Supporters of the Romney-Ryan presidential ticket have been talking a lot about the “Clinton commission” that endorsed the framework for Medicare reform that Romney now champions. Trouble is, it wasn’t really a commission initiated by then-President Bill Clinton, and the group itself never issued formal policy recommendations.
Clinton never established his own Medicare commission, but in the late 1990s, he did appoint four members to a 17-member group known as the National Bipartisan Commission on the Future of Medicare. Led by then-Sen. John Breaux, D-La., and then-Rep. Bill Thomas, R-Calif., the group met for two years to consider solutions to the health insurance program’s long-term fiscal woes. But in the end, no proposal was able to win the supermajority that would have been needed to bring a report to Congress. Clinton himself opposed the majority’s proposal issued in 1999.
“There never was anything approved by a vote of the commission,” said Bruce Vladeck, a senior adviser at the health care consulting firm Nexera, who was a Clinton appointee to the commission.
Yet the opposite impression lives on in statements by Mitt Romney, his running mate Rep. Paul Ryan, R-Wis., and other GOP leaders.
“To the extent they’re A) calling it the Clinton Commission, and B) implying that the Clinton Commission supported it, it’s not true,” said Stuart Altman, a professor of health policy at Brandeis University, who sat on the National Bipartisan Commission on the Future of Medicare.
The commission makes its way into Ryan’s stump speech discussion of Medicare reform: “It originated in the Clinton commission in the late '90s, the bipartisan commission to save Medicare,” Ryan typically says.
On Monday morning, Reince Priebus, chairman of the Republican National Committee, brought it up during an appearance on MSNBC's Morning Joe. “What we've talked about mainly comes out of the Clinton commission of the late 1990s,” he said. "I mean, what we're talking about right now comes out of that plan.”
The Medicare commission was formed by the Balanced Budget Act of 1997, a law passed through the reconciliation process by a Republican-controlled Congress, which also made substantial cuts to Medicare payment rates for doctors. Clinton was able to name four members to the group — all four of whom voted against the final proposal. Other appointments came from Republican and Democratic leadership in Congress.
Like the Romney and Ryan proposals, the commission did consider moving Medicare into a system where private plans would compete with the government program for customers. But unlike Ryan’s plan, the commission’s plan would not have placed a cap on Medicare's growth rate. The plan earned 10 votes — including those of two Democrats — but it needed 11 to move forward.
Several of the Democratic appointees were skeptical that such a system would save Medicare any money, and some expressed concern that it could undermine traditional Medicare, issuing statements likely to sound familiar in the current debates.
“The proposal before us would convert Medicare from a universal guarantee to a government voucher for private insurance,” said commission member Rep. John Dingell, D-Mich., according to a New York Times article.
But members recall other sticking points, not present in today’s debate. Many Democrats, including Clinton, thought Medicare needed more revenue, a nonstarter with GOP members, Vladeck said. There was also disagreement about whether Medicare should include a drug benefit for all seniors. The Republican-led majority opted against that expansion. But Republicans eventually changed their minds, adding the Part D prescription-drug benefit to the program four years later.
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