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INFOGRAPHIC: Not All Cuts To Medicare Are Created Equal

Mitt Romney and Paul Ryan have spent the better part of their young campaign hitting President Obama and the Affordable Care Act for cutting an estimated $716 billion from Medicare.

But Romney and Ryan have offered a proposal that would voucharize the Medicare program and significantly reduce the government’s contribution. Romney has pledged to balance the budget by the end of his second term and would have to cut as much as $2 trillion from Medicare to achieve his goal, spending the money on tax breaks for the rich. Seniors, meanwhile, would be stuck with higher premiums:

NEWS FLASH

Romney Officially Embraces Ryan’s Plan For Medicare | Mitt Romney’s presidential campaign sought to distance the former Massachusetts governor from Paul Ryan’s controversial Medicare privatization plan on Saturday, but by Monday, Romney fully embraced his running mate’s proposal. During a press availability in Miami, Romney turned down three opportunities to explain how his vision would differ from Ryan’s, telling reporters, “my plan for Medicare is very similar to his plan for Medicare.” Watch it:

Ron Wyden Pushes Back Against Being Linked To Paul Ryan’s Medicare Plan

In two speeches over the last few days, Mitt Romney invoked Democratic Senator Ron Wyden of Oregon to attempt to burnish Rep. Paul Ryan’s (R-WI) credentials as a compromiser and a savior of Medicare. In one, Romney said his vice presidential pick “found a Democrat to co-lead a piece of legislation to make sure we can save Medicare.” In another, he brought up Wyden by name: “Paul Ryan and Senator Wyden said, ‘No, we need to restore, retain and protect Medicare… That’s what our party will do.”

Sen. Wyden, however, did not take kindly to the association. Wyden fired out a statement Saturday evening that read, in part:

Gov. Romney is talking nonsense. Bipartisanship requires that you not make up the facts. I did not ‘co-lead a piece of legislation.’ I wrote a policy paper on options for Medicare. Several months after the paper came out I spoke and voted against the Medicare provisions in the Ryan budget. Governor Romney needs to learn you don’t protect seniors by makings things up, and his comments today sure won’t help promote real bipartisanship.

The plan Sen. Wyden co-authored with Ryan does bear a striking resemblance to the proposed Medicare changes in Ryan’s latest budget for the House GOP. Both keep traditional Medicare as a kind of public option, in an exchange where it would compete with private plans offering insurance to seniors. The government would give seniors support for purchasing these plans, and that support would be benchmarked to the cost of the second-least expensive plan. The plans would also be prohibited from discriminating based on pre-existing conditions.

But there are also some key differences between Ryan and Wyden: For one thing, the Wyden-Ryan plan would cap the growth rate of this new version of Medicare at the growth of the economy plus one percent, while Ryan’s budget would cap it at economic growth plus 0.5 percent. And, as Wyden pointed out, their joint plan was a policy proposal — not a piece of actual, sponsored legislation. Paul Ryan himself has admitted the two plans are not the same thing.

More important, however, is understanding Wyden’s support for these Medicare reforms within the context of his stances on broader health care reform. Wyden voted for President Obama’s Affordable Care Act — the health reform bill that used a similar exchange structure to cover all Americans not already ensured by their employers, Medicare, or Medicaid. Before that, Wyden co-authored a bill with Sen. Bob Bennett (R-UT) which would have extended the exchange-based coverage system to every American not in Medicare or in the military. Meanwhile, the latest House GOP budget — which Wyden pointedly refused to support — repeals the ACA, casting everyone who isn’t a senior back into the country’s prior dysfunctional system, with severe cuts to Medicaid to boot.

It is clear that Wyden supports these changes to Medicare as one part of a comprehensive system to provide every American with competitive and affordable health care. Ryan supports them as one opportunistic step in the GOP’s efforts to dismantle the social safety net.

Politics

Republicans In Competitive Races Distance Themselves From Ryan’s Medicare Plan

Mitt Romney may hope that picking Paul Ryan as his running mate will help him shore up the Republican base, but many of Romney’s fellow Republicans in competitive elections aren’t quite as happy to see Ryan’s name on the November ballot.

Republicans in tight congressional races are moving to distance themselves from Ryan and the piece of legislation for which he is best known, his extreme “Path to Prosperity” budget, in hopes that they can win over swing voters by criticizing the Medicare-ending plan.

Here are just some of the candidates eschewing the Ryan budget:

Richard Tisei – In his district outside of Boston, Tisei won’t win on a hardline Republicans budget plan, so Tisei has tried to avoid the issue of the Ryan budget altogether. “I just don’t think it’s going to be an issue in this race,” he told Politico.

George Allen – Virginia’s senate race is Allen’s best hope to get back into politics after his 2006 loss, and he’s hoping to be able to ally himself with the Romney-Ryan ticket without having to embrace Ryan’s proposed Medicare cuts. At a rally on Thursday, when Allen was asked about supporting the Ryan plan, he told reporter, “I think your assertion’s incorrect,” and “I haven’t had a chance to look at their latest permutation from it.”

