The Paul Ryan Medicare Shuffle

Jamelle Bouie / The American Prospect

He still doesn't care about poor people.

When Wisconsin Representative Paul Ryan ran for vice president last year, he campaigned against the $716 billion Medicare cut in the Affordable Care Act, calling it a "raid" on the program. "Medicare should not be used as a piggy bank for 'Obamacare,'" said Ryan last August, after joining the Romney campaign, "Medicare should be used to be the promise that it made to our current seniors. Period. End of Story." This was the whole of Ryan's message on Medicare, which included an ad that combined scaremongering with a fair amount of racial resentment:



But Ryan's message has always had two problems. First, President Obama's cuts to Medicare are on the provider side; he's reducing payments to hospitals and doctors in order to fund better benefits for seniors and cover low-income people under the Affordable Care Act. And second, by shrinking the pool of Medicare recipients to the oldest and the sickest, Ryan's plan would leave the program in far worse shape than anything proposed by the administration.

It's also worth noting a small, rhetorical problem with Ryan's message: He doesn't disagree with the president's Medicare cuts. And as he revealed yesterday on Fox News Sunday, he plans to include those cuts as part of his budget for House Republicans: “We end the raid and we apply those savings to Medicare to make Medicare more solvent and extend the solvency of the Medicare trust fund,” said Ryan.

Writing for Talking Points Memo, Sahil Kapur notes that this is a return to his pre-presidential position: His 2011 and 2012 budgets kept the president's Medicare cuts, but repealed the Affordable Care Act. We don't have details for this year's budget, but we should expect the same.

And where did those Medicare savings go in Ryan's previous budgets? Lower taxes. Or, to be more specific, Ryan cut half a percentage point from the annual growth rate he allowed for Medicare spending in previous budgets. He then used those savings to fund upper income tax cuts. If Ryan is who we think he is—an anti-welfare state crusader—we should expect something similar from this new proposal.