“This budget reflects the same skewed priorities… Americans rejected in November.”

“It will take more than accounting gimmicks to achieve real deficit reduction.”

Washington, D.C. – Senate Majority Leader Harry Reid spoke on the Senate floor today regarding Representative Paul Ryan’s budget proposal. Below are his remarks as prepared for delivery:

Early this year, with November’s election losses fresh in their minds, top Republicans promised a kinder, gentler Republican Party – a Republican Party that cared about “every American…achieving their dreams.” Republicans bandied about words like fairness and opportunity. They made overtures toward women and Hispanics. They promised cooperation and an end to brinksmanship. House Majority Leader Eric Cantor even spoke of, “an agenda based on a shared vision of creating the conditions for health, happiness and prosperity for more Americans and their families.” The rebranding was under way.

Then a few weeks passed. And the Republican emphasis on fairness and equity passed along with them.

Today House Budget Committee Chairman Paul Ryan will unveil an extreme budget that is anything but balanced. This budget reflects the same skewed priorities the Republican Party has championed for years – the same skewed priorities Americans rejected in November. The Ryan Republican budget will call for more tax breaks for the wealthy, an end to Medicare as we know it and draconian cuts to education and other programs that help America’s economy grow and prosper.

As Yogi Berra famously said, “It’s déjà vu all over again.” We’ve seen this show before. The Ryan Republican budget will shower more tax breaks on millionaires and continue to tilt the playing field to the advantage of big corporate interests, while raising taxes for the middle class. And, like last year, the plan refuses to close a single tax loophole in order to reduce the deficit.

Meanwhile it guts investments in education, health care, public safety, scientific research and job-creating clean energy technology. The Ryan Republican budget would end the Medicare guarantee and force seniors into a voucher program. It would ax preventive health care such as cancer screenings and charge seniors more for prescriptions. And it would further reduce funding for food inspectors, police officers and first responders.

And as if protecting wealthy special interests while shifting the burden to seniors and the middle class wasn’t bad enough, the Republican budget also devastates the economy, costing jobs and slowing growth. Not only is this the wrong approach, it’s the same old approach.

And to make matters worse, the Paul Ryan Budget 3.0 uses the same fuzzy math as his previous two budgets. It relies on accounting that is creative at best and fraudulent at worst to inflate its claims of deficit reduction.

Democrats believe it is critical that we stabilize the deficit. But it will take more than accounting gimmicks to achieve real deficit reduction. And at a time when corporations are making record profits, the stock market is soaring and wealthy Americans’ income continues to rise, that deficit reduction shouldn’t be come at the expense of middle-class families, senior citizens and the poor.

Americans have demanded a fair approach to deficit reduction that makes sensible cuts, but asks profitable corporations and the wealthiest among us to share the burden. Democrats have been listening. That’s why this week Budget Committee Chairman Patty Murray will introduce a budget that reflects those balanced principles. The Democratic plan will cut wasteful spending and reduce the deficit, close tax loopholes that benefit the rich and invest in what the economy needs to grow. It will encourage a strong middle class.

Congressman Ryan and his Republican colleagues in Congress have taken a different approach – an approach that makes it plain they missed the message of the November elections. Their budget will once again put moneyed special interests ahead of middle-class families. And no amount of rebranding will hide that.

“In the event that Republicans make good on their threat by failing to act, or by moving unilaterally to pass a debt limit extension only as part of unbalanced or unreasonable legislation, we believe you must be willing to take any lawful steps to ensure that America does not break its promises and trigger a global economic crisis — without Congressional approval, if necessary,” the leaders write.

Senate leaders made clear their willingness to pursue balanced approach to cutting spending and reducing our deficit, but reiterated their insistence that any approach be a balanced between smart cuts and revenues from the wealthiest Americans.

###

The full text of the letter is below.

January 11, 2013

The President
The White House
Washington, DC 20500

Dear Mr. President:

As you know, Republican leaders are threatening to bring on an economic catastrophe unless Democrats make deep cuts to Social Security and Medicare.

This threat is outrageous and absurd. Defaulting on America’s legal obligations would undermine the American economy and spread global economic havoc. Just two years ago, Speaker Boehner himself admitted that failure to raise the debt limit “would be a financial disaster, not only for us, but for the worldwide economy.”

It is hard to imagine that the Speaker and Leader McConnell would really follow through on their threat to let our nation default on its debts. They are responsible leaders who know better. Sadly, some of their Republican colleagues do not. Therefore, we believe that you must make clear that you will never allow our nation’s economy and reputation to be held hostage. In the event that Republicans make good on their threat by failing to act, or by moving unilaterally to pass a debt limit extension only as part of unbalanced or unreasonable legislation, we believe you must be willing to take any lawful steps to ensure that America does not break its promises and trigger a global economic crisis — without Congressional approval, if necessary.

As you know, increasing the debt limit does not authorize new spending. It merely ensures that we meet our existing obligations. Those obligations were incurred by both Republicans and Democrats, and are the responsibility of all Americans.

Accordingly, we hope that you will continue to ignore claims that agreeing to an increase in the debt limit would somehow represent a concession by Republicans to Democrats. All Americans, Democrats and Republicans alike, have a stake in ensuring that our country meets its legal obligations. Financial markets have long viewed securities backed by the full faith and credit of the United States as the most trustworthy in the world. This lowers borrowing costs for homes, cars, and college for all Americans and strengthens our economy. If we violate that trust for the first time in history, we will never fully regain it, and every American will suffer.

For all these reasons, we support your view that an extension of the debt limit is not something for which Democrats should have to negotiate. At the same time, as a separate matter, we agree about the importance of developing a broad, bipartisan agreement on fiscal policy that strengthens our economy and reduces our long-term budget deficit.

As you have said, any such agreement must treat all Americans fairly and include not just responsible spending cuts but additional revenue from the wealthy and the elimination of wasteful tax breaks. It would be wrong to slash earned benefits for seniors and middle class families, while allowing corporations, millionaires, and billionaires to continue to exploit wasteful tax loopholes. We therefore hope that you will continue to insist that the entire budget be on the table, and that any agreement be fully balanced and fair.

Thank you for your consideration of our views.

Respectfully,

Senator Harry Reid
Senator Dick Durbin
Senator Chuck Schumer
Senator Parry Murray

A PDF of the letter can be found online here.

Washington Post/ABC Poll: 60% Say Romney Would Do More to Favor the Wealthy.Asked “as president do you think Romney would do more to favor the (middle class) or more to favor the (wealthy),” 60% said that Romney would do more to favor the wealthywhile only 30% said Romney would do more to favor the middle class. [Washington Post/ABC Poll, 8/27/12]

• Pew Research Center Poll: 71% Believe Romney Policies Benefit the Wealthy Over Middle Class And Poor. “More than six-in-ten Americans (63%) say the GOP favors the rich over the middle class and poor, and 71% believe the policies of a President Mitt Romney would be good for wealthy people. Much smaller shares say the same about the Democratic Party (20%) and the policies of President Barack Obama in a second term (37%).” [Pew, 8/27/12]

Washington Post/ABC Poll: Americans Prefer Roads and Bridges to Cutting Taxes.Asked “what do you think is a better way for the government to try to create jobs – (by cutting taxes); or (by spending money on projects like roads, bridges and technology development),” 52% supported spending on projects like roads, bridges and technology development while only 33% supported cutting taxes. [Washington Post/ABC Poll, 8/27/12]

Washington Post/ABC Poll: 56% See Unfairness as A Bigger Problem Than Over-Regulation.  Asked “what do you think is the bigger problem in this country – (unfairness in the economic system that favors the wealthy), or (over-regulation of the free market that interferes with growth and prosperity,” 56% said unfairness is the bigger problem while only 34% said over-regulation is a bigger problem. [Washington Post/ABC Poll, 8/27/12]

“By picking Representative Paul Ryan, Governor Romney has doubled down on his commitment to gut Social Security and end Medicare as we know it. Romney’s choice demonstrates that catering to the Tea Party and the far-right is more important to him that standing up for the middle class.

“The months ahead will provide Americans with a clear choice between the Romney-Ryan plan to gut Social Security and Medicare, and Democrats’ balanced approach to deficit reduction that combines smart spending cuts with asking millionaires and billionaires to pay their fair share. Democrats in the Senate look forward to engaging in that debate.”

As a Result, 30 Million Americans Could Get Kicked Off Medicaid – Forcing Seniors to Be Denied Critical, Life-Saving Care

New State-by-State Analysis of Impact of Extreme GOP Budget Found HERE

Washington, DC—The Democratic Policy and Communications Center (DPCC) today released new national and state-by-state reports (see below) revealing the devastating impact the Republican Medicare-ending budget would have on seniors, families, and nursing home residents.  The report shows that, on top of ending Medicare as we know it and increasing seniors’ out-of-pocket health care costs by nearly $6,000, the GOP budget would also cut $1.7 trillion in Medicaid benefits for seniors, families, and those in nursing homes, which could force as many as 30 million Americans off of the program.

The GOP budget cuts $550 billion in health care benefits specifically for seniors and the disabled, which could lead to them being denied access to life-saving care and shutting nursing homes down across the country.  With state governments across the country already cash-strapped, the reduced federal support and increased burdens included in the GOP proposal would require them to drastically slash benefits, increase taxes, or both.

Report Highlights:

• The Republican plan could force as many as 30 million Americans off of Medicaid.
• The Republican plan cuts over $1.7 trillion from health care services provided through Medicaid, including $550 billion in health care for seniors and the disabled.  As a result, nursing homes across the country could be forced to slash services, turn away seniors, or close their doors.
• The Republican plan would shift costs to state taxpayers at a time when 41 states already face a budget crisis.  This could lead to huge tax hikes on taxpayers in states across the country.

The Republican budget also doubles-down on their effort to end Medicare as we know it. Under their plan, over 45 million soon-to-be seniors would be forced out of Medicare’s guaranteed benefits and onto a voucher, and out-of-pocket costs for the typical senior could go up by nearly $6,000.  The DPCC national report and state-by-state breakdown on the impact on Medicare can be found below:

National
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
District of Columbia
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
West Virginia
Wisconsin
Wyoming

Budget Will Immediately Reopen Prescription Drug ‘Donut Hole’, Costing Current Seniors Over $10,000 by 2020

New State-By-State Reports Showing Devastating Local Impact on Seniors

Washington, D.C. – The Democratic Policy and Communications Center (DPCC) today released new state-by-state reports that outline the devastating impact of the new Republican budget. Instead of strengthening Medicare, the new Republican budget would end Medicare as we know it, raise the eligibility age to 67, and turn guaranteed benefits for over 45 million seniors into a voucher that will shift higher costs to seniors over time. Under the proposal, set to receive a vote in the House next week, seniors would see their out of pocket costs increate by as much as $5,900 per year.

In addition to ending Medicare as we know it, the Republican budget would also force millions of current seniors across the country back into the prescription drug “donut hole,” costing them more than $10,000 over the next 10 years. A county-by-county breakdown of what seniors saved in prescription drug costs in 2012 can be found here. Seniors would lose all of that money out of their pockets going forward if the GOP budget was enacted into law.

Report Highlights:

• Over 45 million Americans who are in 47-56 “near retirement” age group would be forced onto health care “vouchers” when they retire, starting in 2023.
• The Republican plan could increase out-of-pocket health care costs for a typical 67 year-old senior by $5,900.
• Nationwide, over 3.2 million seniors saved more than $2.1 billion in prescription drug costs last year. The GOP budget would eliminate those savings in the years to come.
• Over 35 million seniors could pay more for preventative services this year.

• Alabama
• Alaska
• Arkansas
• Arizona
• California
• Colorado
• Connecticut
• Delaware
• District of Columbia
• Florida
• Georgia
• Hawaii
• Idaho
• Illinois
• Indiana
• Iowa
• Kansas
• Kentucky
• Louisiana
• Maine
• Maryland
• Massachusetts
• Michigan
• Minnesota
• Mississippi
• Missouri
• Montana
• Nebraska
• New Hampshire
• New Jersey
• New Mexico
• New York
• Nevada
• North Carolina
• North Dakota
• Ohio
• Oklahoma
• Oregon
• Pennsylvania
• Rhode Island
• South Carolina
• South Dakota
• Tennessee
• Texas
• Utah
• Virginia
• Vermont
• Washington
• Wisconsin
• West Virginia
• Wyoming

Over the past year, Republican efforts to force seniors to pay more than double what they would pay under traditional Medicare – by converting Medicare into a voucher-type program – were repeatedly rejected by the American people and rejected by Congressional Democrats.  Recently, however, vocal opposition to the extreme Republican ideology comes from a long-time advocate of the Republican-backed health policy proposals.

Henry Aaron, considered one of the “fathers” of the premium support model, and health economist Austin Frakt, argued that Republican attempts to embrace his concept, “lack safeguards for beneficiaries. They threaten to shift costs to the elderly and disabled and force them to shop for coverage in a confusing insurance market.”

In their essay in last week’s New England Journal of Medicine, Aaron and Frakt unequivocally rejected the Republican proposals as dangerous policy.  In contrast to Aaron’s original premium support concept developed in 1995,  the two authors ask two fundamental questions of the Republican proposals: “Is premium support along the lines now being proposed a good idea? Is now the time to be making fundamental changes in Medicare? We believe that the answer to both questions is no.” They continue, “Whatever virtues such a [premium support] plan may have had in 1995, circumstances have changed.”

Instead, Aaron and Frakt argue that “traditional Medicare is better structured than private plans to meet that [growth] target without harming enrollees.” They conclude that implementation of the Affordable Care Act is the most important step to strengthen Medicare and control future growth in expenditures.  We agree.

Last year’s Republican budget suggested converting Medicare into a voucher-type program, forcing seniors to pay $6,359 more for health care – more than double what they would pay under traditional Medicare – and  slashing benefits for more than 20 million Americans. In addition, their budget would have “reopened” the prescription drug donut hole, forcing seniors to pay an estimated $44 billion in additional drugs costs. Although the public clearly rejected their proposed reforms, Republicans have dug in on their pursuit of policies  which protect special interest subsidies and tax breaks for those at the top, while jeopardizing programs critical to America’s seniors.

This time, House Speaker John Boehner and Chairman Ryan announced plans to “end Medicare as we know it” with a new wrinkle.   Health economists indicate that this new premium support model, “likely would shift substantial costs to beneficiaries rather than protect them from such cost increases, could lead to the demise of traditional Medicare over time rather than preserve it, and likely would produce few savings.” The plan has already been rejected by Congressional Democrats and the White House.

Meanwhile, Republicans are working to pave the way for this and other radical proposals to cut Medicare and Social Security benefits for seniors. This week, the House Budget Committee will consider a Ribble-Ryan bill (H.R. 3577) that purports to “streamline the budget process.”  According to an analysis by the Center on Budget and Policy Priorities, this legislation could make it easier to require deep cuts to Medicare, Medicaid, and Social Security through the budget.

Instead of pushing extreme policies that will end Medicare, Republicans should work with Democrats to cut waste, reduce fraud, and improve efficiency in the delivery of health care using America’s innovative technology.

Today the House will consider legislation that would force the nation to default on our financial obligations for the first time in history unless Congress adopts a radical new constitutional amendment.

That amendment would impose arbitrary, reckless budget caps that would – without a doubt – force massive cuts to Medicare, Social Security and other crucial benefits. At the same time, it would constitutionally protect wasteful loopholes and tax breaks for millionaires and billionaires.

To meet an arbitrary spending cap frozen at 18 percent of Gross Domestic Product, it would shrink benefits and services back to levels not seen since 1966. In 1966, Medicare was one year old and there were 100 million fewer people in this country.

For those who think rewinding 45 years is a good thing, consider how much America has changed since 1966. For example, life expectancy is 9 years longer today than it was 45 years ago.

Medicare has allowed Americans to live longer, healthier lives. This legislation would roll back that progress.

And it would enshrine in the Constitution a set of priorities so backward, even Republican advisors to Presidents Ronald Reagan and George W. Bush have called it unwise.

In the first decade alone, it would mean more than $3,000 a year in cuts to each senior’s Social Security check. It would slash our social safety net, decimating Medicaid and cutting Medicare benefits by $2,500 for every senior.

In fact, the non-partisan Congressional Budget Office says that within 25 years, it will slash government benefits and services in half. That includes Social Security, Medicare, Medicaid, veterans’ benefits and every other government service, no matter how essential.

Yet it would make it almost impossible to end even the most wasteful tax breaks and loopholes already in place, such as handouts to oil companies making record profits, corporations that ship jobs overseas, and rich people who buy yachts or and private jets. It would require a two-thirds majority in both houses of Congress to raise even a penny of new revenue.

Meanwhile, it does absolutely nothing to protect our economy from the kind of recession from which we are beginning to recover. In fact, if the economy wasn’t already in a recession, experts say this legislation would quickly produce one.

Bruce Bartlett, an economic advisor to President Reagan and a Treasury official under President Bush, said the kind of rapid spending cuts called for in this House legislation would “unquestionably throw the economy into recession.”

This legislation goes beyond the draconian budget that Republicans passed earlier this year. That budget would have ended Medicare as we know it. It would also have cut clean energy by 70%, axed education funding and cost hundreds of thousands of private-sector jobs.

This is worse. It would attack all the same programs, but its cuts would be deeper. And it would slash Social Security as well.

This legislation is so restrictive, Republicans’ own budget – the budget they passed this year – would not meet its standards.

It is so restrictive, not one year of either the George W. Bush or Ronald Reagan administrations would meet its standards.

Of the last 30 years, the only two years that would make the cut were during the Clinton administration.

As the Washington Post said, “Every single Senate Republican has endorsed a constitutional amendment that would’ve made Ronald Reagan’s fiscal policy unconstitutional. That’s how far to the right the modern GOP has swung.”

Bruce Bartlett, the economic advisor to Reagan, said this about the legislation:

“This is quite possibly the stupidest constitutional amendment I think I have ever seen. It looks like it was drafted by a couple of interns on the back of a napkin.”

And that, in my opinion, is being awfully hard on the interns.

Bill Hoagland, a budget advisor to Republican Congressional leaders for 25 years, described it best when he labeled this legislation a “misleading political cheap shot.”

A balanced budget is something we can all get behind. But this legislation isn’t really about balancing the budget. It’s about scoring political points.

But based on 30 years of evidence and Republicans’ own measuring stick, the stunt falls flat.

After all, who do you think helped President Clinton balance the budget during the only two years of the last 30 that actually lived up to the restrictive rules outlined in this legislation? It was Democrats in Congress.

Today, Democrats are trying to rein in spending again. We’re also trying to avert a catastrophic default on our nation’s financial obligations.

Republicans are the ones standing in the way of a deal to avert default, refusing to move an inch despite our offers to cut trillions from the deficit.

As conservative columnist Ross Douthat wrote in the New York Times yesterday, we could already be on the way to a deal if, “more Republicans had only recognized that sometimes a well-chosen concession can be the better part of valor.”

“A lot has changed since 1966, when Medicare took effect. New technologies and medicines are being invented all the time that keep Americans healthier and help them live longer. Hip replacements and chemotherapy – pioneered in the 60’s – are now performed in the United States every single day.

“Medicine has changed. But one thing hasn’t changed: seniors need Medicare. In fact, the rising cost of health care today means seniors need Medicare’s protection now more than ever.

“Republicans would trade away the health and safety of today’s seniors for the sake of tax breaks for billionaires, wealthy oil companies, corporations that ship jobs overseas and corporate jets owners. That’s why I will never stop fighting to preserve this successful program. As long as I am in the Senate, I will oppose Republican plans to weaken or undermine it. Because Republicans’ plan to end Medicare is one idea whose time will never come.”

Washington, D.C.–Nevada Senator Harry Reid made the following remarks today on the Senate floor on Medicare. Below are his remarks as prepared for delivery:

Often very good ideas – no matter how important – take time to ripen. And even when they are ripe, they need dedicated advocates to make them reality. Let me give you an example.

President Harry Truman once said this:

“Millions of our citizens do not now have a full measure of opportunity to achieve and to enjoy good health. Millions do not now have protection or security against the economic effects of sickness. And the time has now arrived for action to help them attain that opportunity and to help them get that protection.”

But in 1945, when Truman spoke those words to Congress, the time had not yet truly arrived. In fact, it would be another 20 years before Truman’s good idea was realized. It was 20 years before Truman became the first of 19 million Americans to receive a Medicare card.

President Lyndon Johnson signed Medicare and Medicaid into law in the Truman Presidential Library in Independence, Missouri. The law took effect almost a year later – 45 years ago this week – on July 1^st, 1966.

At the time that Medicare took effect, only half of Americans 65 and older had access to health care coverage. A third of American seniors lived in poverty.

“Poverty was so common that we didn’t know it had a name,” Johnson said, describing a time before Medicare.

Today, virtually every American over 65 has access to health care. And the number of seniors that live below the poverty line has dropped by 75 percent.

That’s no accident. Medicare provides 47 million Americans with the access to care and the protection from poverty that Truman envisioned more than 65 years ago.

And Medicare and Medicaid don’t only protect seniors from poverty – they also protect those seniors’ children. Forty-six years ago, middle-class families often spent themselves into the poor house honoring their commitment to their fathers and mothers. Today seniors and their children have the security that Medicare and Medicaid will be there to honor that commitment – providing health care and nursing home care when they need it.

But Medicare doesn’t only save American seniors money. It also saves their lives.

In 1964, just before Medicare was signed into law, seniors lived an average 70 years. Today, the national average is more than 78 years. There is, perhaps, no achievement greater than that. This law literally extended Americans’ life expectancy.

Forty-six years ago, before signing Medicare into law, President Johnson made this vow:

“No longer will this Nation refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country.”

Democrats intend to honor that solemn vow. But today Medicare is under siege.

Republicans would trade away the health and safety of today’s seniors for the sake of tax breaks for billionaires, wealthy oil companies and corporations that ship jobs overseas. They would trade that sense of security – that “hand of justice” Johnson described – to protect tax breaks on corporate jets.

Their ideological budget would end Medicare as we know it, once again subjecting seniors to the rising costs of health care. Democrats refuse to let that happen.

A lot has changed since 1966. New technologies have been developed that keep Americans healthier and help them live longer. New medicines for diabetes, Parkinson’s and Alzheimer’s are being invented all the time. And hip replacements and chemotherapy – pioneered in the 60’s – are now performed in the United States every single day. Medicine has changed.

But one thing hasn’t changed: seniors need Medicare. In fact, the rising cost of health care today means seniors need Medicare’s protection now more than ever.

That’s why I will never stop fighting to preserve this successful program. As long as I am in the Senate, I will oppose Republican plans to weaken or undermine it. Because Republicans’ plan to end Medicare is one idea whose time will never come.

Senator Inhofe: “And the American people have caught on. Just look at the polls.” [Press Release, 12/17/09]

Senator McConnell:“You’ve seen the polls. They’re unanimous.” [Press Conference, 11/17/09]

• Senator McConnell: “If you look at the poll data, all of these published polls, going back over the last few weeks, the opposition is widening. A couple of weeks ago, it was nine points opposed on Gallup. Earlier this week, 14 points down in the Quinnipiac poll. And now, 61 to 36 in the CNN poll.” [Press Conference, 12/11/09]

Senator Sessions: “The truth is, the American people have never supported this bill. Polling numbers show they still do not support this bill.” [Press Release, 2/2/11]

Senator Barrasso: “That is not just my opinion. If you ask what the public believes, in polling across the country the American people have overwhelmingly rejected this bill that is now signed into law by the President.” [Floor Speech, 4/27/10]

Majority Leader Cantor: “It has been litigated according to the American people, if you look at the polling on this.” [Cantor Pen and Pad, 1/4/11]

…THEY SHOULD LISTEN TO THEM AND ABANDON THEIR PLAN TO END MEDICARE:

Bloomberg

• “Democrats are winning the messaging war on Rep. Paul Ryan’s bid to overhaul Medicare, with a new Bloomberg poll finding 57 percent of Americans believe they would be worse off under his plan. Only 34 percent said they would be better off if Congress replaced ‘traditional Medicare’ with a program to purchase private insurance with government subsidies, as Ryan has proposed.”  [Politico, 6/23/11]
• “The poll also found Ryan is now the nation’s third most disliked Republican, with net unfavorable ratings that trail only former House Speaker Newt Gingrich and former Alaska Gov. Sarah Palin. But more than half surveyed said they have no opinion of the Wisconsin Republican.” [Politico, 6/23/11]

Bloomberg

• 49% of respondents said they’re worried about Republicans gaining control of the White House and Congress and following through on pledges to slash funding for Medicare and Medicaid.

CBS News Poll:

• Support for the Republican Medicare plan: Continue as it is now: 58% Change to a payment program (Republican Plan): 31%
• Among independents 58% percent oppose the GOP plan while less than half (43%) of Republicans support it.

Washington Post/ABC News Poll:

• Who do you trust to do a better job protecting the Medicare system? Obama: 49%  Congressional Republicans: 35%
• Support for the Republican Medicare plan: Oppose: 49%  Support: 32%

CNN Poll:

• Support for Republican Medicare plan:  Oppose 58%  Support 35%
• Opposition to Republican Medicare plan among seniors: 74%

Reuters Poll:

• Support for Republican Medicare plan:  Oppose: 43%  Support: 37%

Pew Poll:

• Among those 50 and older opposition to the Republican Medicare plan is 51% with 42% strongly opposed

Yesterday my friends, the chairman of the Foreign Relations Committee and the ranking member of the Armed Services Committee, introduced a resolution supporting U.S. involvement in the NATO action in Libya.

I commend my friends, who have introduced a strong, bipartisan resolution with an impressive list of cosponsors, including Senators Levin, Kyl, Durbin, Feinstein, Graham, Lieberman, Blunt, Cardin and others. And I hope it will have overwhelming support.

Some Republicans in the House of Representatives and on the campaign trail have expressed concern over our involvement in this conflict. They have clearly decided to use the War Powers Resolution as a political bludgeon to pursue a partisan agenda.

But I also believe there is a larger question we must each ask ourselves as Senators as we consider this military action: Was our participation in the international effort to stop mass murder and chaos in Libya a just decision? I am confident it was.

Muammar Qaddafi’s repressive dictatorship is a threat to the region and to U.S. national security. Our support of this mission is crucial for our NATO alliance that is leading this mission and for the people of Libya, who have lived far too long under Qaddafi’s brutal regime.

I thank the senior Senator from Massachusetts and the senior Senator from Arizona for beginning the deliberate, bipartisan discussion of this important matter here in the Senate. Working together, this bipartisan group of Senators has made a clear statement to our allies, to the world, to the Libyan people and to Qaddafi that we support the Administration’s actions in Libya.

The Senate is truly at its best when bipartisan lawmakers work together.

That is why it is so unfortunate, M. President, that yesterday Republicans were unwilling to join us in our efforts to create jobs for Americans who need them. For the fourth time this year, my Republican colleagues stalled a jobs bill that could have put hundreds of thousands of Americans to work.

This was the second jobs bill Republicans have killed by piling on unrelated amendments. Two more jobs bills passed the Senate, but are wasting away in the House. All four of these bills were common-sense efforts to spur innovation, investment and hiring by private companies. All four had a proven track record of creating jobs.

The message Republicans have sent is clear: they care more about partisan politics than they do about putting Americans back to work.

Later today, Democrats will talk about our plan to reduce the jobs deficit, a problem just as critical to Americans as our budget deficit. We hope our Republican colleagues will join us to tackle this problem. So far, they have put politics first.

I don’t know what it will take for Republicans to get the message that people in Nevada and across the country care more about jobs than any other issue. It is the most important thing Congress should focus on.

Instead, Republicans are focused on the one thing Americans don’t want: ending Medicare as we know it.

The vast majority of Americans say they oppose the Republican plan to balance the budget on the backs of seniors by killing Medicare. The number among seniors and Independents is sky high in opposition to the Republican plan to change Medicare as we know it.

There is no mystery to why they oppose it. The Republican plan to end Medicare would put insurance company bureaucrats between seniors and their doctors. It would raise drug prices from day one. And it would increase the cost of cancer screenings and treatments for 7 million seniors – and more.

Seniors can’t afford this dangerous plan, nor can America. The Senate can’t afford to waste any more time. It’s our job to create jobs. And it’s time for Republicans to leave Medicare alone and let us get back to work.

Democrats Are Committed to Improving Access to Cancer Prevention and Treatment Services for Seniors.

The Affordable Care Act provides seniors with new cancer prevention and treatment tools, including free screenings like mammograms and colonoscopies.  In 2008, 43% of female Medicare beneficiaries did not receive a mammogram.  Studies suggest that 3,700 lives could be saved if 90% of women 40 and older receive a mammogram.  The Affordable Care Act eliminated cost sharing requirements for mammograms and other prevention tools, dramatically improving access to important lifesaving services.  [HHS, 3/16/11; HHS, 7/14/10]

Under the Republican Budget, More Than 7 Million Seniors Will Be Required to Pay More for Cancer Prevention Starting Next Year. The Republican budget will require seniors to pay a 20% co-insurance for many cancer prevention services, including screenings like mammograms and colonoscopies.  By forcing seniors to pay the 20% co-insurance, the Republican budget could result in beneficiaries paying an additional $160 out-of-pocket. These increased costs could force thousands of seniors to forego mammograms and colonoscopies, thus possibly putting their lives at greater risk.  [HHS, 3/16/11]

Despite Republican claims that their budget will not impact current seniors, the GOP budget will increase costs for cancer prevention immediately and require:

• More than 7,800,000 senior women pay a 20% co-insurance for breast cancer screening
• More than 2,000,000 senior women pay a 20% co-insurance for cervical cancer screening (pap test)
• More than 1,200,000 senior women pay a 20% co-insurance for cervical cancer screening (pelvic examination)

Cancer Patients Have Already Saved More Than $32 Million on Their Medication This Year, But The Republican Budget Eliminates Those Discounts, Making Lifesaving Drugs Unaffordable for Many Seniors. By re-opening the donut hole, the Republican budget will force seniors with cancer to pay millions more for their life-saving medications. By providing significant discounts on prescription drugs to seniors in the donut hole, Medicare saved seniors with cancer $32 million for cancer drugs in the first part of this year alone.  In fact, nearly 20% of the discounts to date have been for cancer medication. The House budget would eliminate these savings moving forward. According to a recent report, 16 percent of Medicare patients did not fill their cancer drug prescriptions due to the high costs. The Republican budget imposes new costs on seniors with cancer starting in 2012, thereby risking the health of our most vulnerable senior population. [HHS, 5/24/11; Journal of Clinical Oncology, 5/11]

Click here for state-specific data on how the Republican budget will force seniors in your state to pay more for life-saving preventive health services in 2012.

‘Delivery System Reforms’ Save Money by Improving the Quality of Care and Reducing Readmissions, Reducing Administrative and Medical Errors, And Increasing Coordination Across Care Providers

Fully Implementing Reforms and Expanding Existing Pilot Programs Could Save Hundreds of Billions of Dollars and Cut Costs for Seniors Without Cutting Their Benefits

Washington, DC – Today, U.S. Senators Sheldon Whitehouse (D-RI), Tom Harkin (D-IA), Patty Murray (D-WA), Charles E. Schumer (D-NY), and Debbie Stabenow (D-MI) called on Senate Republicans to abandon their plan to end Medicare as we know it or any other proposal that entails cuts to seniors’ Medicare benefits and instead ensure the long term solvency of the program by building on the cost-saving reforms put in place by the Affordable Care Act (ACA).  The Senators said that the healthcare law put in place a number of “delivery system reform” policies to encourage innovation and efficiency in the delivery of health care to America’s seniors.  These reforms, some of which are currently in the pilot program stage across the country, have already shown the promise of saving many billions of dollars a year and greatly extending the life of Medicare.  The Senators said that instead of working to end Medicare, Republican legislators should be building and expanding on these reforms.

In a letter to Senate Republican Leader Mitch McConnell, the Senators said: “The House-passed Ryan Budget overlooks the fact that significant changes to our health care system are already underway thanks to the health care law that was passed last year. To protect Medicare, we should build on these kinds of delivery system reforms, rather than cut seniors’ benefits.”

The Affordable Care Act included a number of novel tools and programs to encourage innovation in the delivery of health care.  These delivery system reforms fall into five priority areas: quality improvement, prevention, payment reform, administrative simplification, and information technology.  Each priority area promises to save money by improving the quality of care.

The Affordable Care Act helps achieve that goal by placing significant emphasis on high quality care and patient safety.  Under the law, the Center for Medicare and Medicaid Services (CMS) will move beyond just paying health care claims to improving health and the quality and affordability of health care. CMS is working toward a health care delivery system that will reduce avoidable hospital readmissions and at the same time create incentives to foster a more person-centered health care approach. The new ACA policies envision health care truly becoming an integrated, collaborative approach as diagnoses, treatments, prescriptions, and patient interactions are captured, stored, and immediately available to relevant and appropriate health care providers. This improved health care system will significantly reduce redundancies, needless delays, and unwarranted referrals, thereby saving money and improving the quality of care.