Denny Rehberg – Rep. Denny Rehberg (R-MT) is running a competitive race for the Senate, and while he embraced Romney’s pick of Ryan, he simultaneously tried to signal to voters that Ryan and he had policy disagreements, writing in a release shortly after the announcement, there are “few occasions where” the two disagreed.

Chris Collins – Rep. Kathleen C. Hochul’s (D-NY) competitor refused to even discuss the Ryan budget with reporters over the weekend, fleeing from the quandary of the Ryan budget and its effects on Medicare. “I’m not going to get into a discussion now about a budget that may be passed next year with a new president and new Congress,” Collins told the Buffalo News, “I’m not going to go back and relive any proposal in the past because they are in the past.”

Brendan Doherty – The Rhode Island House candidate, Brendan Doherty, told Slate reporter Dave Weigel that he does not support the part of the Ryan budged that is “privatizing Medicare.”

Linda McMahon – McMahon’s opponent goaded the Connecticut senatorial candidate into distancing herself from the Ryan budget, releasing a statement asking whether McMahon would support Ryan’s Medicare cuts. In response, a McMahon spokesperson gave National Journal perhaps the most firm statement of opposition from a Republican candidate. “Linda McMahon will never support a budget that cuts Medicare,” he said.

As evidenced by this strategy video that instructs Republicans on how to cope with voters’ negative associations with the Ryan budget, this is a serious — and losing — issue for most Republicans. Their best hope is to quickly pivot the conversation away from Medicare, or they risk losing senior voters.

Update

Maggie Brooks, who is running for the House in New York, doubled down on her disapproval of Ryan’s Medicare plan Monday, saying “It has always been my position that I do not support the Ryan budget and its proposals regarding Medicare. However, I applaud Governor Romney’s choice as Congressman Ryan understands the dire need for fiscal reform, reducing our immense national debt, and controlling unsustainable levels of federal spending.”

Paul Ryan Proposed IPAB-Like Measures He Now Wants To Repeal

One of vice presidential candidate Paul Ryan’s favorite criticisms of the Affordable Care Act is that the Independent Payment Advisory Board (IPAB) — a 15-panel board that recommends ways to reduce Medicare costs — would “ration” health care for seniors. But in 2009, Ryan proposed two cost-control advisory boards in his Patients’ Choice Act that were remarkably similar to the Obamacare provision.

The ACA explicitly prohibits the IPAB from cutting benefits and the board would only develop a plan to lower costs only if health care spending exceeds a set threshold. Ryan’s boards are more severe and would have gone further to lower provider reimbursement rates by including penalties for physicians who don’t follow guidelines.

ThinkProgress compared the two plans:

PCA ACA
Board Structure Commission–5 members appointed by the President subject to Senate approval. No commissioner may engage in any other business, vocation, or employment; Forum–15 members chosen by the Commission 15 members appointed by the President subject to Senate approval. No member may engage in any other business, vocation, or employment.
Operative Element “The development and periodic review and updating of standards of quality, performance measures, and medical review criteria” Offer recommendations as to how to cut back on Medicare spending costs
Scope of Authority Entire health-care system; commissioners will select specific targets. Medicare
Recommendation Frequency Recommendations must be made once a year Recommendations are only made when the Medicare’s per capita expense exceeds its growth targets
Source of Enforcement Authority Commission works directly with the Secretary of Health and Human Services without congressional oversight. IPAB’s recommendations must be approved by Congress.
Guideline enforcement Exclude providers from federal health care programs or impose civil fines Impose cuts in health providers’ reimbursement benefits

Former ThinkProgress intern Sarah Bufkin contributed to this post.

Five Reasons Why Paul Ryan Is Bad For Women’s Health

During the Republican primary, GOP presidential nominee Mitt Romney promised to pick a running mate who is just as anti-abortion as he is, and he seems to have found that in Paul Ryan. “I’m as pro-life as a person gets,” Ryan, who is Roman Catholic, told the Weekly Standard in 2010.

The Republican from Wisconsin has cast 59 anti-choice votes on abortion and reproductive rights issues during his seven terms in Congress. From supporting restrictive limitations on abortion services to restricting military women’s access to abortion care, Ryan’s record firmly establishes him as an anti-choice politician. Here are five of his extreme positions everyone should know about:

1. Ryan co-sponsored a “personhood” amendment that would give legal rights to a fetus starting at conception. Ryan joined 62 other Republicans in co-sponsoring the Sanctity of Human Life Act, an anti-abortion measure declaring that a fertilized egg “shall have all the legal and constitutional attributes and privileges of personhood.” This would outlaw abortion, some forms of contraception and in-vitro fertilization.

2. Ryan supports banning all abortions, even in cases of rape and incest. In addition to his support of the personhood amendment, Ryan won his congressional seat in 1998 by emphasizing his opposition to all abortions without exceptions. But this puts him at odds with Mitt Romney, who has said he would allow exceptions in cases or rape and incest.

