Archive for the ‘Medicare’ tag
Speaking of Shock and Awe, I wonder if the Tea Party types realize that by voting for Trump and his GOP buddies, they are about to get their wish fulfilled, and get government hands off of their Medicare. Because Medicare will cease to exist as soon as Trump takes office. Oopsie…
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.
First, Ryan claims that Obamacare has put Medicare under deeper financial stress. Precisely the opposite is true. And it’s so straightforward Ryan unquestionably knows this. The Affordable Care Act actually extended Medicare’s solvency by more than a decade. Ryan’s claim is flat out false.
Second, I’ve heard a few people say that it’s not 100% clear here that Ryan is calling for Medicare Phase Out. It is 100% clear. Ryan has a standard, openly enunciated position in favor of Medicare Phase Out. It’s on his website. It’s explained explicitly right there.
Ryan says current beneficiaries will be allowed to keep their Medicare. Says. But after the cord is cut between current and future beneficiaries, everything is fair game. For those entering the system, Ryan proposes phasing out Medicare and replacing it private insurance with subsidies to help seniors afford the private insurance. That is unquestionably what it means because that is what Ryan says. So if you’re nearing retirement and looking forward to going on Medicare, good luck. You’re going to get private insurance but you’ll get some subsidies from the government to pay the bill.
(click here to continue reading Ryan Plans to Phase Out Medicare in 2017.)
Nah, probably not. Many don’t seem to be particularly well-informed.
Paul Ryan’s ideas are so toxic to the voting public, he can never articulate these ideas. He’s been a flim-flam man for so long, he’s probably forgotten what it is like to be honest. Perfect for the party of Donald Trump, in other words.
The details of Ryan’s vision have always remained somewhat foggy. The conservative revolution Ryan has in mind isn’t a popular or cultural one; it is entirely legislative. And the predicate for enacting it isn’t to sell a set of ideas to the public, but to steel the spines of legislators to vote for Ryan’s ideas no matter what the public thinks.
Ryan’s revolutionary ideas themselves aren’t entirely clear, either, though that wasn’t always the case. Before he became the undisputed intellectual leader of the conservative movement in the Obama era, he laid out a series of specific and radical reforms–including Social Security and Medicare privatization–in a 2008 bill called the Roadmap for America’s Future. When it fell to him as chairman of the House budget committee to draft a governing agenda for the whole party, though, many of the details vanished.
Ryan still wants to devolve Medicare into a subsidized system of competition between insurance carriers, but only for seniors in the distant future. He still wants to hand Medicaid over to the states and slash its budgets by hundreds of billions of dollars. He still wants to cut income tax rates for the wealthy to about a third of their current level. He still wants to spend lavishly on the military. But when asked how to pay for it all, he’s exceedingly vague. He promises to cut tax expenditures, but doesn’t say how or which ones. He promises to slash the domestic discretionary budget (which disproportionately benefits the poor), but won’t say which programs, or by how much.
All of that was to be decided after Republicans won the White House. That was Ryan’s game plan when he was budget chairman; it remained his game plan as the GOP’s vice presidential nominee in 2012. And the plan seemed to be well within reach when Republicans finally consolidated control of Congress in 2015, and a raft of talented candidates were lining up to fill the last piece of the puzzle: the presidency.
It’s impossible to fully grasp Ryan’s thinking without understanding how close he feels he’s come to realizing a decades-old dream. That dream, as Grover Norquist told CPAC four years ago, culminates with the election of a figurehead. “We are not auditioning for fearless leader. We don’t need a president to tell us in what direction to go. We know what direction to go. We want the Ryan budget…We just need a president to sign this stuff. We don’t need someone to think it up or design it. The leadership now for the modern conservative movement for the next 20 years will be coming out of the House and the Senate…Pick a Republican with enough working digits to handle a pen to become president of the United States.”
(click here to continue reading Why Paul Ryan Can’t Quit Donald Trump | New Republic.)
In a just universe, Donald Trump will lead to an overwhelming loss to the Republican Party, putting the GOP as the minority party for decades in both House and Senate.
