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March 22, 2012 10:01 AM In Ryan Budget Fight, Will Poor Folks Be An Afterthought?

By Ed Kilgore

If you’ve been reading Ezra Klein’s outstanding reporting at WaPo on Paul Ryan’s revised budget proposal, or Jonathan Cohn’s at The New Republic, or my own commentary here, you are probably aware that we all think the remarkable thing about what Ryan is trying to do is his unprecedented effort to decimate federal benefits and services benefitting the poor, across the board.

But that’s not what Ryan and his allies have been worried about, at all, as evidenced by this piece on GOP planning from Jake Sherman of Politico:

On the day before the budget rollout, top Republicans gathered in Speaker John Boehner’s smoky Capitol conference room with National Republican Congressional Committee officials and went over key phrases. Call the Medicare reform “bipartisan,” they were told. Frame it as helping to “fix Medicare and keep it from going bankrupt.” Be sure to point out that Americans 55 or older would not be affected. And say it gives seniors the choice of “staying in the current Medicare system or using the new one.”
Using this phrasing, 46 percent in an internal GOP poll — conducted in January — would support the Republican argument that Medicare is going bankrupt, Republicans were giving them a choice and the GOP is trying to preserve the program. The Democratic argument that Republicans were ending Medicare registered at 37 percent.
The precise, strategic sales job of the Ryan budget is a far cry from last year’s clunky rollout, and a sign that Republicans have learned some lessons in political strategy on the divisive issues underlying the Ryan vision.

Medicare, Medicare, Medicare. It’s all about Medicare, and how seniors perceive the Ryan budget as affecting Medicare. Take care of that problem, and it will be clear sailing for the Ryan budget, its proponents clearly believe. And they may well be right, since a lot of Democrats don’t really want to talk about anything else, either.

Indeed, in the entire Sherman piece, the word “poor” appears exactly once, at the tail end of a Democratic litany of criticism of the Ryan budget that begins, of course, with “Medicare.”

But here’s the thing: Ryan’s proposed changes to Medicare, which he’s watered down and backloaded, are probably not even the most significant health care provisions in the proposal. Here’s Jon Cohn:

[I]t’s not the Medicare population that takes the biggest hit this time. It’s the Medicaid population. For starters—and this was the very first thing Ryan mentioned at his press conference—Ryan would repeal the coverage expansions of the Affordable Care Act. This is old news, I know. But few people seem to appreciate the impact. Take away the Affordable Care Act and you take away insurance from the 30 million people who are supposed to have it come 2014, when the law goes into full effect. About half of them are supposed to get that coverage from Medicaid.
Now throw in Ryan’s proposal to convert Medicaid into a block grant, under which the federal government would no longer guarantee insurance coverage for everybody that meets eligibility standards. Instead, the government would simply write checks to the states, for predetermined amounts, and let them figure out how best to spend the money. To generate the savings his budget needs, he’d reduce the value of those grants over time, relative to health care costs and current projections.

The bottom line on health care is this, Cohn concludes:

Altogether, the CBO says, spending on Medicaid, the Children’s Health Insurance Program, and subsidies for private insurance would be nearly 75 percent lower in 2050 than projected under current law. (See figure below, from the CBO report.) Let that sink in for a minute: Ryan wants to reduce the government’s investment in helping people get health insurance by three-quarters.

Will that “sink in” when the public debate over the Ryan budget gains momentum? Or will Democrats collude with Republicans in making it all about Medicare, and whether or not seniors can or should trust Republicans assurances that they’ll let the rest of the population go to hell in a handbasket before they’ll touch their benefits! (Matter of fact, even an exclusive focus on seniors should lead back to Medicaid, since low-income seniors, and those receiving long-term care assistance, are its disproportionate beneficiaries).

Yes, yes, I understand seniors tend to vote in high numbers, and that if Republicans lose the advantage among white seniors they enjoyed in 2008 and 2010, they are toast in 2012. I also understand that Ryan and company really do want to abolish “Medicare as we know it,” and for that matter, Social Security as well, and that’s a very bad thing that progressives have a responsibility to expose and fight.

But I also know that poor people don’t have a lot of political clout in this country, and that progressives have a special responsibility to defend them, whether or not they are swing voters or reside disproportionately in battle-ground states.