Program changes made in the Affordable Care Act have improved substantially the outlook for Medicare and thus fulfilled the promise of lower costs, improved care and better health for seniors. Estimates indicate that the new benefits and services provided to seniors by the Affordable Care Act will save the typical senior over $3,500 over the next decade.   The reforms are projected to save Medicare over $100 billion in the next five years.

In the letter, the Senators cited two specific projects currently underway that underscore the potential of delivery system reform:

• Michigan Keystone Intensive Care Unit Project - This project reduced blood infections by 66 percent by requiring clinicians to run through a checklist of basic instructions, such as washing hands with soap, cleaning each patient’s skin with antiseptic, and placing sterile drapes over patients.  The Michigan Health and Hospital Association found that the checklist reforms saved more than 1,500 lives and $200 million in the first 18 months.
• The Sacramento-Area ACO Pilot Project - Spearheaded by the California Public Employees Retirement System (CalPERS) in contract with Blue Shield of California, the project focused on coordinating care by sharing clinical and case management information.  After one year of implementation, health care costs for the CalPERS ACO program increased less than 2 percent for the year compared to an increase of nearly 10 percent for other CalPERS enrollees covered by Blue Shield.  Preliminary outcomes show that the CalPERS ACO project reduced inpatient readmissions by 17 percent and saved $15.5 million.

The full text of the letter is below.

The Honorable Mitch McConnell

Senate Minority Leader

S-230 U.S. Capitol

Washington, DC 20510

Dear Leader McConnell:

Democrats are committed to extending the solvency of Medicare, but we want to do it while preserving the program in its current form. We do not support cutting benefits as a solution.

Unfortunately, Congressman Ryan’s proposed solution – privatizing Medicare– would bring unnecessary suffering to American seniors, while missing the salient fact that health care costs are exploding for everyone, no matter who the insurer is. The House-passed Ryan Budget also overlooks the fact that the Affordable Care Act makes significant changes to our health care system to control health care costs, changes that are already underway. To protect Medicare, we should build on these kinds of delivery system reforms, rather than cut seniors’ benefits.

As you may know, the Affordable Care Act includes a number of novel tools and programs to encourage innovation in the delivery of health care. These delivery system reforms fall into five priority areas: quality improvement, prevention, payment reform, administrative simplification, and information technology. Each priority area promises to save money by improving the quality of care: a win-win for our health care system and the American people.

Economists across the political spectrum agree that these changes substantially improve Medicare’s financial outlook and thus fulfill the promise of lower costs, improved care and better population health. Estimates indicate that the new benefits and services provided to seniors by the Affordable Care Act will save the typical senior over $3,500 over the next decade, while reducing the deficit by $210 billion this decade and more than a trillion dollars in the next.

We should build upon these reforms that are already enacted. Across the country, there are examples of delivery system reforms already underway that should be replicated to achieve further savings in Medicare, without cutting seniors’ benefits.

For example, the Michigan Keystone Intensive Care Unit Project is a well-known model of the significant impact that quality improvements can have on patient safety and health care costs. This project reduced central line-associated bloodstream infections by 66 percent by requiring clinicians to run through a checklist of basic instructions, such as washing hands with soap, cleaning each patient’s skin with antiseptic, and placing sterile drapes over patients. The Michigan Health and Hospital Association found that the checklist reforms saved more than 1,500 lives and $200 million in the first 18 months.

In addition, new payment reform models, such as accountable care organizations (ACOs), are poised to change health care delivery by incentivizing care coordination and evidence-based medicine. A Sacramento-area ACO pilot project, spearheaded by the California Public Employees Retirement System (CalPERS) in contract with Blue Shield of California, focused on coordinating care by sharing clinical and case management information. After one year of implementation, health care costs for the CalPERS ACO program increased less than 2 percent for the year compared to an increase of nearly 10 percent for other CalPERS enrollees covered by Blue Shield. Preliminary outcomes show that the CalPERS ACO project reduced inpatient readmissions by 17 percent and saved $15.5 million.

The Michigan Keystone Project and CalPERS ACO offer glimpses of the potential of delivery system reform, but we agree that there is still much more work to be done. We also need to invest in prevention programs, which can keep people from getting sick in the first place; simplify administrative processes, which will reduce time and money wasted by doctors and hospitals arguing against denied claims; and strengthen our health IT network, which the RAND Corporation has estimated would save $81 billion a year.

We hope that you will acknowledge that very significant changes are already underway that will help the Medicare program be more efficient and improve all Americans’ health, and deserve our bipartisan support. Thank you for your attention to this vital matter, and please feel free to call on us if we can be of any assistance.

Sincerely,

Senator Sheldon Whitehouse (D-RI)

Senator Tom Harkin (D-IA)

Senator Patty Murray (D-WA)

Senator Charles E. Schumer (D-NY)

Senator Debbie Stabenow (D-MI)

I am happy to see Republicans opening up to what Democrats have being saying all along: cutting wasteful subsidies to big oil should be on the table if we are going to reduce the deficit.

Yesterday my friend, the senior Senator from Tennessee, said we should consider ending taxpayer subsidies for oil companies making record profits.

Democrats agree. Handouts like these – to companies that made $36 billion in the first quarter of this year alone – must be part of the discussion as we get our fiscal house in order.

As we decide where to cut, we will need to make some tough choices. But not every choice has to be difficult.

If we are serious about reducing spending, ending tens of billions in taxpayer giveaways to big oil companies shouldn’t be one of the difficult decisions.

And when the other side says the alternative is to end Medicare, slash Medicaid and put millions of seniors at risk, the choice is that much clearer.

We cannot take with one hand from those who can least afford it and give with the other to those who can.

Before we end Medicare as we know it or eliminate Medicaid funding for nursing homes, as the Republicans have proposed, we should cut wasteful spending.

During the course of a year, one in five Americans will be on Medicaid. The cuts Republicans propose affect real people.

The elderly man in the nursing home. The child missing her yearly checkup. The pregnant woman whose baby depends on proper prenatal care. The person with a disability who is able to live alone thanks to the helping hand Medicaid provides.

And these cuts will affect you, too. Cutting Medicaid simply shifts costs – it doesn’t lower them.

Each patient who doesn’t get the care he needs from a doctor today will get it tomorrow for twice the price in an emergency room. And you and I will foot the bill.

The American people have spoken loudly and clearly. They do not want to balance the budget on the backs of seniors, children or people with disabilities.

I am glad to one of my Republicans colleagues is finally getting the message.

Chaser: SAME POLL: Among independents 58% percent oppose the GOP plan while less than half (43%) of Republicans support it. Overall 58 percent said they were opposed to the GOP Medicare plan. [CBS News Poll, 6/13/11]

CBS News Poll:

• Support for the Republican Medicare plan: Continue as it is now: 58% Change to a payment program (Republican Plan): 31%
• Among independents 58% percent oppose the GOP plan while less than half (43%) of Republicans support it.

Washington Post/ABC News Poll:

• Who do you trust to do a better job protecting the Medicare system? Obama: 49%  Congressional Republicans: 35%
• Support for the Republican Medicare plan: Oppose: 49%  Support: 32%

CNN Poll:

• Support for Republican Medicare plan:  Oppose 58%  Support 35%
• Opposition to Republican Medicare plan among seniors: 74%

Reuters Poll:

• Support for Republican Medicare plan:  Oppose: 43%  Support: 37%

Pew Poll:

• Among those 50 and older opposition to the Republican Medicare plan is 51% with 42% strongly opposed

Washington Post/ABC News Poll: “Republicans Appear to Have Handed Obama an Opening on Medicare in the Budget Blueprint They Adopted This Spring.”

• Who do you trust to do a better job protecting the Medicare system? Obama: 49%  Congressional Republicans: 35%
• Support for the Republican Medicare plan: Oppose: 49%  Support: 32%

CNN Poll: “Majority Gives Thumbs Down to Ryan Plan.”

• Support for Republican Medicare plan:  Oppose 58%  Support 35%
• Opposition to Republican Medicare plan among seniors: 74%

Reuters Poll: “More Oppose Than Support Republican Medicare Plan.”

• Support for Republican Medicare plan:  Oppose: 43%  Support: 37%

Pew Poll: “Opposition to Ryan Medicare Plan from Older, Attentive Americans.”

• Among those 50 and older opposition to the Republican Medicare plan is 51% with 42% strongly opposed

Democrats in the Senate hoped to spend this week creating jobs.  Republicans are doing everything they can to make sure we can’t.

They think that standing in the way like this will hurt Democrats.  They’re wrong.  It hurts all Americans: families, business owners, the middle-class, the unemployed – everyone.

We planned to work this week on debating and reauthorizing the Economic Development Administration, which for more than 45 years has created jobs where they’re most needed: in economically distressed communities.  In just the last five years, it’s created 300,000 jobs.

This was our first bill of this new work period because creating jobs is our first priority.  But Republicans are stopping us from moving to it because creating jobs is the last thing they care to do.

The merits of reauthorizing this job-creating administration are clear.  EDA works with businesses, universities and leaders at the local level, so it creates jobs from the bottom up.  It helps manufacturers and producers compete in the global marketplace.  And it’s a great investment: every dollar from EDA attracts seven dollars in private-sector investment.  That’s an incredible return rate.

The American people demand that we create jobs.  They sent us here to create jobs.  Democrats are ready to work, but we can’t do it alone.

Just last week, Republicans pointed to a new jobs report and demanded the Senate keep our focus on growing the economy.  We agree, and that’s exactly what this bill will do.  But now those same Republicans are standing in the way.

And why are they standing in the way?  Because they demand we end Medicare in order to pay for more tax breaks for millionaires.  Their priorities couldn’t be more backward.

This isn’t the first time Republicans have done everything they can to try to stop us from creating jobs.  Earlier this year we brought a bill to the floor that would help small businesses innovate, invent and invest in new jobs.  Republicans simply said “no.”

I’ve never seen such irresponsible legislating in all my time here.  The American people are watching, and they’re waiting for their leaders to act.  Democrats are waiting for Republicans to drop these charades and finally get to work.

Democrats are ready to create jobs.  We’ve done it before, with programs like the Economic Development Administration, and we’re ready to do it again.  The American people are desperate for stable and secure jobs.  All they ask of us is that we do ours.

Republicans’ Reckless Plan Would Jeopardize Seniors’ Current Benefits and Double Their Out-of-Pocket Costs, Leaving Them At The Mercy Of Private Insurance Companies

In Letter to Vice President Biden, Senators Bill Nelson, Cardin, Brown, McCaskill and Tester Urge “Unwavering Opposition” to Medicare-Ending Proposal During Deficit Discussions

Washington, DC— Senators Bill Nelson (D-FL), Ben Cardin (D-MD), Sherrod Brown (D-OH), Claire McCaskill (D-MO) and Jon Tester (D-MT) today called for Republicans to take the House-passed plan to dismantle Medicare off the table in bipartisan deficit reduction talks. In a letter to Vice President Joe Biden, who is leading these discussions, the senators urged the administration to continue to oppose any GOP efforts to insert their plan to dismantle Medicare into a deficit reduction package.

“As the working group moves beyond areas of consensus and into parts of the budget that will require the toughest choices, we wish to identify in advance one proposal that we cannot support in any form—the House-passed plan to dismantle Medicare,” the senators wrote.

“For the good of the nation’s seniors, it must remain off the table,” the senators continued.

Despite the public’s overwhelming rejection of the GOP proposal to dismantle Medicare, many Republican leaders are insisting that the plan be part of a package to lower the debt.  House Budget Chairman Paul Ryan recently declared that the plan to dismantle Medicare is “part of the debt ceiling talks.” And last week, Senate Republican Leader Mitch McConnell echoed that it is “on the table.”  Further, the House majority recently reaffirmed its commitment to this plan through the adoption of a rule that declares the House-passed budget shall have “force and effect.”

Numerous reports have revealed the devastating impact the GOP’s Medicare-ending budget would have on the nation’s seniors.  Across the country, the GOP’s reckless plan would cost 2 million private sector jobs over the next five years and increase seniors’ out-of-pocket health care costs by $6,359 in 2022 – more than double what they would otherwise pay.  Analyses also show that starting next year if the GOP plan is law, nearly four million seniors nationwide will be forced to pay $2.2 billion more in prescription drug costs, and at least one million seniors will have to pay more than $110 million more for annual wellness visits in 2012.

The senators called the GOP plan to end Medicare unacceptable, saying: “Our nation’s seniors are not responsible for the fiscal challenges we face, and they should not be responsible for shouldering the burden of reducing our deficits.”

A copy of the letter appears below.

The White House

Vice President Joe Biden

1600 Pennsylvania Avenue, NW

First Floor, West Wing

Washington, DC 20500

Dear Vice President Biden,

It has come to our attention that the bipartisan working group you are leading is making considerable progress in identifying ways to reduce the deficit. We are encouraged by the progress being made in these negotiations and stand ready to work with you towards the passage of a responsible deficit reduction package that will set our nation on a healthy fiscal course.

But as the working group moves beyond areas of consensus and into parts of the budget that will require the toughest choices, we wish to identify in advance one proposal that we cannot support in any form—the House-passed plan to dismantle Medicare.

As you know, the House-passed budget would end Medicare as we know it by destroying the guaranteed-benefit system and instead requiring seniors to enter the private insurance market. Despite the public’s overwhelming rejection of this proposal, and even after the Senate vote against it, many top congressional leaders are now saying they want the plan included as part of a package to reduce the deficit. Just last week, House Budget Chairman Paul Ryan declared that the plan to dismantle Medicare is “part of the debt ceiling talks.” Then on Sunday, Senate Republican Leader Mitch McConnell echoed that it is “on the table.”

This proposal would never pass Congress on its own, and it does not belong in a larger deal either. It would be devastating for America’s seniors, who would see their out-of-pocket costs for health care double and the benefits they currently enjoy jeopardized.  Under this risky proposal, insurance company bureaucrats would decide what care seniors get.

We are aware the administration has rejected this proposal since its passage by the House, and we applaud your efforts to educate the American people about its serious implications. We encourage you to remain unwavering in opposition to this scheme. For the good of the nation’s seniors, it must remain off the table.

We share the goal of ensuring the long-term health of Medicare. We hope to identify delivery system reforms and other sources of savings that can extend the life of Medicare in its current form. But we will never allow any effort to dismantle the program and force benefit cuts upon seniors under the guise of deficit reduction.  Our nation’s seniors are not responsible for the fiscal challenges we face, and they should not be responsible for shouldering the burden of reducing our deficits.

Thank you again for your leadership in these budget talks and for your continued work standing up on behalf of the nation’s seniors.

Sincerely,

Senator Bill Nelson

Senator Ben Cardin

Senator Sherrod Brown

Senator Claire McCaskill

Senator Jon Tester

Safe Over 55? Maybe Not.

Republicans say their Medicare plan wouldn’t affect anybody near retirement age. But it would.

by Tim Fernholz, National Journal Magazine

Republicans are convinced that burnishing the public’s view of their unpopular proposal to overhaul Medicare depends on assuring today’s seniors that they won’t be affected.

“The retirees are going to be taken care of; there’s no ifs, ands, or buts about it,” House Speaker John Boehner vowed in an interview with CBS last month. The plan’s architect, Rep. Paul Ryan of Wisconsin, has said time and again that the changes wouldn’t affect anybody getting close to retirement. “We propose to not change the benefits for people above the age of 55,” Ryan, chairman of the House Budget Committee, insisted last week.

There’s only one problem with the strategy: It’s not true.

The policies in the House GOP budget, if enacted, would begin affecting millions of seniors almost immediately by increasing their costs for prescription drugs and probably long-term care. Further, Medicare costs could rise over time if healthier seniors choose to abandon the traditional benefit program.

Exploiting the fear of change is a constant in health care politics, so nearly every reformer tries to play down the dislocation inherent in plans to make the system fiscally sustainable. During his own reform push, President Obama promised citizens they could keep their existing health insurance plans if they liked them. That was not exactly true: Although the new law doesn’t eliminate the current insurance system, it does put in place new incentives that experts predict will significantly change individuals’ health care options.

Republicans capitalized on the fear of those potential changes, as well as of hundreds of billions in genuine cuts to Medicare spending that were part of last year’s law, and they won heavily in November’s midterm elections. The president’s party lost seniors by more than 20 percentage points after splitting their vote 50-50 with the GOP in the prior midterm election. This year, however, it is the Republicans’ turn to be nervous, as opinion polls and their surprising loss in a special election in upstate New York revealed voter anxiety about their plan.

In response, the GOP is doubling down on the idea that today’s seniors won’t be affected. That’s partly true. Ryan’s plan to convert Medicare into a limited insurance subsidy, the most controversial aspect of the budget, wouldn’t take effect until 2022.

But the proposal would also repeal last year’s health care law, which means reopening a coverage gap in Medicare’s prescription-drug benefit that the statute closed. The gap, commonly called the “doughnut hole,” requires seniors to pay 100 percent of any prescription costs after the annual total reaches $2,840 and until it hits $4,550. Those who spend more or less have at least three-quarters of the costs covered. Under the 2010 health law, Medicare will pay 7 percent of the cost of generic drugs and 50 percent on name-brand pharmaceuticals; by 2020, the doughnut hole will be closed.

If Congress were to pass Ryan’s plan and repeal the law, as House Republicans want, the 3 million to 4 million seniors left in the doughnut hole each year would immediately face significant out-of-pocket costs. They and all other Medicare beneficiaries would also lose access to a host of preventative-care benefits in the health care law, including free wellness visits to physicians, mammograms, colonoscopies, and programs to help smokers quit.

Perhaps more jolting, the Republican budget would cut spending on Medicaid—health care for the poor—much of which goes to long-term care for the elderly. Some 9 million seniors qualify for both Medicare and Medicaid benefits, and about two-thirds of all nursing-home residents are covered by Medicaid. The GOP budget proposes cutting some $744 billion from Medicaid over 10 years by turning the system into block grants that limit federal contributions and give states more choice in structuring benefits. No one knows exactly which Medicaid services states would choose to cut back, but senior citizens account for a disproportionate share of Medicaid outlays and would almost certainly bear some of the burden.

“We know that two-thirds of the dollars in Medicaid go to people who are disabled or over 65, so this is the big funder of long-term care in this country,” said David Certner, AARP’s legislative-policy director. “We also know this could have an impact on home- and community-based care, which is the kind of care individuals prefer the most [and] often the ones that will be cut first.”

The plan to grandfather traditional Medicare for those older than 55 could also have negative consequences for current seniors: In 2022, when the limited-subsidy program would be introduced, seniors who qualified for traditional Medicare would be allowed to switch to the new program. If healthier or younger beneficiaries make the change to lower their out-of-pocket costs, those still participating in Medicare would be part of an insurance pool that is less healthy and more expensive. To cover those higher per-person costs, Medicare might well be forced to either raise premiums or limit reimbursements to health care providers—which could prompt many to stop taking Medicare patients.

Republicans say that comparing their plan with the projected costs of unsustainable programs is an exercise in magical thinking. They have a point. But the idea of cutting benefits deeply without affecting anyone over 55 is almost as fantastic.

http://www.nationaljournal.com/member/magazine/ryan-plan-would-have-immediate-effect-on-seniors-20110602?print=true

Having grown up in a family that could not afford health care, I know how difficult it can be to go to a doctor when you need one.

That’s one of the reasons I worked on health insurance reform. No person in the United States should go without care when they need it.

I remember an afternoon in October 1951 when my 10-year-old brother Larry fell off his bike and broke his leg. There was no money for a doctor. His leg was never set, and it eventually healed crooked.

Doctor visits were not an option in my home — not for us kids and not for my parents either. My mother’s teeth fell out one by one because she never could pay to see a dentist. She had to gum her food and couldn’t eat the meat we had, so we ate a lot of beans and rice.

Last year’s health insurance reform law provides benefits to seniors on Medicare, people with preexisting and chronic conditions, and small businesses. We have eliminated lifetime limits and made preventive care more affordable.

When writing the law, we knew it would take time to implement, and we worked to minimize the number of people who would have lost coverage before health insurance reform was fully enacted. We provided funding for employers to continue early retiree coverage and gave tax credits to small businesses — both groups were susceptible to losing coverage in the current system.

And we wanted to ensure that low-income children, the elderly, and people with disabilities would be protected, so we included an important provision requiring states to keep Medicaid and the Children’s Health Insurance (CHIP) strong. It prevents states from cutting Medicaid coverage for adults prior to January 1, 2014 and protects children’s coverage in Medicaid and CHIP through 2019.

Unfortunately, my Republican colleagues have introduced a bill that would unravel these stability protections, possibly denying hundreds of thousands of women and children access to health care provided through Medicaid and eliminating or cutting the Children’s Health Insurance Program, depending on the state.

Republicans argue that cutting kids and parents from Medicaid saves money. In fact, such cuts would prove quite costly. Hospitals, community health care centers, and other providers would have increasing rates of uncompensated care, leading to increased costs for everyone else.

By 2013, 400,000 deserving people — two-thirds of them children — would lose vital health care services under the Republican plan, according to the Congressional Budget Office.

The stakes get even higher in 2014. That’s when Medicaid will expand. The lowest-income citizens will be eligible for Medicaid coverage. We will truly see a decline in the uninsured in this country. But if the Republican plan becomes law, the Congressional Budget Office estimates 1.7 million children would lose health insurance by 2016. Half the states could entirely eliminate their CHIP programs, while remaining states would dangerously roll back coverage.

Medicaid and CHIP provide care for Americans who cannot afford it. Most recipients are women and children. The Republican plan would let states drastically limit enrollment and eligibility rates — and must be opposed.

There are a lot of people today who are just like my mother and brother — people who cope with unnecessary pain because they lack money. In Nevada, for instance, nearly 250,000 people rely on health services through Medicaid that they otherwise could not afford.

Medicaid and CHIP exist to provide mothers and children, among others, the safety net they need. These programs have helped reduce the child uninsured rate by more than half, to less than 10 percent, over the last decade. Without them, the health of low-income Americans would be much worse.

Helping people treat conditions that may become life-threatening is far less costly than helping people whose conditions have already reached a critical stage.

This July marks the 46th anniversary of Medicaid, an opportunity to reflect on the millions of Americans whose lives are supported or saved, thanks to its existence.

There is no better way to mark this anniversary than by making sure we keep Medicaid strong and viable, and oppose attempts to weaken it.

“Republicans are holding the United States’ credit hostage to ram through their plan to end Medicare. They are now saying they won’t accept any plan to reduce the deficit unless it also cuts Medicare. Voters have resoundingly rejected this ideological agenda. Republicans should drop it and move on.”

###

McConnell: I Won’t Agree To Raise The Debt Limit Without Medicare Cuts

Brian Beutler | May 27, 2011, 12:17PM

Senate Minority Leader Mitch McConnell (R-KY) says substantial Medicare cuts must be part of a spending and deficit cut package to get his support to raise the debt limit.

In a Capitol briefing with reporters Friday, McConnell declared affirmatively that unspecified Medicare cuts are on the table in bipartisan debt limit negotiations, led by Vice President Joe Biden, and, he expects, will be part of the solution. But in response to a question from TPM, he went further than he has in the past in laying down a marker on that issue. Medicare cuts must be part of that deal to get his support — even if negotiators manage to find trillions of dollars in savings elsewhere, even if his other priorities are met.

“To get my vote, for me, it’s going to take short term [cuts, via spending caps]… Both medium and long-term, entitlements.,” McConnell said. “Medicare will be part of the solution.”

To clarify, I asked “To clarify, if [the Biden group] comes up with big cuts, trillions of dollars worth of cuts, but without substantially addressing Medicare, it won’t get your vote?”

“Correct,” McConnell said.

That’s not a filibuster threat, but it is a clear indication of what the GOP is demanding in private deliberations. McConnell repeatedly cited Bill Clinton and House Minority Whip Steny Hoyer, who this week acknowledged — as have many Democrats — that resolving the long-term deficit problem will require addressing Medicare. Hoyer in particular said that Medicare will be on the table in current debt negotiations, and with revenues off the table — that means they’re talking politically dangerous cuts. And for Republicans, that’s the point.

Here’s how McConnell described it, in response to a different question about the political cost to Republicans of having voted already to privatize Medicare.

“I think the 2012 election will take care of itself — it’s about a year and a half from now,” he said. “I would think that we will hopefully have done something significant in this area by then, and the American people can decide whether they want to punish both sides for having done that, because it will take both sides to do it. It will come out of the conversations that are going on now led by the Vice President.”

Of course, not all Medicare cuts are created equal, and Medicare spending can be reduced without necessarily cutting seniors’ benefits. But the idea here is clear: if the country’s to avoid defaulting on its debt, there has to be a bipartisan vote to cut Medicare. And the hope for McConnell and the GOP is that this will obscure the test vote they took on phasing the program out entirely.

The question now is whether Democrats will be on board with this, or whether they’ll try to call the GOP’s bluff.

http://tpmdc.talkingpointsmemo.com/2011/05/mcconnell-medicare-must-be-cut-to-raise-debt-limit.php

“Republicans need to wake up and smell the coffee: people in Nevada and across the country oppose the Republican plan to kill Medicare. We saw people’s opposition on full display during Tuesday’s special election in New York, where the central issue was the Republican plan to put insurance company bureaucrats between patients and their doctors. Last night, the Senate also sent a strong message that the Republican proposal is a nonstarter. Yet the author of this proposal, Rep. Paul Ryan, seems tone deaf on this issue, and just last night said that there will be ‘no retreat’ for Republicans on their plan to end Medicare.

“Democrats want to work with Republicans to address the challenges facing our country, including the deficit. But we will never support a plan to balance the budget on the back of America’s seniors. It’s time for Republicans to listen to the American people, drop their plan to end Medicare and work with Democrats on more responsible ways to reduce our deficit.”

Washington, D.C.—El Líder de la Mayoría del Senado Harry Reid hizo hoy las siguientes declaracionesen el pleno del Senado sobre el plan republicano para acabar con el Medicare. Ese plan que afectaría el futuro de la comunidad hispana desproporcionadamente ya que 3,1 millones de latinos participan en el programa y 26% de los beneficiarios del Medicare en el 2030 sean minorías étnicas. El plan republicano tendría consecuencias nefastas ya que muchos retirados en la comunidad Latina viven con hijos y nietos. Al acabar con el Medicare, los republicanos lastiman a familias de bajos recursos quienes no pueden pagar por costos de medicinas y visitas medicas.  A continuación, apartes de su discurso tal como fue preparado:

Por semanas, jóvenes y personas mayores de todo el país han expresado su oposición al plan republicano para destruir el Medicare.

No solo son demócratas. Varios Republicanos también se están oponiendo. Newt Gingich lo calificó como un plan radical de “ingeniería ultra derechista”.  Muchos senadores republicanos también han reclamado, y justamente lo han calificado como un plan que demolería un pilar de nuestra sociedad y que rompería nuestra promesa a las personas mayores y a los enfermos.

Anoche…los votantes estadounidenses tuvieron su primera oportunidad para expresar su opinión sobre el asunto. Fueron a las urnas y rechazaron rotundamente al plan y al candidato quien prometió acabar con el Medicare. En un elección especial en Nueva York, el plan republicano de acabar con el Medicare fue el tema más importante. Fue el que más les preocupó a los votantes- y lógicamente el que más los alarmó.

Este plan le entregaría la salud de nuestros jubilados a compañías de seguro con un insaciable apetito por las ganancias…Y obligaría a nuestros retirados a pagar más por su cuidado médico a cambio de beneficios reducidos. Este es un mal negocio, sin importar como uno lo mire.

Pero lo que más llamó la atención es que el republicano quien apoyó este plan de su partido para acabar con el Medicare, fue rechazado en un distrito con una gran mayoría republicana…y el cual ha estado en manos republicanas por cuatro décadas…La elección especial de anoche se llevó a cabo para reemplazar a un congresista republicano que había ganado su puesto por un margen de 3 a 1.

Los demócratas en el congreso- y hasta algunos republicanos sensatos- saben que el plan republicano para acabar con el Medicare es un plan irresponsable y que no se puede defender. Anoche, los votantes le demostraron a todo el país a y al Congreso que ellos también lo ven así.

CONTACTO: José Dante Parra/Nathaly Arriola, (202) 224-2939

For weeks, Americans old and young have been speaking out against the Republican plan to kill Medicare.

It’s not just Democrats.  Republicans have been speaking out against it, too.  Newt Gingrich called it a radical plan and “right-wing social engineering.”  Several Republican Senators have similarly spoken out, calling it what it is: a plan that would shatter a cornerstone of our society and break our promise to the elderly and the sick.

Last night, though, the most important voices were heard: American voters had their first chance to do something about it.  They went to the polls and resoundingly rejected that plan, and the candidate who ran on the promise to dismantle Medicare.

In a special Congressional election in upstate New York, the Republican plan to kill Medicare was the number-one issue.  It’s what the voters most cared about – and were most scared about.  As well they should be.

Here’s what it would do: It would turn over seniors’ health to profit-hungry insurance companies.  It would let bureaucrats decide what tests and treatments seniors get.  And it would ask seniors to pay more for their health care in exchange for fewer benefits.  That’s a bad deal all around.

What’s telling is not just that voters rejected this plan.  It’s that the Republican candidate pushing the Republican plan to kill Medicare was rejected in a very Republican district.

The district, which stretches from Buffalo to Rochester, has been in Republican hands for four decades.  It’s produced influential Republicans like Jack Kemp, who served in Congress, the Cabinet and ran on a Presidential ticket.  Last night’s special election was held to replace a Republican congressman who had won his seat by a 3-to-1 margin.

John McCain won the district in 2008.  George W. Bush won the district four years earlier.  Last year’s Republican candidate for Governor in New York lost in a landslide – but he won big in this district.  That’s how conservative it is.

Democrats in Congress – and even some candid Republicans – know the Republican plan to kill Medicare is irresponsible and indefensible.  Last night, voters showed the country and the Congress they know it, too.

Cornyn: “I will say that Republicans do not want to end Medicare as we know it.  That is an intentional Falsehood. That is a Lie.” [Cornyn Floor Speech, 5/25/11]

…But The Wall Street Journal Does Not Agree.

“The [Republican] plan would essentially end Medicare.”  [Wall Street Journal, 4/4/11]

…But That Just Isn’t True. The GOP Plan to end Medicare Would Re-Open the Donut Hole, Forcing Millions of Seniors to Pay More for Prescription Drugs From Day One.

Nationwide, nearly four million seniors would pay $2.2 billion more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

In Wisconsin, more than 69,100 seniors would pay $39 million more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

The Republican plan could force at least 20,400 Wisconsin seniors to pay over $2.1 million more for annual wellness visits in 2012. [DPCC Report]

…But That Just Isn’t True. The GOP Plan to end Medicare Would Re-Open the Donut Hole, Forcing Millions of Seniors to Pay More for Prescription Drugs From Day One.

Nationwide, nearly four million seniors would pay $2.2 billion more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

In Nebraska, more than 28,000 seniors would pay $16 million more for prescription drugs in 2012 alone under the Republican plan.  [DPCC Report]

The Republican plan could force at least 6,200 Nebraska seniors to pay over $660,500 more for annual wellness visits in 2012. [DPCC Report]

Washington, D.C.–El Líder de la Mayoría del Senado Harry Reid hizo hoy el siguiente discurso en el pleno del Senado sobre el plan republicano para acabar con el Medicare. Abajo incluimos apartes de su discurso tal como fue preparado:

“…todos sabemos cuáles van a ser los titulares principales de esta semana y cuál será el debate más importante de la semana. La conversación de la semana girara en torno al plan republicano para eliminar el Medicare.

“…El plan republicano demolería uno de los pilares de nuestra sociedad, y rompería la promesa que le hemos hecho a nuestras personas mayores y a los enfermos.

“Ese plan le entregaría la salud de nuestros jubilados a compañías de seguro con un insaciable apetito por las ganancias…Y obligaría a nuestros retirados a pagar más por su cuidado médico a cambio de beneficios reducidos.

“Entonces no cuesta mucho trabajo comprender porque el pueblo estadounidenses tampoco apoya el plan republicano. Y yo tampoco lo apoyo. Pero a pesar de que casi toda la bancada republicana de la Cámara de Representantes votó por su propio plan, a veces es difícil discernir cual es la posición del partido republicano sobre el tema.

“Vimos la semana pasada cuán rápido cambió de opinión sobre el tema un candidato presidencial republicano. Primero uso el adjetivo correcto para este plan: radical.  Dijo que era ’ingeniería social de extrema derecha’. Unas horas después –después de que otros republicanos lo acorralaron– se dio marcha atrás y dijo que apoyaba el plan para acabar con el Medicare.

