What President Obama isn’t saying about Medicare

By Jonathan Martin for Politico

President Barack Obama wanted to make the differences with his GOP opponents crystal clear at a rally in senior-heavy Melbourne, Fla., earlier this month.

“Here’s the bottom line,” Obama said: “Their voucher plan for Medicare would bankrupt Medicare. Our plan strengthens Medicare. No American should have to spend their golden years at the mercy of insurance companies.”

The president better hope his audience hadn’t thumbed through Bob Woodward’s latest book.

As Woodward explains in “The Price of Politics,” Obama was willing to make significant changes to the cherished federal health care plan for seniors last year as part of a grand bargain with congressional Republicans.

And 2011 was hardly the first time Obama considered confronting the costly and popular program; it’s also highly likely it won’t be the last if he’s reelected.

In 2009, right before he was sworn in, the president-elect told The Washington Post he wanted to make “hard decisions” on entitlements.

Now that he’s in the midst of a tough reelection against a Republican whose running mate is identified with a controversial Medicare proposal, however, Obama is sounding notes out of the traditional Democratic hymnal. The incentive to attack Mitt Romney and Paul Ryan on the issue is simply too alluring to resist and, for the moment, any notion of being seen as a big, post-partisan figure who wants to bravely take on the most difficult of issues is taking a backseat to the political needs of the president and his party.

To be sure, there are major differences between the Republican plan for restructuring Medicare — which would ultimately nudge seniors toward the private market — and what Obama would tolerate. And Romney, by attacking the president for Medicare cuts in the new health care law, ignores that Ryan included the same reductions in his own budget.

But Obama is more willing to alter Medicare than he’s letting on. That’s because his campaign is based in part on motivating core supporters and swing voters with fear-stoking about what the GOP would do to the Great Society pillar.

In his campaign ads airing in Florida, Obama hits Romney and Ryan for their plan to offer next-generation seniors the choice of a voucher to pay for health care costs and asserts that such voters could pay up to $6,400 more under the GOP proposal.

And on the stump in the Sunshine State, Obama invariably repeats the same charge about the Republicans wanting to “voucherize” Medicare.

What gets less notice in the president’s speeches to Florida audiences is the fig leaf he deploys to cover the changes he’d be willing to make to the program.

“Yes, we will reform and strengthen Medicare for the long haul — but we’ll do it by reducing the cost of health care, not by dumping those costs onto seniors,” Obama said at the rally in Melbourne.

Not surprisingly, the president doesn’t delve into what exactly he means when he pledges to “reform and strengthen Medicare for the long haul.”

“President Obama’s political attacks against Gov. Romney on Medicare are deeply disingenuous and hypocritical,” said Romney adviser Danny Diaz, adding: “Instead of passing meaningful reforms to preserve and strengthen Medicare for future generations, it’s clear President Obama prefers to demagogue the issue on the campaign trail. Voters deserve better from their president — they deserve an honest conversation about ensuring the program’s long-term solvency for tomorrow’s seniors.”

Obama is already on the record indicating a willingness to cut costs from Medicare as part of reforming the program.

That was the central idea behind last summer’s would-have-been grand bargain: Democrats make concessions on spending, including Medicare, in exchange for Republicans compromising on additional revenues.

As Obama himself explained when he appeared in the West Wing last July to announce the collapse of the deal: “We then offered an additional $650 billion in cuts to entitlement programs — Medicare, Medicaid, Social Security. We believed that it was possible to shape those in a way that preserved the integrity of the system, made them available for the next generation and did not affect current beneficiaries in an adverse way.”

Behind the scenes, Obama and his top aides made clear that they were willing to swallow serious changes to Medicare in exchange for deficit reduction.

As Woodward’s new book lays out, there was agreement between the White House and congressional Republicans on raising the eligibility age for Medicare — the only question was on how fast to phase it in.

Obama officials initially proposed raising the age from 65 to 67 “by one month a year, meaning the full two-year increase wouldn’t be complete until 2046,” Woodward wrote.

After House Speaker John Boehner balked at such a slow phase-in, the White House gave some on the issue.