You just can’t look objectively at Ryan’s budget and make it anything less than the most audacious attack on federal responsibility for the poor and disabled since the Great Society. It makes the Reagan budgets of the early 1980s look kind and generous. Let’s please don’t forget that as the debate unfolds.

Ed Kilgore is a contributing writer to the Washington Monthly. He is managing editor for The Democratic Strategist and a senior fellow at the Progressive Policy Institute. Find him on Twitter: @ed_kilgore.

Comments

  • jcricket on March 22, 2012 10:21 AM:

    Ryan wants to give funding to states to do with it as they want...and you can bet red states with governors ushered into office in 2010 by Teabaggers will take the money and immediately reduce corporate taxes in their states. (look at Wisconsin!)

    So...the national taxpayer will be subsidizing a teabagger governor's crony capitalism raid on the treasury.

    This is what they are after...after the Bush years emptied out the national treasury of the surplus and created the huge deficit, now they are looking at a new way of siphoning off taxpayer money.

    Ryan is just hoping that not enough people are paying attention.

  • stormskies on March 22, 2012 10:24 AM:

    So once again it's a matter of 'selling' this sadistic Ryan plan. Of course that means LYING about what the reality actually is. So of course lying is what these sadistic Repiglicans are the very best at: it's all they really know how to do.

    And, yet again, these sadistic pigs called Repiglicans will be dependent on two things to make their sadistic wet dream come true. (1) The corporate media who will megaphone their 'selling' points so as to create yet another smoke screen that shields the actual reality of what this sadistic policy will do, and (2) the underlying stupidity of a vast amount of our fellow citizens who will be fooled by the Luntz created selling points.

    These Repiglicans are simply fucking sadists. Nothing more, nothing less.

  • Diane Rodriguez on March 22, 2012 10:32 AM:

    Moral bankruptcy informs the actions of the GOP. The meme that "don't worry, we're only going to booty bang those younger than you, oh, and also poor people" is a core value with the current Congressional Republicans. There were a whole bunch of old white folks claiming Tea Party alliances that spent an entire summer brawling and spitting their hate of everything not white, old and ignorant. Anger over your own mortality and the irrelevance of your own importance is a powerful catalyst. The GOP is quite successful in using anger to gain control for Machiavellian purposes.

    Unfortunately, there are too many TV personalities and bloggers ( they ceased being journalists long ago) who refuse to move off the "centrist" dime and call extremist behavior for what it is. Wholesale destruction not does merit a debate. More and more Mussolini comes to mind.

  • Josef K on March 22, 2012 10:41 AM:

    Isn't this how revolutions get started?

  • martin on March 22, 2012 10:41 AM:

    The dems should take a page from the deficit hawks and start reminding the seniors, and everyone else, what this budget will do to their children and their grandchildren.

  • anon-y-mouse on March 22, 2012 10:47 AM:


    George W. Bush tried to use coded words as he went around selling privatization of Social Security. Recall they used terms such as personal accounts rather than private.
    It failed.
    I still have the newpaper's color photos of seniors in revolt, irately holding placards reading "Hands off my social security."

    There is time to counteract the Republican strategies.

    People pay attention to these life-sustaining programs.

    Look what happened in Wisconsin as attention was drawn to Paul Ryan as a result of activism.

    Keep the faith. Stay positive. Gear up for the election.
    Know your state's voting law and get ready now for November.

    There is already backlash on Ryan's cruel proposals from medical professionals. And they see a lot of people daily.

  • boatboy_srq on March 22, 2012 11:01 AM:

    Medicare, Medicare, Medicare. It’s all about Medicare, and how seniors perceive the Ryan budget as affecting Medicare.

    Medicare recipients are a substantial portion of the remaining GOP voting bloc.

    We shouldn't be surprised that they're all for screwing the folks coming after them: they're making sure they get theirs and the rest of us can "bootstrap" just like they did. Oh, wait...

  • Mudge on March 22, 2012 11:03 AM:

    It is as it's ever been. The Republicans wail about cutting government health care costs (Medicare, Medicaid) but say absolutely nothing about how to cut actual health care costs. This is just a plan to transfer the costs from government to individuals, who can ill afford them. Add in that the great majority of Medicaid outlays go to children, the elderly and the disabled, the most at risk and least able to find ways to offset a decrease in government support.