While record numbers of Americans sign up for the larger Medicaid health insurance program for the poor, financial issues are emerging for medical care providers in the two dozen states that didn’t go along with the expansion under the Affordable Care Act.
Reports out in the last week indicate the gap between those with health care coverage is widening between states that agreed to go along with the health law’s Medicaid expansion and those generally led by Republican legislatures and GOP governors that are balking at the expansion.
The moves against expansion are “beginning to hurt hospitals in states that opted out,” a report last week from Fitch Ratings said. The U.S. Department of Health and Human services has said Medicaid enrollment in the 26 states and the District of Columbia that agreed to go along with and implemented the expansion by the end of May “rose by 17 percent, while states that have not expanded reported only a 3 percent increase,” HHS said in an enrollment update for the Medicaid program.
“We expect providers in states that have chosen not to participate in expanded Medicaid eligibility to face increasing financial challenges in 2014 and beyond,” Fitch said in its July 16 report. “Nonprofit hospitals and healthcare systems in states that have expanded their Medicaid coverage under the Patient Protection and Affordable Care Act have begun to realize the benefit from increased insurance coverage.”
(click here to continue reading Hospitals See Troubles In Red States That Snubbed Obamacare’s Medicaid Deal – Forbes.)
What consistently boggles my mind is that the poor, uninsured people in Republican-leaning states still vote for Republicans. Self-hating folk presumedly. Or else the Tea-Bagger propaganda is so powerful, it has convinced them to vote against their own interests.
A report last week from the Robert Wood Johnson Foundation and the Urban Institute described the coverage difference as a “gulf in percentage of people without health insurance” that is growing larger between states that expanded Medicaid and those that did not.
As of June, the report said 60 percent of the nation’s uninsured residents live in states that did not expand Medicaid. That figure was up from 49.7 percent in September of last year.
Warren Buffett’s Op Ed begins:
SUPPOSE that an investor you admire and trust comes to you with an investment idea. “This is a good one,” he says enthusiastically. “I’m in it, and I think you should be, too.”
Would your reply possibly be this? “Well, it all depends on what my tax rate will be on the gain you’re saying we’re going to make. If the taxes are too high, I would rather leave the money in my savings account, earning a quarter of 1 percent.” Only in Grover Norquist’s imagination does such a response exist.
Between 1951 and 1954, when the capital gains rate was 25 percent and marginal rates on dividends reached 91 percent in extreme cases, I sold securities and did pretty well. In the years from 1956 to 1969, the top marginal rate fell modestly, but was still a lofty 70 percent — and the tax rate on capital gains inched up to 27.5 percent. I was managing funds for investors then. Never did anyone mention taxes as a reason to forgo an investment opportunity that I offered.
(click here to continue reading A Minimum Tax for the Wealthy – NYTimes.com.)
And of course, he’s right, but logic has been banned from the modern conservative party. Historical perspective as well, apparently, unless Regan is involved. At least President Obama has said that Social Security is off the table, in the short term at least. Just waiting for Defense spending to join the deficit party – we could halve our military spending every year for the next ten, and still spend more than any other country on the planet. Even the Democrats never seem to mention slicing defense spending as part of the Grand Bargain.
In a speech at the Center for American Progress on Tuesday, Sen. Dick Durbin (D-Ill.) , urged progressives to be open to Medicare and Medicaid reforms as part of long-term deficit talks.
But he also said both entitlement programs, along with Social Security, should be off the table during fiscal cliff negotiations.
“Progressives should be willing to talk about ways to ensure the long-term viability of Social Security, Medicare and Medicaid, but those conversations should not be part of a plan to avert the fiscal cliff,” Durbin said in his remarks.
“I think the point we tried to make in the campaign was the Paul Ryan approach [turning Medicare into a quasi-voucher program] we think threatens the existence of these programs and the services they provide,” Durbin told reporters later in the day. “That’s unacceptable. There has to be a better, more positive approach that saves money and at the end of the day, is going to keep these programs alive.”