“Hace 46 años, el Presidente Lyndon Johnson –quien fuera líder de la mayoría del Senado anteriormente—promulgó el Medicare en ley. Dijo lo siguiente mientras firmaba:

‘Pocos pueden mirar más allá de los discursos, o de las batallas políticas, y divisar al doctor quien está dándole cuidado al débil; o ver al interior del hospital donde se reciben a los afligidos por el dolor, o sentir en sus corazones la dolorosa furia causada por la injusticia que le niega, la cura milagrosa al enfermo o al anciano’.

“Gracias al Medicare, esas injusticas ya no son tan profundas como lo fueron en ese entonces. Las personas mayores y los enfermos entre nosotros todavía buscan ayuda y buscan tener salud. Y todavía es nuestra responsabilidad actuar basándonos no en impulsos políticos, sino basados en compasión y preocupación por el prójimo. Es nuestra responsabilidad no permitir que la politiquería corto-placista nos motive, y más bien actuar en pro de aquellos quienes necesitan el Medicare – las personas quienes necesitan esta red de seguridad social para no caer en la pobreza, la enfermedad o algo peor.

“Mientras los republicanos siguen buscando decidir si quieren o no acabar con el Medicare, hay alguien quien si sabe lo que quiere: el pueblo estadounidense.

“Ellos son consistentes en este tema y son bien claros: No quieren que destruyamos a su Medicare. Debemos escucharlos”.

CONTACTO: José Dante Parra, (202) 224-2939

###

“This will be a busy week in the Senate.  We have to renew the Patriot Act.  It’s not a perfect law, but it plays an important role in keeping our country safe.  We also have to reauthorize the Federal Aviation Administration.

“But we all know what will be the focus of this week’s biggest debate and biggest headlines.  The primary conversation this week will be about the Republican plan to kill Medicare.

“People are talking a lot about that plan because there’s a lot in there to fear.  The Republican plan would shatter a cornerstone of our society, and would break our promise to the elderly and the sick.

“It would turn over seniors’ health to profit-hungry insurance companies.  It would let bureaucrats decide what tests and treatments seniors get.  And it would ask seniors to pay more for their health care in exchange for fewer benefits.  That’s a bad deal all around.

“So it’s easy to understand why the American people don’t support it.  I won’t support it, either.  And though Republican in the House supported this Medicare-killing plan almost unanimously, sometimes it’s difficult to tell where the Republican Party stands on the issue.

“We all saw how quickly one prominent Republican Presidential candidate spun himself into circles last week.  First he called the plan for what it is: radical.  He said it was ‘right-wing social engineering.’  Hours later, after Republicans jumped all over him, he reversed course and said he supports the plan to kill Medicare.

“Another prominent Republican, one who serves in this body, has been all over the map as well.  First he said – in his words – ‘Thank God’ for the Republican plan to kill Medicare.  Then he said he was undecided.  Now he says he opposes it.  We’ll tune in tomorrow to see if he changes his mind again.

“Our Republican colleagues can’t seem to believe the same thing today that they said yesterday.  But when Democrats talk about Medicare, we still believe today the same thing we believed years ago, decades ago and generations ago: We believe in our responsibility to each other.

“Forty-six years ago this summer, President Lyndon Johnson, a former Majority Leader of this Senate, signed Medicare into law.  As he did so, he said the following:

‘Few can see past the speeches and the political battles to the doctor over there that is tending the infirm, and to the hospital that is receiving those in anguish, or feel in their heart painful wrath at the injustice which denies the miracle of healing to the old and to the poor.’

“Because of Medicare, those injustices don’t exist as sharply as they did then – but they still exist.  The old and the poor among us still seek help and healing.  And it is still our responsibility to act not on political impulses, but with human concern and compassion.  It is still our responsibility not to be motivated by short-term politics, but to be moved by the people who need Medicare – the people who count on this safety net to keep them from poverty, illness or worse.

“If we pay attention to those people, we’ll notice something else, too.  While Republicans are tripping over themselves and trying to decide whether or not they want to kill Medicare, you know who hasn’t changed their mind at all?  The American people.

“They haven’t wavered one inch.  They have been as constant as Republicans have been erratic.  They have been consistent, and they have been clear: They don’t want us to destroy their Medicare.  We owe it to them to listen.”

From Day One, Republicans’ Reckless Plan Will Force Millions of Seniors to Pay More for Prescription Drugs and Wellness Visits

New Interactive State-by-State Map, With Data, Can Be Found at http://democrats.senate.gov/gop-budget/

Washington, DC— The Democratic Policy and Communications Center (DPCC) today released national and state-by-state data revealing the devastating effect the Republicans’ Medicare-ending budget would have on the economy and seniors’ health care costs.  Across the country, the GOP’s reckless plan would cost 2 million private sector jobs over the next five years and increase seniors’ out-of-pocket health care costs by $6,359 in 2022 – more than double what they would otherwise pay.

The report also shows that starting next year if the GOP plan is law, nearly four million seniors nationwide will be forced to pay $2.2 billion more in prescription drug costs, and at least one million seniors will have to pay over $110 million more for annual wellness visits in 2012.  The Republican budget could also cut more than $503 billion in federal health care funding for seniors and the disabled through Medicaid, including life-saving nursing home coverage.

The DPCC national report and state-by-state breakdown can be found here.  Earlier today, the Joint Economic Committee (JEC), chaired by Senator Bob Casey (D-PA), released a state-by-state report detailing how the GOP budget will more than double seniors’ out-of-pocket costs by 2022.  That analysis can be found here.

Report Highlights:

• The Republican plan to end Medicare will increase out-of-pocket health care costs for a typical 65 year-old senior by $6,359 in 2022 – more than double the cost under current law.

• The Republican plan could force at least one million seniors to pay over $110 million more for annual wellness visits in 2012.

• Nationwide, nearly four million seniors would pay $2.2 billion more for prescription drugs in 2012 alone under the Republican plan.

• By turning Medicaid into a block grant program, the Republican plan could cost America more than two million private-sector jobs over the next five years.

• Nationwide, the Republican plan could cut more than $503 billion in federal health care funding for seniors and the disabled through Medicaid, including life-saving nursing home care.

The non-partisan Congressional Budget Office has estimated that a typical 65-year-old Medicare beneficiary in 2022 would see their out-of-pocket health care costs increase from $6,154 to $12,513 under the Republican budget.  Using that data along with cost-sharing data from the Centers for Medicare and Medicaid Services, the JEC has estimated out-of-pocket costs on a state-by-state basis.  While the increase varies by state, residents in all states will see their out-of-pocket expenses more than double when they turn 65 in 2022.  Residents in Florida face the largest increase –$7,383.

The report also shows that current Medicare beneficiaries will be harmed by the GOP budget, immediately losing preventive services such as mammograms and facing higher prescription drug costs.

“This new JEC analysis helps to fill in the picture on just how disastrous and costly the Republican Medicare plan is for our older Americans,” said Senator Bob Casey (D-PA), Chairman of the JEC.  “If Republicans have their way, traditional Medicare will no longer exist in 2022.   Instead, our elderly will get a voucher to purchase private insurance, but the voucher won’t keep pace with health care costs.   The result would be a staggering increase in out-of-pocket costs beginning in 2022.  In my state of Pennsylvania, someone turning 65 in 2022 would face a $6,300 increase in their health care expenses.  Our elderly Americans cannot afford to have their health care expenses double, but that’s exactly what the Republican plan delivers.”

The increased out-of-pocket costs result from older Americans bearing a larger share of health care costs under the Republican plan and the increase in total health care costs that results from shifting from traditional Medicare to a less efficient, more expensive voucher program.

“The Republican Medicare plan doesn’t rein in health care costs,” continued Casey.  “Instead, it simply shifts the costs onto the backs of our elderly.  The Republican ‘solution’ is providing our elderly with dramatically higher costs and less care.   Current beneficiaries will suffer and the next generation will face retirement without Medicare and without the peace of mind it offers.”

Current Medicare beneficiaries will lose key benefits under the GOP budget, the report notes.  The Republican plan reopens the donut hole – the gap in Medicare Part D that had forced beneficiaries to pay 100 percent of their drug costs after they exceeded an initial coverage limit and until they qualified for catastrophic coverage.  Additionally, the Republican plan eliminates the free annual wellness exam beneficiaries currently receive and forces older citizens to pay for preventive services such as mammograms.

Please click here for the state-by-state breakdown of the increase in out-of-pocket health care costs.

###

The Joint Economic Committee, established under the Employment Act of 1946, was created by Congress to review economic conditions and to analyze the effectiveness of economic policy.

www.jec.senate.gov

Arizona Republic (AZ): Anthem Audience Challenges Quayle During Presentation On Medicare. “U.S. Rep. Ben Quayle had finished a Power Point presentation on the national debt this week when members of the audience started a running commentary and flashing signs that read ‘Hands off our Medicare.’ About 225 people filed into the Fellowship Church in Anthem on Monday to hear about a $14.3 trillion budget shortfall and ways to resolve it. The gathering quickly turned into a sort of political rally, with people arguing with the freshman lawmaker who represents Arizona’s 3rd Congressional District, which includes Phoenix, Scottsdale and Paradise Valley.” LINK

The Palm Beach Post (FL):At Town Hall Meetings, Critics Confront GOP Rep. West Over Medicare Cuts. “The shouting began before U.S. Rep. Allen West, R-Plantation, uttered a word at his town hall meeting here Tuesday afternoon. ‘Where are the jobs?’ a man yelled from the audience as West was about to begin a slide presentation. … Democrats and their allies have turned up the volume at town halls across the U.S. since the Republican-controlled House voted to change Medicare for those now 54 and younger from a fee-for-service program to one in which the government provides subsidies for seniors to buy private insurance plans.” LINK

The Vancouver Columbian (WA): Crowd Pulls Few Punches At Herrera Beutler Town Hall. “Several hundred people showed up at Skyview High School for the session. They passed a couple dozen protesters near the entrance who hoisted signs saying, ‘Save Medicare: Tax the Rich’ and ‘People not Profits.’ Several supporters of Planned Parenthood wore pink T-shirts to protest Herrera Beutler’s vote to end federal funding of family planning services. … when she insisted that the Republican budget blueprint for 2012 ‘protects Medicare,’ a chorus of boos and catcalls and shouts of “liar” erupted in the auditorium. ” LINK

Ocean City Today (MD): Rep. Harris Told GOP Plan “Will Kill Medicare As We Know It.” “The auditorium was filled with senior citizens concerned about Medicare and, as with the numerous town hall meetings of 2009, the crowd reached pitched debate on health care issues. George Benton of West Ocean City was concerned about the costs for future generations and that costs could increase for existing beneficiaries within several years. ‘The Paul Ryan bill will kill Medicare as we know it,’ argued Benton. ‘These good people want their tax dollars to go toward their grandchildrens’ costs. We’ve been borrowing all this money from China to pay for the Iraq War and for Bush-era tax cuts on the wealthy.’” LINK

Las Vegas Review-Journal (NV): Heck Town Hall Meeting Sparks Passions. “The crowd didn’t just argue with Republican Rep. Joe Heck at a town hall meeting in Boulder City on Wednesday. The 50 people in attendance often shouted at each other, indifferent to whether the Republican federal budget Heck was there to discuss would hurt or help Medicare and the job market.” LINK

Associated Press(MN): Freshman Rep. Cravaack Defends Medicare Vote. “Terry Bell, 62, of Cambridge, criticized the slides for being inaccurate. He asked Cravaack to point out the last time Republicans produced a balanced budget. ‘Your party has added to the deficit ever since the Ford administration,’ Bell said. ‘The only time you get the least bit concerned is when the Democratic Party gets in.’” LINK

Connecticut Post (CT): Seniors Express Fear Over Possible Medicare Changes. “James Marbury has been through a lot in his 84 years. He fought in the Korean War. When he came home from fighting, Marbury, who is black, experienced rampant racism, not being allowed in certain restaurants and being forced to use a separate YMCA from his white peers. With all he’s experienced, he feels that he and other seniors have earned the right to certain protections in their old age, such as the reassurance that they’ll be able to get affordable health care whenever they need it.” LINK

KSAZ Fox News (AZ): Congressman Quayle Takes Heat for Medicare Decision. “Monday night at a town meeting in Anthem, it was Ben Quayle who got beat up a bit while meeting with his constituents. Many people in the crowd were fired up about his stance on the proposed changes to the Medicare system. Quayle favors the Republican plan which would give seniors vouchers to buy health insurance on the private market.” LINK

South Florida Sun Sentinel (FL): Rep. Allen West Faces Tough Questions At Town Hall In Pompano Beach. “Plenty were hostile. For example, one asserted that the House Republican plan to change Medicare ‘is obviously not something Americans want. Even Republicans have been backing off of this unpopular plan.’” LINK

WBFB ABC News (FL): Congressman’s Meeting Interrupted By Shouting. “Another town hall meeting organized by U.S. Rep. Allen West, R-Plantation, devolved into a shouting match Monday night. About 100 people came to hear the congressman speak. Police escorted one person out of the meeting.  … ‘I didn’t agree with his explanation about Medicare. I’m very concerned about cutting Medicare and changing Medicare without looking at the revenue side,’ resident Dave King said.” LINK

Duluth News Tribune (MN): Sparks Fly In Cravaack’s Visit To Iron Range. “But it was clear that most in the audience, a diverse mixture of active and retired union members, small-business owners, visible DFL supporters and people who were busy drawing on one or more of those entitlement programs, had come to ask more specific questions or simply raise their own talking points. It wasn’t far into Cravaack’s slide show presentation — he jokingly called it ‘death by PowerPoint’ — that people began jumping in. … After the meeting, Reeths said Cravaack seemed to be ‘toeing the party line,’ he said. ‘So far, I haven’t seen any points where he’s willing to step away from the party line and say he supports some compromise; that’s very disappointing.’” LINK

Associated Press (WA): Lively Vancouver Town Hall For Jaime Herrera Beutler. “the Camas Republican fielded sometimes hostile questions about her vote to restructure Medicare and her reluctance to support raising the federal debt limit… Protesters near the entrance held signs saying, ‘Save Medicare: Tax the Rich’ and ‘People not Profits.’ Several supporters of Planned Parenthood wore pink T-shirts to protest Herrera Beutler’s vote to end federal funding of family planning services.” LINK

ThinkProgress: Rep. Webster Threatens To Kick Out Town Hall Constituent For Asking About Raising Corporate Taxes. “The town hall backlash that began last month over the Republican plan to end Medicare and extend tax breaks for the wealthy is showing no signs of abating. Rep. Dan Webster (R-FL) encountered many angry constituents Tuesday night during a town hall meeting outside Orlando. Attendees repeatedly admonished Webster for his support of the Ryan budget and pleaded with him to do more to ensure corporations pay their fair share in taxes.” LINK

Millions of Seniors In “Donut-Hole” Would Pay over $9,300 more for Rx Drugs by 2020

Senate Dems Release New National And State-by-State Report on Increased Cost Current Enrollees Would Face in Coming Years Under Republican Budget

Washington, DC— Today, Health and Human Services Secretary Kathleen Sebelius and Sens. Jay Rockefeller (D-WV), Barbara Mikulski (D-MD), Sherrod Brown (D-OH), and Sheldon Whitehouse (D-RI) revealed the immediate and devastating impact the extreme House Republicans’ budget plan would have on at least four million seniors across the country.  The Republican budget would reopen the prescription drug donut hole, costing each of the four million seniors who fall into the coverage gap up to $9,300 by 2020.  In total, it would cost seniors $44 billion in prescription drug costs over this time period, including $2.2 billion next year alone.  It would also force at least one million seniors and people with disabilities to pay over $110 million more for their annual wellness visits in 2012.

The Senators released a state-by-state report detailing the number of seniors who would be thrown back into the prescription drug donut hole, the additional costs seniors would pay for prescription drugs, and the number of Medicare enrollees who would pay more for their annual wellness visit under the Republican budget [LINK].

“There’s a right way to preserve Medicare, and that’s by improving it,” Secretary Sebelius said. “President Obama has begun to do just that. The Republican plan would end Medicare as we know it and impose significant costs on today’s seniors and tomorrow’s seniors. That is clearly the wrong way.”

“Since passing their reckless budget plan, Republicans have continued to make the false claim that their plan protects Medicare benefits for seniors – this is simply not true,” Senator Rockefeller said.  “Medicaid is just as important for seniors as Medicare and Social Security, and we ought to be asking Republicans why they want to slash our country’s only long-term care program.”

“The Ryan budget jeopardizes women’s health at all stages of life – it is devastating to seniors, women of child-bearing age, and even children,” Senator Mikulski said. “It continues the assault on women that House Republicans began in H.R. 1. It decimates Medicare and Medicaid, but gives a bailout to rich insurance companies. This budget is so ridiculous that it’s hard to take seriously, but I know they are serious. And I’m serious about stopping them.”

