to be protected, as promised. 

What You Did and Did Not Hear about Social Security Last Night

Debate watchers predicted last night’s Vice Presidential debate might put policy above personality (for a change) and to some degree that happened.  For starters, the words Social Security and Medicare were finally uttered by participants.  That’s progress given that millions of average Americans and their families depend on these programs, plus the fact that the candidates’ records couldn’t be more different. The discussion itself; however, certainly wasn’t very deep. Here is the exchange.

There are a couple key points here.  Mike Pence absolutely refused to acknowledge or address in any way his record as one of Congress’ leading supporters of privatization.  As we reported earlier, when Pence was in the House he supported a privatization scheme that was even more draconian than the failed effort by President Bush.  Even after the President admitted defeat, Pence continued to push for the privatization of Social Security.  But Pence’s dodge and deflect skills were in full force last night:

KAINE: But -- but you have a voting record, Governor.

PENCE: And I get all of that. I just, look...

KAINE: I...

PENCE: There's a question that you asked a little bit earlier that I want to go back to.

KAINE: I can't believe that you won't defend your own voting record.

PENCE: I have to go back to.

QUIJANO: We...

PENCE: Well, look, I -- you're running with Hillary Clinton, who wants to raise taxes by $1 trillion, increase spending by $2 trillion, and you say you're going to keep the promises of Social Security. Donald Trump and I are going to cut taxes. We're going to -- we're going to -- we're going to...

KAINE: You're not going to cut taxes. You're going to raise taxes on the middle class.

PENCE: ... reform government programs so we can meet the obligations of Social Security and Medicare.

Republican talking points have long required that candidates use “reform” when they mean cut, and “protect” when they mean privatize.  The promise to protect current seniors’ benefits is also a poll-tested strategy designed to misdirect attention away from plans to cut benefits for future generations. This “greedy geezer” approach assumes seniors only care about their own benefits, not their children and grandchildren’s.   

“The purest articulation of intergenerational warfare as a wedge to break up Social Security's political coalition is a 1983 paper published by the libertarian Cato Journal. It was titled "Achieving a 'Leninist' Strategy," an allusion to the Bolshevik leader's supposed ideas about dividing and weakening his political adversaries.

The paper advocated making a commitment to honor Social Security's commitment to the retired and near-retired as a tool to "detach, or at least neutralize" them as opponents of privatization or other changes. Meanwhile, doubts among the young about the survival of the program should be exploited so they could be "organized behind the private alternative."

So when you hear a politician promising to exempt the retired and near retired from changes to Social Security, while offering to make it more "secure" for future generations, you now know the game plan.”...Los Angeles Times, 2012

Senator Tim Kaine was right to try and force some clarity from the Trump/Pence campaign on their specific plans for the nation’s most effective retirement and health security programs because, in a nutshell, the Donald Trump of this campaign does not resemble the “Social-Security- is-a-Ponzi scheme” Donald Trump of any other year.  Why, is not really mystery as Trump 2.0 himself has said:

"As Republicans, if you think you are going to change very substantially for the worse Medicare, Medicaid and Social Security in any substantial way, and at the same time you think you are going to win elections, it just really is not going to happen" ...Trump at 2013 Conservative Political Action Conference

Hopefully, last night’s VP debate won’t be our only chance to hear the Presidential campaigns address Social Security and Medicare.  American voters deserve to hear specifics about what these candidates have done and said...not just what they promise they’ll do. 

Why Tonight’s Debate Matters – Especially for America’s Seniors

By most accounts, tonight’s Vice Presidential debate candidates Democratic Senator Tim Kaine and Republican Governor Mike Pence will meet for the only time as virtual unknowns to many voters. NBC has this analysis:

 

“The two running mates are among the least known vice presidential candidates in recent elections. Remember Sarah Palin, Dick Cheney and even Joe Biden? Of course. But many voters in 2016 have never heard of Clinton's and Trump's number two. In the latest NBC/WSJ poll, 55 percent of respondents either didn't know enough about Kaine to form an opinion about him or were completely neutral. And 49 percent said the same thing about Pence.

 “While both candidates' primary goal is to reassure skeptical voters that their ticket can be trusted and that they compensate for the presidential candidates' perceived weaknesses, a secondary goal will be to drive home policy differences. Because both Pence and Kaine, with long histories of governing, are well steeped in policy, this could be the most substantive debate of any of the three presidential debates.”

If issues finally take center stage tonight, we would certainly hope to hear the stark differences between the two candidates on Social Security and Medicare described for voters. As we first detailed here, Mike Pence, was one of Congress’ most aggressive Social Security privatization supporters. As leader of the Republican Study Committee, the House’s far-right wing caucus, during the Bush administration, Pence doubled-down on President George Bush’s failed privatization efforts by calling for an even larger private accounts scheme to be implemented sooner, putting Americans at even greater fiscal risk than the President’s doomed plan. The Washington Times reported in 2005:

“The Bush plan allows workers to divert 4 percent of their wages into investment accounts, and to choose from a set of investment strategies. But the conservatives are leaning more toward a plan sponsored by Rep. Paul Ryan, Wisconsin Republican, which would allow diversion of 6 percent of wages.

‘Conservatives want to see personal retirement accounts that have immediate relevance to younger Americans, that they can see the value, and that will require that they be big and that they be implemented in the final bill without delay,’ said Rep. Mike Pence, Indiana Republican and chairman of the 100-member Republican Study Committee (RSC).”

Beyond privatization, Pence’s comments make it clear there isn’t a Social Security, Medicare or Medicaid benefit cut he won’t embrace:

“I think everything has to be on the table...I think it’s absolutely imperative, whether it’s Social Security, Medicare or Medicaid.”

“With regard to entitlements we’re going to have to take some deep cuts in domestic spending.” CNN, 2010

“I was tea party before it was cool.”  Indianapolis Monthly, 2011

On health issues, Pence’s record is just as anti-senior as his Social Security stance. He aggressively opposed the Affordable Care Act (ACA) and fought for its repeal, which would worsen Medicare’s solvency and take away billions in added benefits and cost savings for seniors.  He voted against the creation of a prescription drug benefit (Part D) in Medicare, opposes allowing the re-importation of prescription drugs and allowing Medicare to negotiate for lower drug prices, he supported legislation that would deny non-emergency treatment for lack of a Medicare co-pay, and most importantly supports the GOP/Ryan budget which would destroy Medicare in favor of “Couponcare,” giving seniors a voucher to take shopping for insurance rather than protecting traditional Medicare’s guaranteed coverage.

Not surprisingly given his legislative history, we scored Mike Pence at 0% on issues important to seniors during the 2011-2012 Congress since he voted for multiple pieces of legislation that would cut benefits and programs that protect senior’s health and financial security.

Tim Kaine, on the other hand, has long opposed the privatization of Social Security.  He supports healthcare reform through the Affordable Care Act and has co-sponsored the Medicare Prescription Drug Negotiation Act (S. 31), which would end the ban on prescription drug price negotiations for Medicare, allowing the government’s largest health care program to use the same price negotiation process that the Veterans Administration uses to negotiate with pharmaceutical companies.  Kaine is also a member of the Senate Special Committee on Aging and co-sponsored the reauthorization of the Older Americans Act. 

The differences between the two Vice Presidential candidates on the issues of Social Security and Medicare couldn’t be starker.  We only hope tonight’s debate provides an opportunity for voters to hear about the issues which directly impact millions of Americans’ lives. 

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