Ezra Klein: Paul Ryan and Ron Wyden want to bring Obamacare to Medicare

[flpoljunkie]

Wonkbook: Paul Ryan and Ron Wyden want to bring Obamacare to Medicare

By Ezra Klein, Thursday, December 15

Back in February 2010, I sat down with Rep. Paul Ryan to talk about health-care reform. Ryan had his own bill back then: the Roadmap, which was, in many ways, a precursor to the budget he crafted for the Republicans earlier this year. But he was open to some other ideas, too. At one point, I asked him about Sen. Ron Wyden's Healthy Americans Act. "If I were a Democrat, it’s the bill I’d be on," Ryan replied. "He’s got more mandates than I’d like. But if Ron Wyden and I were in a room, we could hammer out a deal by tomorrow."

Well, Wyden and Ryan eventually did enter that room and hammer out a deal. But not for health-care reform. For Medicare reform. Their proposal, released Monday afternoon, envisions a kinder, gentler version of premium support than what Ryan proposed in his budget. In Ryan-Wyden -- Ryden? -- traditional fee-for-service Medicare is kept as one of the options, the private plans have to be at least as comprehensive as Medicare, and if the system can't control its costs, Congress takes a bite out of providers rather than passing higher premiums onto Medicare beneficiaries.

The Ryden plan is part of an ongoing attempt by the Republican Party to carve out a more politically sustainable position on Medicare reform. Conservative activists might like Ryan's original plan, but voters don't. Wonks might admire its boldness, but they admit that its numbers don't add up. And so you've seen efforts to sand the edges off the idea: Yuval Levin's "confident market" proposal and Mitt Romney's Medicare framework, are both efforts to rework Ryan's plan in a way that preserves traditional Medicare as an option and makes market reforms more palatable to voters. With the Ryden plan, Paul Ryan has joined them in that effort to leave the Ryan plan behind and replace it with something voters -- and some Democrats -- find less threatening.

But the secret of these types of premium-support platforms is that they are, in essence, a vindication of the Affordable Care Act. The cost containment is supposed to come through competition between plans, and works like this: "All plans, including the traditional fee-for-service option, would participate in an annual competitive bidding process to determine the dollar amount of the federal contribution seniors would use to purchase the coverage that best serves their medical needs. The second-least expensive approved plan or fee-for-service Medicare, whichever is least expensive, would establish the benchmark that determines the coverage-support amount for the plan chosen by the senior. If a senior chose a costlier plan than the benchmark, he or she would be responsible for paying the difference. Conversely, if that senior chose a plan that cost less than the benchmark, he or she would be given a rebate for the difference."

more...

http://www.washingtonpost.com/blogs/ezra-klein/post/wonkbook-paul-ryan-and-ron-wyden-want-to-bring-obamacare-to-medicare/2011/12/15/gIQAj0CnvO_blog.html

[Bolo Boffin]

1. "they are, in essence, a vindication of the Affordable Care Act."

Except that by maintaining traditional Medicare as an option, this plan has a public option.

[flpoljunkie]

2. I see the 'Ryden' plan as weakening Medicare and not doing anything to drive down the cost either.

Am not happy with Wyden for helping Republicans blur the differences between Democrats and Republicans on Medicare. This will not save Medicare, but it may save Republicans from getting hit with 'ending Medicare as we know it' in the 2012 elections.

[Bolo Boffin]

4. I've been reading more about this over at Balloon Juice. Ay yi yi. n/t

[Mass]

3. Once again, a terrible plan that would gut Medicare at term.,

[flpoljunkie]

5. Agree. TPM: More Backlash For Wyden Than For Ryan On Controversial Medicare Plan

More Backlash For Wyden Than For Ryan On Controversial Medicare Plan


Sen. Ron Wyden (D-OR) and Rep. Paul Ryan (R-WI)

BRIAN BEUTLER DECEMBER 15, 2011

Sen. Ron Wyden wants to assure his colleagues he hasn’t undermined them politically. In a head-turning move, Wyden announced Wednesday that he’s teamed up with House GOP budget chair Paul Ryan on a policy framework to partially privatize Medicare — a move that stunned his fellow Democrats.

