Defending Sebelius: Seniors Would ‘Die Sooner’ Under GOP Budget

Jonathan Chait has a good piece on how this Washington Post editorial sets the conventional wisdom about entitlement reform, shielding Rep. Paul Ryan (R-WI) from any serious criticism about the consequences of his plan. It’s as if having a plan is actually more important than the substance of the actual proposal or as Chait puts it, “The need to do something is deemed so overwhelmingly vital that it’s immoral to criticize any plan that does something, however harmful or poorly designed that something may be.” In that vein, the Post editorial goes after HHS Secretary Kathleen Sebelius for claiming during a recent Education and Labor Hearing that more people might die under Ryan’s proposal:

Health and Human Services Secretary Kathleen Sebelius told a House panel that seniors would “die sooner.” The Democratic National Committee proclaimed in an ad: “Their leaders have called for cutting Medicare, and now for killing it.”

This is false, inflammatory and, as we said, useful — for winning elections, that is. When it comes to solving the government’s most pressing problem, it threatens to set things back.

But why is it false to argue that shifting more of the cost of health care coverage to seniors and strapping them with a depreciating health care voucher would make it harder for them to afford care and cause them to skip (or just not receive) life saving medical treatment? Forty-five thousand Americans die prematurely every year because they lack health insurance coverage — a number that would only grow if Ryan were to repeal most of the Affordable Care Act and transform the Medicaid program into block grants.

The Medicaid changes would contribute to the deaths of the poorest and most vulnerable. Ryan would get rid of the existing matching fund program — under which the federal government pays 50 to 75 percent of each state’s Medicaid costs — and give states block grants that are smaller than projected funding. As a result, states would have to make up the difference by increasing spending or (more realistically) capping enrollment, cutting eligibility, limiting mandatory benefits and lowering provider reimbursements. In fact, an analysis of Newt Gingrich’s 1995 block grant proposal concluded that had that plan been adopted, 48 states would have experienced a reduction in federal dollars and “more than 6 million people would have lost Medicaid coverage in 2002.” If all this wouldn’t cause people to “die sooner” than I don’t know what will.