“They still wanted to raise it at the slower rate of one month per year, but would agree to start the process four or five years earlier,” wrote Woodward.

Also on the table during the aborted talks between Vice President Joe Biden and House Majority Leader Eric Cantor: higher premiums for seniors at higher income levels.

It’s almost certain that any fiscal agreement will include some sort of expanded Medicare means testing. The president has already demonstrated a willingness to further raise premiums on wealthy seniors and to broaden the reach of the premiums to have more beneficiaries pay for services.

Obama, in an interview with Woodward, acknowledged he was open to nudging reluctant liberals on Medicare and Social Security if Republicans were willing to deal on taxes.

“’I am willing to move on entitlement reform — even if my own party is resisting, and I will bring them along — as long as we have significant revenues so that people feel like there’s a fairly shared burden when it comes to deficit reduction,’” Obama recalled telling Boehner.

Asked how they square Medicare attacks on Romney with their own efforts to squeeze savings out of the program, Obama spokesman Ben LaBolt said they could do so going forward without raising the eligibility age. But LaBolt didn’t issue an ironclad pledge on the age issue, leaving some daylight open for negotiation.

“President Obama has always been willing to make hard choices to confront big challenges, and sometimes that means listening to other ideas,” LaBolt said. “But President Obama believes we can strengthen the future of Medicare without raising the eligibility age and his budget provides a blueprint for doing just that. It cuts fraud and wasteful payments to insurance companies and finds measures that lower costs throughout our entire health care system. What he is not willing to do is accept Gov. Romney’s plan — cutting taxes for millionaires while saying we have no choice but to turn Medicare into a voucher program and repeal the Affordable Care Act.”

If Obama is reelected and does attempt to redraft the outlines of the deal he tried to strike with Boehner, he’ll face resistance: House Minority Leader Nancy Pelosi was uneasy about making such big changes to Medicare during the 2011 discussions and remains wary.

“She has been very clear on that,” said one congressional Democratic official, adding: “Coming after an election when that issue will have been litigated, do they really want to do that? There are pretty significant blocs of members that will say: ‘Hell no.’”

What bothers Democrats on Capitol Hill, but not a lame-duck White House, is that any compromise that includes Medicare cuts would deprive the party of a significant issue heading into 2014.

“Look at the senators who are up next time,” said the congressional Democrat, citing the many red-state and swing-state Democrats up for reelection in two years. “You’d chop them off at the knees right before they start running.”

1 Comment

  1. Richard Heckler on September 28, 2012 at 7:52 pm

    Face it most elected officials are afraid to cut off the medical insurance industry.

    How to Strengthen Medicare Single Payer Insurance? Start by immediately allowing seniors to purchase pharmaceuticals through the VA system.

    Next open Medicare Single Payer Insurance to all taxpayers and let them make the choice as we speak. Allow consumers the opportunity to switch on their terms. No arm twisting. If some consumers do not want to give up expensive coverage it’s their money. What could possibly be more American?

    60% of insured are covered with taxes worth approximately $1.2 trillion tax dollars according to Physicians for a National Health Program. This $1.2 trillion is more than enough to provide insurance to all in the nation under Medicare Single Payer.

    Medicare Single Payer Insurance makes Americans more employable and opens doors for small business ventures. Opens doors for new industry.

    What could possibly be more American? Providing Americans with the choice of IMPROVED Medicare Insurance for ALL is the only equitable approach that includes all of us. No arm twisting.

    IMPROVED Medicare Insurance for ALL would save hundreds of billions annually by eliminating the high overhead and profits of the private health insurance industry and HMOs.

    Why not go into this matter that leaves the choice open to citizens. No arm twisting.

    This program could commence almost immediately by consolidating all of the following into the program.
    • all on social security and their dependents
    • all disabled veterans
    • all Iraq/Afghanistan veterans
    • all government employees
    • all currently uninsured

    What this approach does is provide veterans with more convenient choices for Medical care.

    Face it Medicare Single Payer Insurance will dramatically reduce the cost of medical insurance to all governments and school districts.

    Are Americans ready for IMPROVED Medicare Insurance for ALL? Of course.