Setting aside the policy — which would in essence turn Medicare into ObamaCare with a robust public option — the very existence of the plan has deep implications for the 2012 elections, most of them bad for his own party.

Speaking to reporters Thursday after an event with Ryan, Wyden said the political ramifications are overblown. “Nobody ducks their past votes and their previous statements,” Wyden said. “That’s just a given.”

What he’s alluding to here is the concern that, by teaming up with Ryan, he’s giving GOP candidates in 2012 — and particularly the GOP presidential nominee — cover from charges that they support overhauling Medicare in radical, conservative ways. This attack has dogged the entire Republican party since GOP members of Congress voted en masse for Ryan’s budget, which proposed phasing out traditional Medicare altogether, earlier this year. Wyden says those fears are overblown.

“That is sure to be part of the politics of 2012 on both sides of the aisle,” he said.

But the reaction from Democrats — both nameless, and on the record, has been severe.

more...

http://tpmdc.talkingpointsmemo.com/2011/12/more-backlash-for-wyden-than-for-ryan-on-controversial-medicare-plan.php?ref=fpa

[sufrommich]

6. I wonder what Wyden gets in return

for selling out Medicare? Shame.

[flpoljunkie]

7. Jonathan Chait: Who Are Paul Ryan and Ron Wyden Helping?

Who Are Paul Ryan and Ron Wyden Helping?
By Jonathan Chait

Republican Representative Paul Ryan and Democratic Senator Ron Wyden have a new Medicare plan that involves turning the program, which is a single-payer health insurance system, into a system of private plans with a public option. Is this a good policy idea? Not really, though it’s possible to imagine a decent version of it. (Jonathan Cohn and Austin Frakt have good rundowns — basically, it all depends on the details, which don’t currently exist.) Neither Wyden nor Ryan pretends their idea stands any chance of enactment soon, and they’re not even bothering to try to pass it. The interesting question is how this affects the politics of Medicare.
What Ryan gets is pretty obvious. He has found a way to protect Mitt Romney. Ryan is the author of a radical House budget that, among other things, would transform Medicare into private vouchers, and ratchet down their value over time to the point where they covered a small fraction of the cost of health insurance. It’s wildly unpopular. Unfortunately for Republicans, Mitt Romney found himself in the position last week of embracing Ryan’s deadly unpopular plan, to the glee of Democrats. (Why did Romney do this? Because he needed a line of attack on Newt Gingrich, who had assailed Ryan’s idea as “right-wing social engineering.”)

Wyden’s support gives Romney an out. He can now thread the needle between supporting Ryan, who has unassailable prestige within the Party, without endorsing the details of his plan. All he has to do is simply say he supports the plan Ryan and Democrat Ron Wyden came up with. Now the Ryan plan is no longer an albatross around the neck of the Republican presidential candidate.

The more interesting question is what Wyden gets. Here, I think he is miscalculating. At a purely intellectual level, Ryan is offering a huge compromise. After having hysterically denounced the Affordable Care Act as a vile plot to destroy freedom, Ryan is now proposing to turn Medicare into something almost identical to it, with the exception that it would have a public option. The intellectual basis for the Ryan–Wyden plan is that creating health care exchanges where private insurers compete will reduce health care costs. If that’s true, then the Affordable Care Act is bound to be a huge success, since it contains that very feature. (Since that dynamic is entirely speculative, the Congressional Budget Office conservatively assumed that this feature would not save any money.)

Ryan–Wyden, if properly designed, is not a horrible idea, and denunciations by the Obama administration and leading Democrats are way over the top. It’s the sort of compromise you could live with if you got something for it – say, the GOP abandoning its crazed revenge campaign to sabotage the Affordable Care Act. But it’s hard to avoid the conclusion that Ryan’s plan here is to help Romney get elected and then pass the Ryan plan. And then poor Ron Wyden can issue a press release expressing his disappointment that his friend Ryan couldn’t work together with him in a bipartisan fashion.

http://nymag.com/daily/intel/2011/12/who-are-paul-ryan-and-ron-wyden-helping.html