3. Ryan voted to ban abortion coverage from being included in the state health insurance exchanges. The Stupak amendment that Ryan backed would have prevented women from purchasing plans that cover abortion services through the exchanges set up under Obamacare — even when using their own funds.

4. Ryan compared Roe v. Wade to the Dred Scott Supreme Court decision. “Twice in the past the U.S. Supreme Court—charged with being the guardian of rights—has failed so drastically in making this crucial determination that it ‘disqualified’ a whole category of human beings, with profoundly tragic results,” Ryan wrote in 2010. After the 1857 case, Dred Scott v. Sandford, “the second time the Court failed in a case regarding the definition of “human” was in Roe v. Wade in 1973,” he added.

5. Ryan has supported defunding Planned Parenthood. In 2011, he voted for an amendment that would block Planned Parenthood and the health care organization’s affiliates from receiving any funds in a 2011 continuing appropriations bill.

NEWS FLASH

Ryan Family Financially Benefits From The Health Insurance Industry | Vice presidential candidate Paul Ryan’s wife, Janna, has previously worked as a lobbyist for a “roster of clients [that] included pharmaceutical and insurance clients such as Novartis, Cigna and Blue Cross/Blue Shield,” a Reuters profile reveals. Janna isn’t the only member of the family who has profited from the private health insurance industry. Campaign finance records show that Ryan has received significant funds during the 2011-2012 cycle, raking in $81,850 from pharmaceuticals and $37,468 from HMOs — $65,650 of which came from healthcare-affiliated PACs. Ryan touts a Medicare plan that would expand the role of private insurers by replacing the traditional Medicare plan with a voucher program that seniors could use to purchase private health plans.

Romney Claims Obama ‘Robbed Medicare’ To Distract From GOP Plan To End Medicare

Mitt Romney and Paul Ryan are turning the GOP’s greatest political liability — a proposal to drastically restructure Medicare for seniors — into a sharp attack against President Obama, despite Republican efforts to cut more than a trillion from the program.

“There’s only one president that I know of in history that robbed Medicare, $716 billion to pay for a new risky program of his own that we call Obamacare,” Romney said during the ticket’s first interview together on CBS, honing in on a charge the pair has reiterated at every campaign stop since the two Republicans joined forces on Saturday:

What Paul Ryan and I have talked about is saving Medicare, is providing people greater choice in Medicare, making sure it’s there for current seniors. No changes, by the way, for current seniors, or those nearing retirement. But looking for young people down the road and saying, “We’re going to give you a bigger choice.” In America, the nature of this country has been giving people more freedom, more choices. That’s how we make Medicare work down the road.”

Watch it:

The $716 billion figure comes from the Congressional Budget Office’s latest estimate of the Republican proposal to repeal the law, though the office doesn’t back up the charge that Obama stole the money from the current Medicare budget. Rather, the savings slow the growth of Medicare over the next decade: eliminate overpayments to private insurers, reform provider payments to encourage greater efficiency, tie reimbursements to improvements in economic productivity, and reduce fraud and abuse.

As a result, “growth in spending will be restrained” and the life of the Medicare trust fund is expanded by eight years, the government estimates. Sixteen million seniors are also benefiting from the savings by receiving preventive benefits without deductibles or co-pays and saving more than $3.9 billion on prescription drugs.

The Ryan-backed GOP budet maintains these cuts, but rather than using them to improve the Medicare program, it applies the savings to pay for massive tax cuts. As the budget chairman himself admitted during an April 5, 2011 speech at the American Enterprise Institute (AEI), “We retain the Medicare savings” — and that’s not all. The Republican blueprint transforms the existing Medicare benefit guarantee into a premium support program that would provide seniors with depreciating vouchers to buy insurance from private plans.

The plan essentially institutes cuts on top of the $716 billion reduction. Total federal spending on Social Security, interest, and health care would plunge to 16 percent of GDP by 2050 under Ryan’s budget — “the lowest level since 1950, when Medicare, Medicaid, most federal funding for education, highways, and environmental protection, and various other significant federal activities did not exist,” Congressional Budget Office data indicates. And federal spending per Medicare beneficiary would decrease “by 35 to 42 percent in 2050.”

Romney’s proposal — which is short on details and does not outline cuts to specific programs — is even more extreme. While Ryan would “cut entitlement and discretionary programs (outside of core defense and net interest) by $5.2 trillion over ten years,” the Romney proposal would reduce spending “by between $7.0 trillion and $9.6 trillion.” To meet this goal, “Medicare would be cut by $185 billion in 2016 and $2.0 trillion from 2014 through 2022,” the Center on Budget and Policy Priorities (CBPP) estimates, leading to “large increases in premiums and cost-sharing charges” for beneficiaries.

So if Romney thinks that Obama “robbed Medicare,” then he and Ryan prepared to bleed it dry entirely.

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