    It's all about enriching the "creators" at the expense of (their term) the "moochers". They are sociopaths and have no concern for the majority of citizens of this country. It's as it's ever been.

  • dalloway on March 22, 2012 11:13 AM:

    The pushback is simple: do you trust the people who lied us into Iraq, who looked the other way while the banksters tanked the economy and who tried to privatize Social Security the last time they ran the country?

  • Mitt's Magic Underpants on March 22, 2012 11:17 AM:

    Dems can't play the game. Trillions of dollars more in tax cuts for the 1%, and the Dems can't score. Jeebus.

  • LaFollette Progressive on March 22, 2012 11:31 AM:

    To a Randian true believer like Ryan, eliminating aid to the poor is a virtue, because the aid discourages them from leading productive lives. It's for their own good, of course.

    Even if one buys this dubious premise, though, the blunt fact is that S-CHIP and the lion's share of Medicaid benefits do not cover expenses for able-bodied young adults. Much Medicaid spending goes to the disabled, and services for indigent seniors that Medicare doesn't cover, particularly long-term care. S-CHIP, of course, subsidizes care for children.

    So the practical effect will be to cause suffering, illness, degraded living conditions, and preventable deaths for the disabled, the elderly, and children with chronic diseases. All to teach us a majestic moral lesson about the virtues of hard work (which, remember, they would prefer to occur in an environment with no minimum wage, unions, OSHA regulations, overtime restrictions, or subsidized educational opportunities)

    And, most importantly, this will pay for tax cuts for the wealthy -- cuts which are so large that the spending cuts *don't even balance the budget*.

    Any candidate for public office who endorses this madness deserves to be hounded every single day from now until November. America may be a conservative country, but it does not have a majority of Randian wankers.

  • Danny on March 22, 2012 11:43 AM:

    Will that “sink in” when the public debate over the Ryan budget gains momentum? Or will Democrats collude with Republicans in making it all about Medicare, and whether or not seniors can or should trust Republicans assurances that they’ll let the rest of the population go to hell in a handbasket before they’ll touch their benefits!

    Sorry Ed, but this is b-s writing. Pure hack job.

    Here's this guy, Paul Ryan, a Republican. He's proposed a budget that is loved by Republicans, but which is not only heartless, even mean, but also dangerous in the way it axes pretty much all that government does except defense, Social Security and Medicare. In addition, it also erodes Medicare as we know it.

    And what do you do? You myopically - and preemptively - obsess over whether Democrats will pick a messaging strategy that you would have picked. Worst kind of backseat driving. And burying the lead in a rather inane way.

    That's not the freaking issue here, and I certainly aint interested in your thoughts on the subject. I'm interested in hearing you telling me how the Ryan budget will affect me and this country. That's the issue here.

    If you want influence messaging strategies I suggest you either get back to being a 'Democratic strategist' or just write about the freaking stuff in the Ryan plan that we need to know about. How about that?

  • dp on March 22, 2012 11:45 AM:

    Someone might point out that his proposal will cost EVERYBODY health care money by massively increasing, even over the present situation, the amount of cost-shifting to private insurance by health care providers.

  • Robert Waldmann on March 22, 2012 11:46 AM:

    I was planning to comment typing something like " (Matter of fact, even an exclusive focus on seniors should lead back to Medicaid, since low-income seniors, and those receiving long-term care assistance, are its disproportionate beneficiaries)." Elderly Americans know this. In polls the majority opposed to cutting Medicaid is similar to the majority opposed to cutting Medicare. Democrats can run against the Medicaid cuts even if they are too spineless to stand up for the non-elderly poor.

  • tcinaz on March 22, 2012 11:47 AM:

    Ryan's budget makes complete sense if you couple it with their voter restriction strategy. First, get states to enact voter i.d. laws that disproportionately disenfranchise poor people and minorities. Then deepen the pool of poor people with a budget that is deliberately conceived to do exactly that by increasing the costs of being poor. The end result is a voting advantage for Ryan and Republicans, attacking a class of voters who never support them anyway, at no political cost to Republicans. We have a new Republican war going on, a war on the poor.

  • nerd on March 22, 2012 12:07 PM:

    If the current narrative is about Medicare it is time to change the discussion.

    Perhaps it should be about Ryan the Hood. Steals from the poor to give to the rich.