Sen. Jeanne Shaheen (D-N.H.) agreed with Durbin that Social Security should be off the table, noting that it has not contributed to the debt.
(click here to continue reading For Fiscal Cliff Talks, Medicare Reform Still On Table For Senate Democrats.)
Greg Sargent adds:
Now this is encouraging. I’m told that representatives of major unions and progressive groups met privately this morning with senior Obama administration officials at the White House — and were pleased with what they heard.
Things can always change at a moment’s notice. But attendees at this meeting came away convinced — for now — that the White House firmly believes it has the leverage in the fiscal cliff talks, and has no intention of budging on the demand for higher tax rates from the rich or on other core priorities.
Indeed, one person at the meeting — which included people from the AFLCIO, AFSCME, SEIU, MoveOn and others — came away convinced that the White House would ultimately prove willing to go over the fiscal cliff if necessary, rather than give ground on core demands, though this is not by any means a desired option and isn’t being discussed as a strategic possibility.
…“They remain in the same place: They expect taxes to go up on the wealthy and to protect Medicare and Medicaid benefits,” the attendee added. “They feel confident that they don’t have to compromise.”
White House officials also signaled in the meeting that they are going to insist that Republicans agree to resolve the need to raise the debt ceiling as part of the fiscal talks — and won’t abide a separate fight over it, attendees said. Also key: Attendees got the impression the White House does not view this looming debt ceiling battle in the same terms as the 2011 fight, where Republicans had the leverage.
(click here to continue reading Reasons to be encouraged about fiscal cliff’s endgame – The Plum Line – The Washington Post.)
Sen. Dick Durbin (D-IL), who has almost become the liaison to the left for cuts to federal health care programs in the grand bargain, gave a speech today at the Center for American Progress that included a couple important points:
• Durbin sequenced the provisions of the deal, saying that Republicans would have to build the framework on taxes, which includes an increase in the top marginal rates, before any Democrat will even begin to talk about social insurance programs. This seems like a hardline stance, but it just mirrors the dominant conversation, which has focused on taxes to the exclusion of practically everything else.
• Though Durbin has sought to bring rank-and-file Democrats along on a grand bargain that would include cuts to those social insurance programs, he set out some red lines. In addition to rejecting the privatization of Medicare or Social Security and the block granting of Medicaid – a common tactic to reject the extreme view to provide space for more modest but still damaging cuts – Durbin took Social Security almost entirely off the table. This matches White House Press Secretary Jay Carney’s statements yesterday. It does appear that’s been filed away for the time being.
In addition, Durbin said, regarding spending cuts on anti-poverty social programs, “Let me be clear: Those cuts will not happen.” And he sought to line up with the Administration’s viewpoint that any changes to Medicare and Medicaid can happen without cuts to benefits, through payment reforms or provider cuts. This would “strengthen” those programs through the reform, he said. He also wanted to exempt infrastructure spending fully from any cuts.
(click here to continue reading Durbin Outlines Democratic Approach on Grand Bargain | FDL News Desk.)
Democratic leaders, frustrated by the GOP’s unwillingness to reckon with the need to raise taxes, are publicly airing the hard-bargaining demands they’re bringing to budget negotiations with Republicans.
The Senate’s top two Democrats, in separate remarks Tuesday, each said that Congress could avoid looming across-the-board tax increases and spending cuts if House Republicans agree to freeze all the Bush tax rates except those benefitting top earners. If that were accompanied by an increase in the debt limit, and the creation of a separate track for reforming the tax code and social safety net programs in 2013, the near-term austerity problem will be solved, and lawmakers can call it a day.
In other words, Senate Democrats are staking out the position that entitlement reform should not be on the table in fiscal cliff negotiations.
“If we fail to reach an agreement, the average middle-class family will see their taxes go up by $2,200 a year,” said Senate Majority Leader Harry Reid (D-NV) told reporters at his weekly press availability. “As I’ve indicated, the Senate has already reacted to stop that and the House is one vote away from making that a reality for many millions of Americans who are middle class.”
(click here to continue reading Top Democrats Drive Hard Bargiain In Budget Talks | TPMDC.)