“The Republican budget would pull the rug out from under seniors in order to finance extra tax cuts for millionaires,” Senator Brown said. “If enacted, seniors would see their prescription drug costs explode and would lose access to no-cost annual wellness visits and preventive care. It would hand an $89 million prescription drug tab to split among 159,000 Ohio seniors in the first year alone. Meanwhile, seniors would see an end to Medicare as we know it through privatization. They would be handed vouchers that wouldn’t cover the cost of the health services they count on – doubling their out-of-pocket costs in the first year alone.”

“With Rhode Island seniors struggling to keep up with rising costs at the pharmacy, grocery store, and gas pump, this is not the time to tamper with Medicare by reopening the doughnut hole and taking away access to free preventive screenings,” Senator Whitehouse said.  “I will stand strong against efforts to increase the out-of-pocket health expenses of Rhode Island seniors.”

The Republican budget would also require that seniors pay deductibles, co-insurance, and copayments for many preventive services currently covered by Medicare, including mammograms; colorectal, cervical and prostate cancer screening; cholesterol and other cardiovascular screenings; diabetes screening and flu shots.

Background:

Under the Republican Plan, Nearly Four Million Seniors Will Be Forced to Pay $2.2 Billion More for Prescription Drugs in 2012. The Republican budget would “reopen” the prescription drug donut hole and cost the average senior who falls into the coverage gap approximately $9,300 between 2012 and 2020. Over that time, the Republican budget will cost seniors an estimated $44 billion in prescription drug costs, including $2.2 billion next year alone.  [HHS, 11/4/10; CBO, 3/18/11]

Under The Republican Plan, At Least One Million Seniors and People With Disabilities Will Pay Over $110 Million More For Their Annual Wellness Visits In 2012. At least 1,000,000 seniors are expected to see their physician for an annual wellness visit in 2012. These visits are critical to positive health outcomes for seniors across the country. As a result of the Republican plan, these seniors would each pay an additional $160 for the first visit and $105 for a subsequent visit. [HHS, 3/16/11; Kaiser State Health Facts, accessed on 5/5/11]

All Seniors Enrolled In Medicare Will Be Forced to Pay More for Health Care Services Under the Republican Plan. The Republican plan will require that seniors pay deductibles, co-insurance, and copayments for many preventive services currently covered by Medicare; including cancer screenings such as mammograms and colonoscopies as well as annual wellness visits. Seniors could be forced to pay for many other health services that Medicare currently covers free of charge to the patient, including mammograms; colorectal, cervical and prostate cancer screening; cholesterol and other cardiovascular screenings; diabetes screening and flu shots. [HHS, 11/4/10]

“The Medicare Trustees’ report projects that Medicare will remain solvent through 2024.  This is a slight reduction from last year’s projection, caused largely by the pace of economic recovery.  Without the Affordable Care Act (ACA), Medicare would have gone bankrupt in 2016.

“Clearly, the ACA extended the solvency of Medicare.  It also laid the foundation for system-wide savings and quality improvement through reforms to our delivery system.  We should build upon that foundation by implementing those delivery system reforms that reward quality, promote prevention, simplify administrative processes, realign payment systems, and encourage information technology.  This approach will save money by improving quality of care: a win-win for our health care system and the American people.  We owe it to our country to reach for those savings – not compromise the care on which millions rely.

“Unfortunately, some of my Republican colleagues have proposed to privatize Medicare and shift the rising cost burden to seniors, rather than strengthen Medicare and put our entire health care system on a sustainable path. They have misdiagnosed the problem, and their remedy will do more harm than good.”

Schumer: GOP Tried To Throw Medicare Privatization Plan Overboard But It Is An Anchor Still Tied Around Their Ankles

WASHINGTON, DC—Earlier this week, there were reports that House Republicans might remove their plan to end Medicare from their budget proposal. But Republicans in both the House and Senate quickly defended the original plan, which would end Medicare as we know it and double out-of-pocket costs for millions of seniors.

“House Republicans tried throwing their Medicare plan overboard, but it is still an anchor tied around their ankles. They may not want to embrace the plan anymore, but they still own it,” U.S. Senator Charles E. Schumer said.

Below is a round-up of top Republicans who raced yesterday to double down in support of their plan to privatize Medicare.

Speaker Boehner: Plan to End Medicare “Absolutely Not” Off the Table.Speaker John Boehner tweeted, “Saving Medicare off the table? Absolutely not.” [Boehner Tweet, 5/5/11]

Majority Leader Eric Cantor’s Position “Is the Ryan Budget, Period.” Including Plan to End Medicare. “Eric made very clear that our position is the Ryan budget which — as you know — assumes a debt limit increase and includes Medicare, Medicaid and $715 billion in mandatory savings,” Cantor spokesman Brad Dayspring told POLITICO. “Whether the Democrats will agree to the proposals we’ve outlined is yet to be seen, but that is our starting point so we don’t continue to kick the can down the road and make real cuts and real reforms this year.” “To be clear, the Republican position is the Ryan budget, period,” spokeswoman Laena Fallon said in an email to reporters. [Politico, 5/4/11; The Hill, 5/5/11]

Rep. Joe Walsh: “I Would Be Very Disappointed If We Didn’t Follow Through” With Plan to End Medicare. “I would be very disappointed if we didn’t follow through,” said Representative Joe Walsh. “We have spent, gosh, a month or two now trying to educate the American people to a pretty good reception. I appreciate the chairman’s notion, but I would continue to respectfully challenge him to get this thing through committee.” [New York Times, 5/6/11]

Sen. Rob Portman: “It’s Not a Wise Strategy to Be Taking Things Off the Table.” “It’s not a wise strategy to be taking things off the table today before we’ve begun any discussion to find consensus. I would hope that instead of talking about what’s not on the table we’d be talking about how to find consensus,” Sen. Rob Portman (R-Ohio), a former director of the Office of Management and Budget in the George W. Bush administration, told reporters Thursday. [Washington Post, 5/5/11]

Sen. Ron Johnson “Disappointed”If Plan to End Medicare Isn’t in GOP Budget. After it was reported that Medicare would be removed from the Republican plan, Sen. Ron Johnson said he was “disappointed” by the report. [Financial Times, 5/6/11]

Rep. Jeff Flake: “Surprised”to Hear Rumors of GOP Pulling Back on Medicare. “I don’t know how you can continue to exclude entitlement spending,” said Rep. Jeff Flake (R., Ariz.), who said he was “surprised to hear the talk of pulling back” GOP expectations. [Wall Street Journal, 5/6/11]

Schumer: GOP Tried To Throw Medicare Privatization Plan Overboard But It Is An Anchor Still Tied Around Their Ankles

WASHINGTON, DC—Earlier this week, there were reports that House Republicans might remove their plan to end Medicare from their budget proposal. But Republicans in both the House and Senate quickly defended the original plan, which would end Medicare as we know it and double out-of-pocket costs for millions of seniors.

“House Republicans tried throwing their Medicare plan overboard, but it is still an anchor tied around their ankles. They may not want to embrace the plan anymore, but they still own it,” U.S. Senator Charles E. Schumer said.

Below is a round-up of top Republicans who raced yesterday to double down in support of their plan to privatize Medicare.

Speaker Boehner: Plan to End Medicare “Absolutely Not” Off the Table.Speaker John Boehner tweeted, “Saving Medicare off the table? Absolutely not.” [Boehner Tweet, 5/5/11]

Majority Leader Eric Cantor’s Position “Is the Ryan Budget, Period.” Including Plan to End Medicare. “Eric made very clear that our position is the Ryan budget which — as you know — assumes a debt limit increase and includes Medicare, Medicaid and $715 billion in mandatory savings,” Cantor spokesman Brad Dayspring told POLITICO. “Whether the Democrats will agree to the proposals we’ve outlined is yet to be seen, but that is our starting point so we don’t continue to kick the can down the road and make real cuts and real reforms this year.” “To be clear, the Republican position is the Ryan budget, period,” spokeswoman Laena Fallon said in an email to reporters. [Politico, 5/4/11; The Hill, 5/5/11]

Rep. Joe Walsh: “I Would Be Very Disappointed If We Didn’t Follow Through” With Plan to End Medicare. “I would be very disappointed if we didn’t follow through,” said Representative Joe Walsh. “We have spent, gosh, a month or two now trying to educate the American people to a pretty good reception. I appreciate the chairman’s notion, but I would continue to respectfully challenge him to get this thing through committee.” [New York Times, 5/6/11]

Sen. Rob Portman: “It’s Not a Wise Strategy to Be Taking Things Off the Table.” “It’s not a wise strategy to be taking things off the table today before we’ve begun any discussion to find consensus. I would hope that instead of talking about what’s not on the table we’d be talking about how to find consensus,” Sen. Rob Portman (R-Ohio), a former director of the Office of Management and Budget in the George W. Bush administration, told reporters Thursday. [Washington Post, 5/5/11]

Sen. Ron Johnson “Disappointed”If Plan to End Medicare Isn’t in GOP Budget. After it was reported that Medicare would be removed from the Republican plan, Sen. Ron Johnson said he was “disappointed” by the report. [Financial Times, 5/6/11]

Rep. Jeff Flake: “Surprised”to Hear Rumors of GOP Pulling Back on Medicare. “I don’t know how you can continue to exclude entitlement spending,” said Rep. Jeff Flake (R., Ariz.), who said he was “surprised to hear the talk of pulling back” GOP expectations. [Wall Street Journal, 5/6/11]

Voters Dislike GOP Plan to Change Medicare, Medicaid

By Patrick O’Connor

Republicans have some selling to do.

Changes to Medicare and Medicaid remain wildly unpopular and more than two-thirds of registered voters want to repeal Bush-era tax cuts for households that make more than $250,000 a year, according to the latest Quinnipiac University poll.

More than twice as many voters oppose efforts to change Medicare than those who favor limiting benefits under the popular health-care program for seniors. And a distinct majority opposes new limits on Medicaid, the federal-state health program for the poor.

What’s worse for the GOP, the numbers don’t change much when voters were told how much federal spending Medicare and Medicaid consume.

Quinnipiac told half of the 1,408 registered voters the university polled that Medicare, Medicaid, Social Security and defense spending consume 60% of the budget. The other half weren’t. Among those who were told, 70% opposed efforts to change Medicare, compared with the 75% who weren’t told. For Medicaid, 57% of the first group opposed limits, compared with the 59% of the control group that also opposed changes. The only significant change came on the question of defense spending, with support for cuts increasing by 7% when voters were told how much the government spends on the military.

“So much for the idea that if the public only understood the budget numbers they would be much more amenable to reductions,” said Peter Brown, assistant director of polling at the Quinnipiac University Polling Institute. “Except for defense spending.”

The House Republicans’ budget would turn Medicaid into a system of block grants to the states and transform Medicare from a fee-for-service program to a menu of subsidized private insurance plans for people under the age of 55. Many GOP lawmakers got an earful from their constituents about the budget blueprint during a recently concluded two-week recess.

In addition, 69% of the voters polled favor repealing Bush-era tax breaks on households than earn more than $250,000. Republicans would keep the current rates indefinitely, while President Barack Obama has promised to raise them for people whose income exceeds $250,000.

http://blogs.wsj.com/washwire/2011/05/04/voters-dislike-gop-plan-to-change-medicare-medicaid/

“After Senate Republican leaders spent weeks embracing House Republicans’ plan to end Medicare to give tax breaks to millionaires, why are they suddenly afraid to vote on it? They’ve already praised this plan to end Medicare as we know it, so they shouldn’t be afraid to put it in the record.”

McConnell Called Ryan Budget A “Serious And Detailed Plan.”In a statement Senator McConnell said: “Today, the Chairman of the House Budget Committee, Congressman Paul Ryan, is releasing a serious and detailed plan for getting our nation’s fiscal house in order. Congressman Ryan’s plan would put us on a path to reducing the national debt. It would strengthen the social safety net so we can keep the promises we’ve made to America’s seniors… It’s my hope that our friends on the other side recognize this effort for what it is — a serious, good-will effort to do something good and necessary for the future of our nation and that, for the good of the nation, they’ll join in the effort at some point before it’s too late.” [McConnell Floor Speech, 4/5/11]

Kyl Praised Ryan Budget, An “Effective Blueprint.” Kyl said in a statement, “House Budget Committee Chairman Paul Ryan, who authored the budget, believes it could reverse Washington’s trend of spending beyond its means and passing the debt onto our children and grandchildren.  I believe he’s right on target…I think Congressman Ryan’s budget proposal is an effective blueprint for economic growth.” [Kyl Release, 4/11/11]

Scott Brown Praised Ryan Plan. “Brown also praised a budget plan crafted by Wisconsin U.S. Rep. Paul Ryan that would slash federal spending by about $5 trillion over 10 years while revamping health programs for the elderly and poor. Brown credited Ryan’s budget for its fresh approach, adding that it forced Obama to come up with his own spending plan.  ‘I think, ultimately, if you think that if we can do nothing and you think Medicare and Medicaid and Social Security are going to be viable in years to come, then you’re wrong,’ said Brown. ‘We need to do something.’”  [Lowell Sun, 4/28/11]

Cornyn Praised Ryan Budget, “Filled a Leadership Void.” In a statement Senator Cornyn said, “Congressman Paul Ryan and the House Republicans stepped up and filled a leadership void that the President and Senate Democrats have steadfastly refused to fill. The House Republican budget proposal speaks directly to the frustrations of the American people and addresses the long-term fiscal challenges that we all know we have to face. Instead of demagoguing this serious proposal, I hope President Obama and Congressional Democrats take this opportunity to engage in a constructive debate to get our nation’s fiscal house back in order.” [Cornyn Release, 4/5/11]

Sessions Called Ryan Plan “Honest, Responsible, Serious.” In an interview with radio host Hugh Hewitt, Senator Sessions said, “And it’s never easy to make changes, but Hugh, this thing is, we’re in a deeper hole than in ’94. This is a deep hole, and Paul Ryan’s plan is an honest, responsible, serious plan to get us out of this fix.” [Hugh Hewitt Show, 4/7/11]

Johanns: “Ryan Budget Is A Serious Effort.” In a statement, Senator Johanns said, “Chairman Ryan’s budget is a serious attempt to address our ballooning debt in a responsible way, and I applaud his leadership.” [Johanns Release, 4/5/11]

Hatch Said Ryan Plan Put “Serious Ideas On The Table,” Hatch said in a statement,“…Paul Ryan has put serious ideas on the table to reform Medicare and Medicaid, streamline our tax code, cut spending, and confront our debt. He rightly includes a proposal to kick Fannie Mae and Freddie Mac off the government dole, fully repeal the budget-busting $2.6 trillion health law, and extend the 2001 and 2003 tax relief permanently, while reducing our corporate tax rate.” [Hatch Release, 4/5/11]

CNN: Crowd Turns Loud At Town Hall Session For Freshman GOP Rep. “House Republicans back home for congressional recess have been getting some tough questions about plans to overhaul Medicare, but GOP freshman Daniel Webster’s town hall meeting in Orlando, Florida, Tuesday was beyond tough – it turned into a chaotic scene. Webster used charts and graphs to try to explain the controversial House GOP budget he voted for, but he could barely be heard over angry yelling – mostly about the Medicare proposal. As one man held a sign saying ‘keep your hands off my Medicare,’ another woman screamed that the congressman voted to give corporations a tax cut ‘but take away Medicare for people like me.’”  LINK

Washington Post: Republicans Facing Tough Questions Over Medicare Overhaul In Budget Plan. “Anxiety is rising among some Republicans over the party’s embrace of a plan to overhaul Medicare, with GOP lawmakers already starting to face tough questions on the issue at town hall meetings back in their districts. … Democrats, eager to win back the seniors and independents who abandoned the party in last year’s midterm elections, have declared the vote a ‘moment of truth’ and this week launched a media campaign accusing GOP House members of dismantling Medicare and endangering retirees. The assault has taken some Republicans by surprise, prompting concerns that the party is ceding ground in a policy debate that GOP strategists already viewed as perilous.” LINK

USA Today: Republicans In Congress Get Earful On Medicare. “Some Republicans in Congress are getting an earful back home over their votes to dramatically revamp Medicare for seniors. House Budget Committee Chairman Paul Ryan, R-Wis., who proposed changing the federal entitlement into a voucher program, got booed at such a meeting in his district last week. LINK

