House Budget chairman Paul Ryan released his budget today, and its mostly a retread of what has been proposed in previous years–no retreat, despite the fact that Paul Ryan was on the national ticket and lost based on these proposals.
Many reviews are in and not kind: “The Paul Ryan budget isn’t serious” says one Washington Post columnist. “The Worst of the Ryan Budgets”says the New York Times editorial; Paul Ryan in Wonderland: Chapter Six is the take of the New Yorker.
The Center for American Progress’ ThinkProgress blog went into its The 5 Worst Things About The House GOP’s New Budget, which is mostly about the impact on health care:
1. GIVES HUGE TAX CUTS TO THE RICH AND CORPORATIONS: Ryan’s plan would reduce both top income and corporate tax rates to 25 percent, resulting in trillions of dollars in tax cuts for the wealthy and corporations. The government would lose roughly $7 trillion in revenues compared to Ryan’s projections…
2. FORCES SENIORS TO PAY MORE FOR HEALTH CARE: Beginning 2024, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare. But the budget does not take sufficient precautions to prevent insurers from cherry-picking the the healthiest beneficiaries from traditional Medicare and leaving sicker applicants to the government. As a result, traditional Medicare costs could skyrocket, forcing even more seniors out of the government program. The budget also adopts a per capita cost cap of GDP growth plus 0.5 percent, without specifying how it would enforce it. This makes it likely that the cap would limit the government contribution provided to beneficiaries.
3. JEOPARDIZES MEDICAID: The budget would eliminate the exiting matching-grant financing structure of Medicaid and would instead give each state a pre-determined block grant that does not keep up with actual health care spending. This would shift some of the burden of Medicaid’s growing costs to the states, forcing them to — in the words of the CBO — make cutbacks that “involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost sharing by beneficiaries—all of which would reduce access to care.”
4. REPEALS HEALTH COVERAGE FROM 30 MILLION AMERICANS: The budget repeals the Affordable Care Act’s requirement to purchase health insurance coverage, the establishment of health insurance exchanges, the provision of subsidies for lower-income Americans, the expansion of the Medicaid program, and tax credits for small businesses that provide insurance coverage. As a result, more than 30 million Americans would lose coverage and the budget would eliminate the new law’s consumer protections, which have already benefited tens of millions of Americans. States across the country are already implementing the law and a growing number of Republican governors have finally agreed to expand their Medicaid programs.
It’s a rich hypocrisy that the Paul Ryan budget keeps the taxes and the Medicare savings that he ran against in the last election, but the only thing he would cut is the help it provides low and moderate income people to be able to afford coverage.
Given the impact of the budget on health care, we wonder if Paul Ryan’s statement today wasn’t unintentionally true: