In his deficit-reduction speech on Wednesday, President Obama told the country in no uncertain terms – aside from choosing not to use his opponent’s name – that the Republican budget plan authored by Rep. Paul Ryan, R-Wis., would cause 50 million Americans to lose their health insurance, including elderly patients in nursing care and disabled children.
Speaking to reporters at the White House on Thursday, Office of Management and Budget Director Jack Lew said that those assertions were based on assumptions about where states might cut their budgets rather than actual line items in Ryan’s plan. Obama’s statements were based on the reality that long-term care is one of the largest cost-drivers in the system, he said.
“I think it is a very reasonable projection that the kinds of choices created by the block-granting and the reduced funding would make it impossible to have the mix that we have today,” Lew said of the assumptions. “The only thing that could be reduced in order to keep the growth under control would be that kind of long-term care and the care for disabled. It would be very hard to get the savings any other way.”
Lew also said that the president’s proposal wouldn’t create risk for recipients because it would achieve cost savings by reducing improper payments. “I don’t want to sugarcoat it. It is tough,” he said. “It’s going to put pressure on the system, but it won’t do it in a way that pushes risk to the beneficiary.” He was eager to move on to discuss efforts under the Affordable Care Act to lower long-term health care costs.
Lew also offered few details beyond the president's deficit-reduction speech, except to say that the plan would not raise taxes for those making less than $200,000 as an individual or $250,000 as a family.
Press Secretary Jay Carney was similarly light on details, especially when asked about potential changes to the tax code. “Its filled with a lot of complexities, a lot of loopholes, a lot of things that I think makes the average American tear his or her hair out when they’re trying to do their taxes,” he said. “The goal of tax reform is to make the tax code more simple and more fair.”
He added that the president believes everything should be on the table in negotiations.
But both Carney and Lew - who calls himself an “optimist” and a “realist” - have a sunny outlook about progress on a deal. “Once leaders take on the burden of defining a problem, they then take on the burden of defining a solution,” Lew said.