As Boomers swell Medicare rolls, Congress debates program’s future

WASHINGTON–Between the bombshell comments by Republican presidential hopeful Newt Gingrich and the headlines from a dry but urgent 273-page financial status report, Medicare has taken center stage in the current political debate.

Connecticut’s Democratic House members have collectively held more than a half-dozen town hall meetings on the issue in recent days, mostly to blast the controversial Republican proposal that would essentially privatize the program.

“We had a standing-room-only crowd on a Monday afternoon in Meriden,” Rep. Chris Murphy said of an event he held at a senior center this week. The 5th District Democrat said his message was, “We need to do everything possible to stop the Republicans radical plan to turn Medicare into a private voucher system. And I didn’t have to push that message very hard on Monday, because the 100-plus people who were there were delivering it to me.”

Congressional Republicans, for their part, have been defending their Medicare plan as fiscally responsible and forward-thinking. The GOP is also striking back, targeting House Democrats, including Rep. Jim Himes, D-4th District, with robo-calls attacking him on Medicare.

The tenor of the debate, Himes said, “is ugly, and it’s political, and it’s inaccurate.”

At issue is the fate of one of the nation’s most popular and costly safety-net programs. Medicare provides health care to seniors, serving more than 47 million people in 2010. It’s also eats up a significant slice of federal budget–15 percent–with expenditures hitting $523 billion last year.

The skirmish over Medicare is taking place just as the first Baby Boomers are signing up for the program, putting new pressure on the system. “We have 9,000 people a day become eligible for Medicare,” Health and Human Services Secretary Kathleen Sebelius said at a news conference this week. She said overall, the program will enroll an estimated 3.3 million new beneficiaries every year until while the boom generation is moving through the system.

As lawmakers in both parties scramble for fresh ideas about how to rein in annual deficits and trim the national debate, it’s no wonder that Medicare has emerged as a flashpoint. House Republicans provided the spark with a budget proposal, drafted by Budget Chairman Paul Ryan of Wisconsin, that called for transforming Medicare into a subsidy program.

Instead of the government reimbursing health providers for seniors’ care, the elderly would get a voucher to purchase insurance in the private market. That change wouldn’t affect current retirees, but would go into effect for those who are now under 55. While the plan would save billions of dollars, the nonpartisan Congressional Budget Office has concluded the voucher would not cover actual expenses for most patients–meaning seniors would have to dip into their own pocketbooks to pay the difference.

Ryan said when unveiling his plan that it would make the program more fiscally sustainable, while also giving younger workers more flexibility. But in the weeks after the GOP approved that plan in the House, Democrats have made it their No. 1 target.

“It’s so blatantly unfair to people who have worked their whole lives and paid payroll taxes and would now get stuck with a benefit that everyone knows in their bones is not going to be secure in terms of coverage when you are at that stage of life,” said Rep. Joe Courtney, D-2nd District.

Plus, Courtney said, it’s unlikely that private insurance companies would jump at the opportunity to offer seniors insurance coverage. He noted that part of the reason Congress created Medicare in 1965 was because “insurance companies wouldn’t touch people with that high a risk.”

Newt Gingrich, the ex-House GOP Speaker and 2012 presidential candidate, gave Democrats additional fodder when he said last weekend that Ryan’s plan was “right-wing social engineering”–a statement from which he has since backtracked.

Murphy and Himes, as well as Reps. John Larson, D-1st District, and Rosa DeLauro, D-3rd District, have each held town hall meetings in the last two weeks to talk about Medicare. DeLauro said her message was simple: Republicans want to “end Medicare” and put seniors at “the mercy of the private insurance market.”

“There is nothing in the Republican budget that talks about containing health care costs,” DeLauro added.

Himes has scheduled eight sessions on Medicare this week and next. He also recently sent out a congressional mailing on the issue. “Medicare is supposed to be there for our seniors,” the headline on the franked mail piece says. “Now some in Congress want to take that security away.”

Last Friday, the Medicare trustees issued a financial report, concluding that the program will become insolvent by 2024, five years earlier than last year’s assessment. That has become a fresh line in the GOP’s response. They’ve argued that Democrats want to preserve the status quo and that would eventually mean a bankrupt Medicare program. That’s essentially the message listeners have heard in the robo-calls, paid for by the National Republican Congressional Committee, about Himes’ position on Medicare and which the GOP is using against other Democrats as well.

“Dems’ plan for Medicare? Severe benefit cuts & bankruptcy,” House Speaker John Boehner, R-Ohio, said in a Tweet yesterday.

Himes dismissed the Republican line of attack as “the worst sort of hypocrisy,” noting that Democrats improved Medicare’s financial solvency with major cost-savings measures included in the health reform law. The 4th District Democrat is also one of the few Democrats to embrace entitlement reform as a way to deal with the solvency of those programs and the broader debt crisis.

“Medicare is three-quarters of the enchilada,” said Himes, and represents “$30 trillion in unfunded liabilities. We can’t ignore that,” he said, but “we also can’t fix it on the backs of the most vulnerable.”

Several Connecticut Democrats said they would like to see some of the cost-containment provisions included in the Affordable Care Act expanded or accelerated, as a way to further rein in Medicare expenditures.

Courtney noted, as did last week’s Medicare trustees’ report, that the health reform law extended Medicare’s fiscal life by eight years, by encouraging new payment models and focusing on wellness and prevention, among other things.

“That systemic approach to the health care system, as a way to help Medicare, is what’s really necessary,” Courtney said. He said Congress “left a lot of things on the table” during the health reform debate, from allowing Medicare officials to negotiate drug prices to increasing physician collaboration, that could further reduce Medicare costs.

Himes and Murphy similarly said that speeding up health reform would help address Medicare’s finances. “The health care bill gives a blueprint for how to save Medicare for the long run,” Murphy said. “If that doesn’t get us there, we should look to bringing additional revenue into the program.”

DeLauro said the best way to put Medicare on sounder footing is to rev up the economy, noting that part of the trustees’ bleak analysis about Medicare’s solvency stems in part from lower-than-projected tax revenue.

But with such a polarized debate now underway, it seems unlikely that Congress will reach any sweeping agreement on Medicare this year.

Republicans, for example, have complained that Democrats are using “scare tactics” in their descriptions of Ryan’s plan. The response from some Democrats? “You reap what you sow,” as Courtney put it.

He noted that in the 2010 election, Republicans ran blistering ads against Democrats for the Medicare changes included the health reform bill. “Scaring seniors that health reform was going to take away their Medicare and set up death panels, that worked,” Courtney said. “These guys use Medicare to win a majority and then in record time turned around… butchered the program with this voucher plan.”

Courtney and others said in the end, Medicare will likely end up being a driving issue-again-in the 2012 elections. But this time, Democrats hope it will be to their advantage.

“I would love to have a really civilized process for working through the challenges the program faces,” Courtney said. “But at some point people who campaigned against health care reform have got to spit it out that it provided eight years of solvency for the program and the attacks on health reform were just way off base.”

A GOP mea culpa, on health reform of all issues, doesn’t seem like a very good bet for 2012.