Los Angeles Times: House Republicans Face Backlash At Home Over Budget Plan. “Congress is on its first recess since Republican leaders unveiled a plan to end the federal deficit by dramatically changing Medicare, cutting other government programs and reducing taxes. With members of the House returning home to meet with constituents, politicians have been anxiously looking for signs of trouble. … A similar argument broke out among voters at a knitting circle in the Southern California district of Rep. Mary Bono Mack (R-Palm Springs). …’I don’t trust these guys,’ said Barbara Walden, 77. Once Republicans begin ‘stripping away’ Medicare and Medicaid benefits for the younger generation, she said, they will eventually renege on their promise to protect the program for current seniors. ”  LINK

ABC News: Republican Lawmakers Face Angry, Confused Constituents on Medicare, Budget Cuts. “Americans are particularly concerned, and somewhat confused, about the proposal to overhaul Medicare, a central feature of the Wisconsin congressman’s proposal.” LINK

TIME: The Ryan Budget Vote: An Upstream Swim for Charlie Bass. “Bass spent a lot of time at his town hall trying to explain why it’s not, in his characterization, a voucher system. But he didn’t convince Spitzbarth and Loomis. ‘I like Medicare the way it is,’ Spitzbarth told Bass to applause from the audience, ‘don’t screw it up.’”  LINK

National Journal: Republicans In Swing Districts Take Heat For Supporting Ryan’s Medicare Plan. “Republicans who used seniors’ rage over health care changes to sweep into office last fall are now facing the same type of heat over the same issue: Modifications in Medicare and Medicaid. Many who voted for the plan House Budget Chairman Paul Ryan, R-Wis., laid out to privatize the programs in future years have been in constituents’ crosshairs during Easter recess town-hall meetings. Others have simply avoided meeting with constituents.” LINK

Politico: Freshmen Feel The Heat Back Home. “Any lawmaker in a swing district can expect to take criticism from his right flank at a town hall meeting. But at an American Veterans outpost tucked deep in the Pocono Mountains this week, freshman Republican Rep. Lou Barletta took heat from every direction — from Democrats angry with the tax cuts in the GOP budget, to conservatives who thought he caved on the last continuing resolution vote, to a precocious 16-year-old critical of the lawmaker’s environmental record.” LINK

Orlando Sentinel: Angry Crowd At Town-Hall Meeting Could Be The Norm For Dan Webster. “A town-hall meeting held in Orlando by U.S. Rep. Dan Webster degenerated into bedlam Tuesday, with members of the crowd shouting down the freshman Republican congressman and yelling at one another.. … Tuesday at the Orange County Agricultural Extension office in Orlando, boos and shouts of ‘liar’ were mixed with angry accusations that Ryan’s plan to change Medicare would leave those now younger than 55 without health insurance in their retirement. There also were calls to eliminate the tax cuts first put in place by then-President George W. Bush and to raise corporate taxes rather than cut entitlement programs.” LINK

Politico: Overflow Crowds For Ryan Town Halls. “Record crowds of supporters and opponents flooded town hall meetings throughout southeastern Wisconsin on Tuesday to hear Budget Committee Chairman Paul Ryan (R-Wis.) defend his plan to trim government spending — including controversial changes to the Medicare program. In the district’s Democratic stronghold of Kenosha, at least 200 people were left outside once the 300-seat auditorium filled to capacity. The people in the crowd largely opposed the Ryan plan, holding signs such as ‘RyanCare = Dying Bare,’ ‘Leave Medicare Alone’ or simply, ‘Save Medicare!’ … ‘The problem is, under your program, when you want to give me X amount of dollars, with the insurance companies, the way they operate … if I can’t afford insurance, then where am I going to be?’ asked one 62-year-old woman with a history of cancer who worried she wouldn’t qualify for private insurance coverage under Ryan’s plan.” LINK

Chicago Daily Herald: Dold Faces Tough Questions At Town Hall Meeting. “Fresh off voting for the so-called Paul Ryan budget plan on Friday, newly-elected Congressman Robert Dold returned to Buffalo Grove Saturday where constituents questioned him about several elements of the Republican budget. …But Dold couldn’t even get to the end of the presentation before audience members began peppering him with questions about the Ryan budget, named after House Budget Committee Chairman Paul Ryan, a Republican from Wisconsin. It began with audience members telling Dold they don’t believe chopping 10 percentage points off the highest corporate tax rate will create jobs. A handful of people in the audience identified themselves as business owners and accountants who said their effective corporate income tax rate is already lower than the lowest rates proposed in the Ryan plan.” LINK

Allentown Morning Call: Barletta Town Hall Gets Heated Over Medicare. “Reminiscent of the August 2009 town halls when members of Congress faced angry constituents over health care reforms, a public forum in Carbon County with Rep. Lou Barletta Wednesday night provided a glimpse of the strong emotions stirred by a Republican plan to alter Medicare benefits.” LINK

Huffington Post: GOP Town Halls: Reps Forced To Screen Questions, Duck Out Of Meetings In Secret. “The wave of town hall protests targeting House Republicans, and aided by labor and progressive groups, is forcing lawmakers to put restrictions on the forum’s traditionally open structure. On Tuesday night, Rep. Allen West’s office (R-Fl.) reportedly screened questioners during his town hall event by requiring individuals to fill out index cards which were then vetted by his staff. This was, the Boward County Sun Sentinel noted, different from ‘his usual practice at previous town hall meetings, where West took questions from people who lined up at microphones.’ Separately, House Budget Committee Chair Paul Ryan (R-Wisc.), who has chosen to publicly broadcast his town hall locations rather than avoid the protests, was forced to leave Tuesday night’s forum in a different car and from a different exit out of security concerns.” LINK

Since passing their reckless budget plan last week, Republicans nationwide have continued to make the false claim that their plan protects today’s seniors. But seniors need to know the facts about the GOP plan. The Republican-passed budget will force nearly four million seniors to pay an additional $2.2 BILLION for prescription drugs next year alone.

Wisconsin: On Sunday, House Budget Committee Chairman Paul Ryan said, “And Medicare, let me just tell you, no change would occur to anybody fifty-five years of age or above.” Rep. Sean Duffy (R-WI) claims, “The fact is, this plan does not affect today’s seniors, or anyone on the verge of retirement, 55 years or older.” Both ignore the fact that, under the Republican budget, 69,167 Wisconsin seniors will pay $39 million more for prescription drugs next year alone.

Virginia: House Majority Leader Eric Cantor said Friday, “To be clear, our plan will not touch benefits for today’s seniors and those nearing retirement.”  Cantor ignores the fact that, under the Republican budget, 91,377 Virginia seniors will pay $51 million more for prescription drugs next year alone.

Kentucky: Rep. Brett Guthrie (R-KY) “says the proposed changes to Medicare in the House bill will not affect anyone currently 55 or older.” Guthrie ignores the fact that, under the Republican budget, 74,669 Kentucky seniors will pay $42 million more for prescription drugs next year alone.

North Carolina: Rep. Renee Ellmers (R-NC) said, “This budget does not cut Medicare funding. It makes no changes to Medicare for anyone 55 or older.” Ellmers ignores the fact that, under the Republican budget, 122,598 North Carolina seniors will pay $69 million more for prescription drugs next year alone.

Pennsylvania: After voting for the budget on Friday, Rep. Mike Kelly (R-PA) said, “Under our proposal, seniors are safe, with no changes to the current program for those 55 and older.” Rep. Glen Thompson (R-PA) asserted, “Contrary to the misinformation, this plan keeps our current commitments to seniors, while ensuring the longevity of our social safety net programs for future generations.” And Rep. Bill Shuster (R-PA) said, “It’s extremely important that people 55 years and older know that there will not be one dime of change to what they’ve been promised.” All three ignore the fact that, under the Republican budget, 266,342 Pennsylvania seniors will pay $149 million more for prescription drugs next year alone.

New York: Rep. Michael Grimm (R-NY) said, “What I like about Ryan’s plan is that if you’re 55 and over — so if you’re about to become a senior or you are a senior — this will not affect you.” Grimm ignores the fact that, under the Republican budget, 273,223 New York seniors will pay $153 million more for prescription drugs next year alone.

West Virginia: Rep. Shelley Moore Capito (R-WV) said the GOP budget “does not affect anyone currently on Medicare or anyone 55 and older.” Capito ignores the fact that, under the Republican budget, 42,114 West Virginia seniors will pay $24 million more for prescription drugs next year alone.

Illinois: Rep. Adam Kinzinger (R-IL) said, “Those 55 years and older will see absolutely no change in their current Medicare plan.” Rep. Judy Biggert (R-IL) claimed, “There will be no changes to Medicare for those who are 55 and older.” Both ignore the fact that, under the Republican budget, 163,630 Illinois seniors will pay $92 million more for prescription drugs next year alone.

New Hampshire: Rep. Frank Guinta (R-NH) said, “The two most important things that I want seniors to be aware of is that if you’re 55 and older, there is no change in Medicare or Medicaid benefits.” Guinta ignores the fact that, under the Republican budget, 15,222 New Hampshire seniors will pay $8.5 million more for prescription drugs next year alone.

California: Rep. Dan Lungren (R-CA) said, “First of all, let’s make it clear, if we’re talking about someone 65 and older — anybody 55 and older will not be affected by any changes whatsoever.” Rep. Ed Royce (R-CA) said, “Americans now age 55 and older will not see a change.” Both ignore the fact that, under the Republican budget, 381,298 California seniors will pay $214 million more for prescription drugs next year alone.

Washington: Rep. Jaime Herrera Beutler (R-WA) said, “I’m not going to touch current seniors.” Herrera Beutler ignores the fact that, under the Republican budget, 67,379Washington seniors will pay $38 million more for prescription drugs next year alone.

Georgia: After voting for the House GOP budget on Friday, Rep. Lynn Westmoreland (R-GA) said, “if you are age 55 or over, these changes will not affect you at all.” Westmoreland ignores the fact that, under the Republican budget, 114,974 Georgia seniors will pay $64 million more for prescription drugs next year alone.

Arkansas: After voting for the House GOP budget on Friday, Rep. Tim Griffin (R-AR) said, “If you are 55 or over, there are no, zero changes to Medicare.”Rep. Donald Young (R-AK) stated, “If you are 55 and older your benefits are preserved.”  Both ignore the fact that, under the Republican budget, 2,503 Alaska seniors will pay $1.4 million more for prescription drugs next year alone.

Ohio: Rep. Jim Renacci (R-OH) said, “The budget plan secures Medicare without making any changes to those currently 55 and older.” Renacci ignores the fact that, under the Republican budget, 159,403 Ohio seniors will pay $89 million more for prescription drugs next year alone.

Florida: After voting for the House GOP budget on Friday, Rep. Gus Bilirakis (R-FL) said, “Make no mistake, those who are 55 years or older would see no changes to Medicare whatsoever.” After voting for the budget on Friday, Rep. Tom Rooney (R-FL) argued, “This is a bold plan to save Medicare for future generations without affecting seniors and anyone 55 and older.” Both ignore the fact that, under the Republican budget, 275,927 Florida seniors will pay $155 million more for prescription drugs next year alone.

Idaho: Rep. Mike Simpson (R-ID), said, “The House Republican plan reforms our ailing Medicare program so that it will be there for future generations without impacting the current benefits of anyone 55 or older.” Simpson ignores the fact that, under the Republican budget, 17,805 Idaho seniors will pay $10 million more for prescription drugs next year alone.

Indiana: After voting for the budget, Rep. Marlin Stutzman (R-IN) argued, “Persons that are 55 and older will not see changes to their Social Security and Medicare benefits.” Stutzman ignores the fact that, under the Republican budget, 96,422 Indiana seniors will pay $54 million more for prescription drugs next year alone.

Oklahoma: On Friday, after voting for the budget, Rep. John Sullivan (R-OK) stated, “This plan would not affect current Medicare beneficiaries, and those approaching retirement age – changes would apply only to people currently 54 years of age and younger.”  Rep. Tom Cole (R-OK) said, “The Ryan plan ensures these programs will be available for our children and grandchildren — without making any changes for those age 55 and above. That’s an important point that bears repeating: The Ryan Budget passed last week will not affect benefits for anyone 55 or older.” Both ignore the fact that, under the Republican budget, 61,466 Oklahoma seniors will pay $34 million more for prescription drugs next year alone.

Texas: After voting for the budget, Rep. Mac Thornberry (R-TX) stated that the Ryan plan, “Makes no changes to Social Security and Medicare benefits for those who are 55 years old or older.” Thornberry ignores the fact that, under the Republican budget, 238,072 Texas seniors will pay $133 million more for prescription drugs next year alone.

Minnesota: After voting for the budget on Friday, Rep. Erik Paulsen (R-MN) said, “This budget also strengthens the senior safety net by preserving Medicare for future generations without any disruptions for those at or nearing retirement.”  Rep. Michele Bachmann (R-MN) said, “So really, in a lot of ways, it should be called the ‘55 and under’ plan, because anybody 55 years of age or older will not be touched.”  Both ignore the fact that, under the Republican budget, 71,867 Minnesota seniors will pay $40 million more for prescription drugs next year alone.

Nevada: After voting for the budget on Friday, Rep. Joe Heck (R-NV) argued that the budget made, “no changes to those over 55.”  Heck ignores the fact that, under the Republican budget, 26,767 Nevada seniors will pay $15 million more for prescription drugs next year alone.

“Spin can’t change the fact that Republicans’ plan reopens the doughnut hole, costing seniors more than $2 billion next year alone. No matter what they say, the fact is the GOP wants to finance their tax breaks for millionaires and billionaires by hiking prescription drug prices for seniors.”

###

Myth: House Budget Committee Chairman Paul Ryan wrote, “The House Republican budget keeps America’s promises to seniors and those near retirement by making no changes to their current arrangements.”

Fact: Under the GOP budget, Wisconsin seniors will pay $39 million more for their prescription drugs next year alone.

Myth: House Majority Leader Eric Cantor said yesterday, “Now we are also saying for today’s seniors as well as those nearing retirement, we’re not touching your benefits because we know the political peril that is attached to that.”

Fact: Under the GOP budget, Virginia seniors will pay $51 million more for their prescription drugs next year alone.

Myth: “If you are 55 and older, it would mean no changes to Medicare whatsoever,” said U.S. Rep. Mario Diaz-Balart, R-Miami.

Fact: Under the GOP budget, Florida seniors will pay $155 million more for their prescription drugs next year alone.

Myth: “These programs would only affect people 54 and under,” said U.S. Rep Todd Rokita (R-IN).

Fact: Under the GOP budget, Indiana seniors will pay $54 million more for their prescription drugs next year alone.

20 Million Near-Elderly Will Not Have Medicare When They Retire. Starting in 2022, Medicare will be eliminated for new beneficiaries and converted instead into a voucher program. There are more than 20 million near-elderly Americans who are now ages 50-54 who would not get Medicare when they retire but instead only get a coupon to purchase private health insurance. This approach would transfer control of Medicare to insurers and there would be no guaranteed benefits, essentially ending Medicare. Moreover, the voucher will fail to keep pace with increases in the cost of health care so its value will decline every year, meaning that future seniors won’t be able to get the benefits they need or even end up uninsured. [CBPP, 4/7/2011; Census 2010 data]

CBO: Voucher Proposal Will Double Health Care Costs for Seniors. The voucher will fail to keep pace with increases in the cost of health care. As a result, seniors will be forced to pay higher premiums in order to access the same benefits they would receive under the current system. According to the CBO, a typical senior will spend more than twice as much of his or her own income on health services under the Ryan proposal as compared to the current Medicare system. [CBO, 4/5/11]

Under the Republican Plan, Seniors Will Lose Guaranteed Benefits. Under current law, all seniors have guaranteed access to life-saving health benefits, including screenings for colon cancer, diabetes, and prostate cancer, as well as flu shots. If the Republican plan becomes law, seniors that were eligible for guaranteed health benefits last year could lose their benefits. [Kaiser State Health Facts, accessed on 3/39/11]

Republican Proposal Could Force Seniors to Pay $44 Billion More for Prescription Drugs. The Republican proposal would “reopen” the prescription drug donut hole and cost the average senior who falls into the donut hole approximately $11,794 between 2012 and 2020. Over that time, Ryan’s budget will cost seniors an estimated $44 billion in prescription drug costs, including $2.2 billion next year alone. In 2010, approximately 3.7 million seniors fell into the “Donut Hole.” [HHS, 11/4/10]

CBO: Ryan Plan Means “Most Elderly People Would Pay More For Their Health Care.” In their initial analysis of the Ryan Medicare plan, the non-partisan Congressional Budget Office determined, “Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system… Under the proposal, the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the traditional program…That greater burden would require them to reduce their use of health care services, spend less on other goods and services, or save more in advance of retirement than they would under current law.” [CBO, 4/5/11]

“What do you do when you’re scared that the centerpiece of your entire agenda is about to be exposed as a Trojan horse for your real goal of ending Medicare and Social Security to pay for tax breaks for millionaires and billionaires? You kick and scream and create a diversion, just like Republicans are doing now by criticizing a plan they haven’t even seen yet.