    That is what Ryan's budget is about, massive cuts in expenditures but still massive deficits because of tax cuts for the rich. If you aren't rich, this budget cuts you, dearly

  • schtick on March 22, 2012 12:29 PM:

    The poor an afterthought? Hell no! They gonna pay the taxes to fund the tealiban wars while they stay at home and pop out all those babies that will grow up to fill those bodybags and the 1% of the tealiban will get rich off the no-bid contracts to fleece whatever they can from the taxpayers.

  • iyoumeweus on March 22, 2012 1:05 PM:

    HEALTH CARE
    Raise the Medicare entitlement fee to 2% of total income including wages, salaries, bonuses, interest, dividends, capital gains and other forms of income. Those paying more than $2,000.00 will receive a tax deduction.
    Allow Federal government to negotiate with PHARMA industry to lower drug prices.
    Allow VA Hospitals to care for low income non-veterans.
    Carry out the Medicare/Medicaid cost reductions mandated by the Affordable health Care Act so that the growth can be slowed. Putting these provisions into action fully and as soon as possible is the best way to reign in spending.
    Allow Medicare to bundle payments for several standard procedures nationwide phase in over the next four years payments for all procedures and primary care completely replacing ‘fee-for-service’.
    Implement competitive bidding for durable medical equipment, prosthetics, orthotics, laboratory tests, pharmaceutical and other medical supplies.
    Require electronic eligibility, claims processing and payment as well as centralized physician credentialing.
    Do not pay extra for technologies that are more expensive but no more effective than other available technologies.
    Allow all citizens a under the age of 60 a choice between a Medicare Public Option or private health insurance. All over 60 would receive Medicare.

  • dianne on March 22, 2012 1:18 PM:

    I just don't get these t-partiers. They are the main ones affected by these cuts and like lemmings, they keep marching off a cliff. 60% of all nursing home patients are there because of Medicaid. Once Medicaid is gone, they will have to either go home to be cared for in the bosom of their families (get that LVN degree, ladies) or if they have used up all of their resources, out of the pocketbooks of their families. The Republicans have as many old, sick, frail relatives as anyone else.
    If this happens, they will be the first to scream when that first $6000 bill comes due.
    Once the nursing homes begin to lose patients due to non-payment, then begin to close down, the bills will rise even higher. What then? Warehouse the elderly at the mall?

  • OldSourdough on March 22, 2012 1:28 PM:

    Just to educate you young 'uns a little, Medicaid helps low-income Medicare recipients in two ways. First, Medicare Part A (hospital) is free but Part B (doctor) isn't. There's a monthly premium of about $100. For those whose incomes fall below a certain threshold, Medicaid may pick-up that premium. Second, Medicare has very high deductibles as well as a co-pay. So most Medicare recipients buy a supplement. For low-income recipients, Medicaid is that supplement.

  • Perspecticus on March 22, 2012 1:47 PM:

    "Afterthought"?!? In this discussion, the poor are hardly and afterthought. Hell, the entire budget plan uses the poor to pay for it. No, not an afterthought; the entire focus.

  • Doug on March 22, 2012 8:49 PM:

    I don't see it as an either/or. As Democrats focus on maintaining Medicare as it is, while attacking Republicans' plans to change it for everyone, they can ALSO pledge to keep the current SS and Medicaid programs intact.
    Republicans are going to try to turn; ie, bribe, seniors against their children and grandchildren; by promising to "grandfather" those currently 55 or older. Democratic speculation about how long any Republican agreement on "grandfathering" will last certainly wouldn't be amiss. After all, if Republicans are willing to screw over everyone under the age of 55; how long will it take for them to start screwing over those OVER 55?
    We report, you decide...

  • Bobber on March 22, 2012 9:43 PM:

    I've asked you this before in an e-mail, Ed, (which you never responded to by the way. Jerk.) but isn't the most effective weapon the Democrats have against the Ryan budget the fact that he says Seniors 55 and up are safe from these drastic cuts? Since current workers fund medicare for CURRENT beneficiaries, if you give current workers the option to divert their medicare taxes into the stock market or whatever, wouldn't that deplete money that would go to fund medicare for current seniors? It's seems fundamentally impossible (if I'm understanding how medicare funding works) for the RYan plant to NOT effect current seniors' benefits.