Health care advocacy groups spent Monday spoiling for a fight over expected proposals to privatize Medicare and convert Medicaid into a state-owned and operated program for the poor.
In prepared statements, online posts and even on Twitter, groups such as Families USA, Health Care for America Now and the Center for American Progress fired off preemptive shots against what many expect to be a far-reaching redesign of Medicare and Medicaid by House Budget Chairman Paul Ryan, R-Wis., a fiscal conservative with an eye for deficit reduction.
On Tuesday, Ryan will unveil a budget that likely converts Medicare so that a decade from now, seniors would buy subsidized, private insurance. Ryan’s plan would also likely loosen the federal grip on Medicaid by providing states with a lump-sum, block grant payment.
Details are scarce but left-leaning groups used what information they had, mostly from Ryan’s appearances on weekend television programs, as ammunition to knock Republicans as being callous towards seniors.
A poll conducted last September by National Journal and the Pew Research Center suggest Americans may side with Democrats on this one. The survey of 1,001 Americans found 52 percent oppose a Medicare voucher program, compared to 33 percent who favor one and 15 percent who said they did not know or declined to answer. But among respondents 65 years or older, 69 percent said they oppose vouchers, versus 14 percent who favor them and 17 percent who were unsure.
“To ask people with Medicare and Medicaid to foot the entire bill is not only unfair, but it will eventually lead to much less care and a type of rationing,” said Joe Baker, president of the Medicare Rights Center. “There’s no doubt that putting more costs on consumers, particularly upfront, leads them to access less care.”
Previous voucher efforts have failed to move off of Capitol Hill, and it’s difficult to see how the results would differ this time around. An opposition Senate and a reluctant President Obama nearly ensure that Ryan’s budget blueprint will serve as a conversation starter if not actually policy.
But that doesn’t mean it won’t gain traction from previously unexpected places. Both proposals have the support of Alice Rivlin, former President Bill Clinton’s budget chief, who worked with Ryan to shape the Medicare and Medicaid proposals.
And Ryan’s budget proposal comes at a time when there is heightened awareness over the nation’s deficit, which is projected to increase to $7 trillion over the next 10 years.
“This is not a small matter at all, and Ryan is exactly right to propose what he’s proposing,” said James Capretta, a fellow at the Ethics and Public Policy Center. Capretta said that it is crucial to unwind Medicare from its current fee-for-service payment structure, which often rewards low quality, high cost care. “Medicare is the most important player. Medicare is feeding an unproductive health system.”
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