In just a few short weeks, the dominant Republican line on Medicare has shifted from attacking the Democrats for making cuts to the program to demanding a new round of cuts to reduce the federal deficit.
Republican leaders in Congress lined up last week to scold the president for his vagueness on entitlement-program cuts he would endorse in a big deficit-reduction deal. On Wednesday, House Majority Leader Eric Cantor, R-Va., said that the White House was not making a “good-faith effort” to negotiate program cuts that would reduce spending in Medicare, Medicaid, and Social Security. The Republican objective is to obtain a large package of entitlement-spending reductions—many from Medicare. “This has got to be a part of this agreement or else we just continue to dig the hole deeper,” Cantor said.
It was less than a month ago that the GOP was attacking Obama for cutting Medicare, not shielding it. The $716 billion in Medicare cuts that were part of the Affordable Care Act legislative package became a theme of GOP speeches and television ads around the country. Those cuts were criticized because they were used to pay for the controversial health care law. But the GOP went further in its attacks, saying that the Democrats’ spending reductions would spell trouble for vulnerable senior citizens. Obama “took $716 billion from that program to create ‘Obamacare’, and that affects current seniors,” House Budget Committee chairman and then-vice presidential candidate Paul Ryan said on the stump this summer. Presidential nominee Mitt Romney frequently said that Obama was the only candidate who “cut Medicare for current retirees.”
Television ads from House races around the country echoed this sentiment. The National Republican Congressional Committee had developed a defined strategy for using Medicare to the party’s advantage. : Emphasize that the Democratic candidate supported a health care bill with big Medicare cuts, and, if possible, include a sympathetic senior in the ad. “We have a more-than-adequate response to hit back Democrats with,” Paul Lindsay, the NRCC communications director, said in August. A vidoetaped PowerPoint presentation that circulated among campaign strategists outlined a template for candidates to copy. Ryan himself took a page out of this book, bringing his mother with him on the campaign trail in Florida.
The campaign appears to have been effective. Republicans won big among seniors, a group strongly opposed to Medicare program changes. And polling just before Election Day found that a plurality trusted Romney more than Obama with the Medicare program, even though only 18 percent supported his proposed policy. Daniel Scarpinato, a spokesman for the NRCC, said that the committee’s polls in close district races showed a similar erosion of the Democrats’ usual advantage on the issue. “We think it was an extremely effective strategy, and that it worked,” Scarpinato said.
The GOP plan as put forth in the campaign would have reversed the Obamacare cuts but ensured future savings by converting the program to a defined-contribution system with limits on growth. Seniors would get a fixed credit that they could use toward traditional Medicare or a private health plan. That idea is now a nonstarter. As House Speaker John Boehner acknowledged just after the election, repealing the health law was made impossible by Obama’s victory. And Democratic control of the Senate (along with Obama’s repeated campaign declarations) means that a Medicare voucher plan will not pass in the next two years.
That means any Medicare reform that is part of a future deal will share features with the Obamacare cuts Republicans have been challenging: It will likely affect the program while it still serves many current seniors, and it is likely to find savings by reducing payments made to health care providers. There may be some opportunities for savings that shift more costs to seniors. But the two ideas recently floated by Senate Minority Leader Mitch McConnell to so would represent just a fraction of the savings needed to strike a big deficit deal. No one is talking about rolling back the current cuts any more, just adding more of the same.
The election marked an odd reversal of the parties’ usual strategies. Democrats like to position themselves as the protectors of beneficiaries, while Republicans typically warn about the dangers of runaway government spending. Now, everyone has returned to their usual positions.
This article appears in the Dec. 4, 2012, edition of National Journal Daily as Republicans Do an About-Face on Medicare.