“Democrats are serious about reducing the deficit and protecting seniors’ hard-earned benefits, unlike Republicans who are rejecting the president’s plan without even reading it. Republicans’ shallow, knee-jerk reaction proves that their posturing on the deficit is just an attempt to distract from their bankrupt ideas.”

Schumer: When It Comes To Tackling Rising Medicare Costs, President Did It First—And Did It Better—In Healthcare Law

Senator Says President’s Speech on Deficit Reduction Will Draw Important Contrast with House GOP

Washington, DC—Today, U.S. Senator Charles E. Schumer said the Senate would never pass the House Republicans’ budget proposal that cuts Medicare and urged the plan’s architect, Congressman Paul Ryan, to go back to the drawing board and pursue a fairer proposal.

“The Ryan budget puts the middle class last instead of first. As a result, it will never pass the Senate,” Schumer said.

Schumer said Medicare is better reformed by pursuing broader changes to the health care delivery system like the healthcare law signed by President Obama last year did.

“If we are serious about reining in Medicare spending, there is a far better starting place than the Ryan budget. It is the healthcare law passed by Congress last year,” Schumer said. “Republicans are patting themselves on the back lately for leading on entitlement reform. But when it comes to reining in the runaway costs of Medicare, the truth is, the President did it first and he did it better.”

Ryan’s budget plan, which is expected to receive a vote in the House this week, would end traditional Medicare and replace it with a voucher system that would force seniors to find private insurance. The savings from the plan would fund tax code changes that would reduce rates on millionaires and billionaires to the lowest level since Herbert Hoover’s presidency.

A full copy of Schumer’s remarks, as prepared for delivery, appears below.

U.S. Senator Charles E. Schumer

Senate Floor Remarks

April 12, 2011

As Prepared for Delivery

Madam President, I rise to discuss the issue of our budget.

Later this week, the House will vote on its FY2012 budget resolution. Congressman Paul Ryan, the author of that blueprint, calls it the “Path to Prosperity.”

Madam President, it may be a path to austerity, but it is hardly a path to prosperity.

Nonetheless, with negotiations finished just days ago on last year’s budget, Congressman Ryan has succeeded in jumpstarting the debate about next year’s.

The President himself will join this conversation about how best to do long-term deficit reduction in a major address tomorrow at George Washington University.

This is a debate we must have, and the President’s entrance to it comes not a moment too soon. It will make for a powerful contrast with the House Republicans’ plan.

The contrast we will hear from our President tomorrow will likely not be in terms of commitment to deficit reduction. Paul Ryan’s goal in his budget is to trim the deficit by $1.6 trillion over the next 10 years. He does not succeed in meeting this target, according to CBO—in fact, budget experts say his proposal only achieves $155 billion in deficit reduction—but the number itself is not the issue. Without a doubt, we must be ambitious in setting a target for deficit reduction. We cannot be gun-shy about achieving fiscal discipline.

So no, the contrast will not be about how much we seek to reduce the deficit. It will be about how we go about doing so.

The Republicans would like the looming debate to be one about numbers, but it will instead be one about priorities. And, Madam President, the Ryan budget has all the wrong priorities.

The House Republican budget puts the entire burden of reducing the deficit on senior citizens, students and middle-class families. At the same time, it protects corporate subsidies for oil companies, lets waste at the Pentagon go untouched, and would give even more tax breaks to millionaires.

In short, the Ryan budget puts the middle class last instead of first. As a result, it will never pass the Senate.

In the days since he first rolled out his budget proposal, Congressman Ryan has been hailed for taking on the tough challenges. But a closer look at his proposal shows that it is not bold at all. In leaving Pentagon spending and revenues completely untouched, Ryan’s budget hews exactly to his party’s orthodoxy. It doesn’t gore a single Republican ox. It is a rigid, ideological document.

Consider what Congressman Ryan wants to do on Medicare. In the name of ideology, Paul Ryan’s budget proposes getting rid of Medicare as it exists today and replacing it with a private system that would cut benefits.

Madam President, we’ve seen this movie before. Five years ago, President Bush tried to sell the country on a plan to privatize Social Security. The public rejected it.

Well, if you didn’t like what President Bush tried to do to Social Security, just wait until you see what Paul Ryan and the House Republicans want to do to Medicare.

Their budget plan proposes putting the Medicare system into the hands of private insurance companies. That is a recipe for disaster. It would mean an end to Medicare as we know it.

Beginning in 2022, Americans turning 65 would no longer be enrolled in Medicare, but instead receive a voucher to go shopping for their own health insurance on the open market.

Insurance companies, however, would not be required to honor that voucher, which would average about $8,000. Many private insurance plans for seniors far exceed that price already today. But under the Ryan plan, seniors who cannot find an affordable plan at the value of their voucher will simply have to make up the difference themselves.

This problem would only worsen over time as health care costs rise. Ryan caps Medicare’s spending at the level of inflation even though historically, healthcare costs rise higher than that. As Ryan’s voucher covers a smaller and smaller fraction of actual healthcare costs, seniors would have to cover the gap out-of-pocket.

This is why Alice Rivlin, a Democrat and President Clinton’s former OMB Director who worked with Ryan on his approach for a time, has distanced herself from his final product. She told the Washington Post that she opposes the Ryan plan. She has said: “In the Ryan version, he has lowered the rate of growth and I don’t think that’s defensible. It pushed too much of the cost onto the beneficiaries.”

Other Medicare experts agree with Rivlin. Stephen Zuckerman, a health care economist at the non-partisan Urban Institute said, “The most serious flaw is that the focus of this approach is on limiting federal spending on Medicare, without being concerned about the potential of this change to shift costs to Medicare beneficiaries.”

A better way to rein in Medicare spending would be to trim waste and inefficiency out of the delivery system. But it turns out that Ryan’s plan not only does nothing to reduce overall health care costs, it increases them.

According to the non-partisan Congressional Budget Office, in 2030, traditional Medicare insurance would cost just 60 percent of a private policy purchased with Ryan’s proposed voucher. In other words, the Ryan health care plan would cost two-thirds more than traditional Medicare.

Not only would the Ryan plan increase insurance costs, it would force seniors to shoulder a higher share of those costs.

CBO said, “Under the proposal, most elderly people who would be entitled to premium support payments would pay more for their health care than they would pay under the current Medicare system.”

How much more, Madam President? It is staggering when you look at the numbers. Under the current system, the average senior on Medicare in 2022 will contribute about 25 percent of the cost of their healthcare. CBO found that under the Ryan plan, the share paid by seniors would go up to 68 percent.

This is a crippling burden that would drive the average Medicare recipient into poverty. It is not only too much to ask of our seniors, it destroys the foundation of our healthcare system.

The bottom line is, the House Republican budget would cause the cost of health insurance to rise, and then would make seniors pay a greater share of that higher cost. It is a cut in benefits, plain and simple.

If we are serious about reining in Medicare spending, there is a far better starting place than the Ryan budget. It is the healthcare law passed by Congress last year.

Republicans are patting themselves on the back lately for leading on entitlement reform. But when it comes to reining in the runaway costs of Medicare, the truth is the President did it first and he did it better.

In the healthcare law, Madam President, we made a good start on reducing waste, inefficiency, and duplication in the system. We started down the path of making delivery system reforms. We set up a system for studying the effectiveness of different methods and treatments so that care could be delivered more efficiently. We made a down payment on shifting the larger healthcare system away from a fee-for-service model towards a system that pays providers for episodes of care.

The Ryan proposal adopts none of these cost-cutting approaches. In fact, his budget calls for the repeal of the healthcare law altogether. Left unsaid is that this would have a side effect of re-opening the donut hole, another hit to Medicare beneficiaries.

Now, if the Ryan budget’s only goal was to end Medicare, that would be ample enough cause to work tooth and nail to defeat it. But the Ryan budget doesn’t even put most of its savings from ending Medicare towards deficit reduction. Instead, it puts the savings towards further tax breaks for the wealthiest Americans.

That’s right, Madam President. Ryan’s budget not only seeks to permanently extend the Bush tax cuts for millionaires. He wants to cut their taxes even lower than the Bush levels.

As unbelievable as it sounds, he wants to give millionaires and billionaires an extra tax break.

Ryan’s budget proposal would bring the top rate down from 35 percent to 25 percent. This would make for the lowest level since 1931 when Herbert Hoover was President.

This is the trade Congressman Ryan proposes we make: cut Medicare benefits for seniors so we can afford to give millionaires an extra tax break.

This is the exact opposite of what the public wants. They don’t think millionaires and billionaires should even be getting George Bush’s tax cut, let alone an extra one atop that.

In last month’s NBC/Wall Street Journal poll that asked Americans what proposals they most support to reduce the deficit, 81 percent of Americans said they would support a tax on millionaires. This was the highest-polling answer. One of the lowest-polling answers was—you guessed it—cutting Medicare benefits. So the Ryan budget has its priorities completely upside down.

Now, you may ask if Congressman Ryan puts all his savings from cutting Medicare into millionaire tax breaks, how does he propose to achieve any deficit reduction?

The answer is, by targeting the programs most important to middle class Americans. It turns out that the Republican plan to end Medicare is also a plan to end other important programs.

For example, the Republican plan to end Medicare is additionally a plan to cut tens of thousands of teachers. And the Republican plan to end Medicare is additionally a plan cut Head Start for kids. The Republican plan to end Medicare is additionally a plan to cut medical research on diseases like cancer. And the Republican plan to end Medicare is additionally a plan to cut clean energy projects that create jobs and help us become energy independent.

In all, the Ryan plan assumes a steady squeezing of government until by 2050, the total cost of everything save for Social Security and health care is shrunk from 12 percent of GDP to just 3 percent.

But he doesn’t spell out a single detail of how to achieve those cuts. He has a number, but no specifics. That is the definition of a meat axe approach as opposed to a smart, sharp scalpel.

But even though Ryan doesn’t spell out where the cuts would come from to meet his goal, it isn’t a total mystery. We can fill in the blanks. The just-completed debate on the FY2011 budget offers plenty of hints what the Republican approach to cutting spending is.

In the budget debate we just had, Republicans wanted to cut the very programs that create good-paying jobs and help the middle class. They targeted everything from cancer research to financial aid for college.

We fended off many of their worst cuts by successfully pushing to include $17 billion in cuts from the mandatory side. We also got them to agree to reduce Pentagon spending by nearly $3 billion compared to their original budget.

This was not the Republicans’ preferred way to reduce the deficit. Because of ideology, they disproportionately targeted the domestic discretionary part of the budget for cutting, even though it only represents only 12 percent of the total budget.

But our deficit problems weren’t caused by Head Start and cancer research, and we won’t fix them by going after Head Start and cancer research. In the budget debates to come, we need to broaden the playing field beyond domestic discretionary spending.

It should include, for instance, waste in the Department of Defense. The Pentagon makes up half of the discretionary side of the budget, but Republicans continue to treat it as off-limits. Ryan himself leaves it virtually untouched, save for a symbolic trim. To say there isn’t waste at the Pentagon like there is waste elsewhere in the budget is absurd.

The bottom line is, any budget that leaves defense and revenues off the table is ultimately not serious. We need an “all of the above” approach that puts all parts of the budget on the table. A dollar cut from mandatory spending or the Pentagon is just as good as a dollar cut from non-defense discretionary spending.

Deficit reduction is an important goal, but the sacrifice must be shared. The Ryan budget fails that test.

This Democratic Senate will not stand for any proposal that seeks to balance the budget on the backs of the middle class and seniors.

I look forward to hearing the President’s remarks tomorrow. As for Congressman Ryan, I would encourage him to go back to the drawing board and come up with a fairer, more balanced plan.

Thank you and I yield the floor.

States Would Lose Hundreds of Billions of Dollars in Support For The Elderly, Families, and Those in Nursing Homes – Would Be Forced to Dramatically Raise Taxes or Cut Benefits

Protecting Tax Breaks for Oil Companies, Millionaires and Billionaires Should Not Be Prioritized Over Seniors and Middle Class Taxpayers

Washington, D.C. – The Democratic Policy and Communications Center (DPCC) today released new state-by-state reports that outline the devastating impact of House Budget Committee Chairman Paul Ryan’s (R-WI) budget proposal.  The report shows that, on top of ending Medicare, the GOP budget would cut $1.4 trillion in benefits for seniors, families and those in nursing homes, while shifting huge burdens to state governments.  With state governments across the country already cash-strapped, the reduced federal support and increased burdens included in the GOP proposal would require them to drastically slash benefits, increase taxes, or both.  Democrats are committed to reducing the deficit by eliminating wasteful subsidies and combating fraud and abuse in health care programs while protecting Medicaid and Medicare for seniors and families.

“These reports bring home the real world, brutal impact of the GOP’s reckless budget proposal,” said Senator Charles E. Schumer, Chairman of the Democratic Policy and Communications Center.  “The GOP budget pulls the rug out from under Americans who rely on Medicare and Medicaid, and shifts massive burdens to the states at a time when they have their own budget crisis to deal with, forcing them to dramatically raise taxes or cut benefits.”

The state-by-state reports can be found here: http://democrats.senate.gov/gop-medicaid-cuts/

Wall Street Journal: Ryan Plan Would Mean “Higher Out-Of-Pocket Costs And Greater Limits To Coverage.” “The House Republican plan for overhauling Medicare would fundamentally change how the federal government pays for health care, starting a decade from now, likely resulting in higher out-of-pocket costs and greater limits to coverage for many Americans. … House Budget Committee Chairman Paul Ryan’s solution is to end the current Medicare program for people born in 1957 and after.”  LINK

Associated Press: CBO: GOP Budget Raises Health Costs For Retirees. “Most future retirees would pay more for health care under a new House Republican budget proposal, according to an analysis by nonpartisan experts for Congress that could be an obstacle to GOP ambitions to tame federal deficits.” LINK

Reuters: Ryan Plan Would “Shift Healthcare Costs To Elderly Recipients.” “The non-partisan Congressional Budget Office, in its analysis of the Ryan budget, cautioned that some of the Medicare proposals would shift healthcare costs to elderly recipients. Similarly, Medicaid changes would shift some costs to the states, which already are cash-strapped.” LINK

USA Today: GOP “Taking A Huge Political Risk,” Privatized Medicare “Would Cost Beneficiaries More Or Offer Them Less.” “Republicans unveiled a budget-cutting plan Tuesday that would dramatically revamp the twin health care pillars of the Great Society, taking a huge political risk that could reverberate all the way to November 2012 and beyond.Medicare, the government-run health insurance program covering about 47 million seniors and people with disabilities, would be run by private insurers and would cost beneficiaries more, or offer them less. Medicaid, the federal-state program covering more than 50 million low-income Americans, would be turned over to the states and cut by $750 billion over 10 years, forcing lesser benefits or higher co-payments. Social Security eventually would be cut, too.” LINK

Washington Post: Ryan Plan Would “End Medicare” As We Know It. “House Republicans announced a far-reaching vision for a leaner federal government on Tuesday, presenting a 2012 budget blueprint that would privatize Medicare for future retirees, cut spending on Medicaid and other domestic programs, and offer sharply lower tax rates to corporations and the wealthy… Starting in 2022, Ryan also would end Medicare as an open-ended entitlement for new retirees and begin slowly raising the age of eligibility from 65 to 67.” LINK

Politico: Prominent Expert Cited By Ryan As Validator Does Not Back His Plan. “Rep. Paul Ryan (R-Wis.) touted the help of former Clinton adviser Alice Rivlin — ‘a great, proud Democrat’— in promoting a key Medicare provision in his budget proposal Tuesday. The only problem? Rivlin said she told the Republican she doesn’t support the final version of the measure he wrote into his budget — a provision Ryan referred to generally as the ‘Ryan-Rivlin’ plan when rolling out his sweeping economic blueprint. ‘We talked fairly recently and I said, ‘You know, I can’t support the version that you have in the budget,’ Rivlin said in an interview with POLITICO. ‘I don’t actually support the form in which he put it in the budget.’” LINK

Los Angeles Times: Ryan Plan “Would Force Seniors To Pay More For Their Healthcare.” “The largest savings in their plan would come from slashing popular programs that cover about 100 million Americans. The GOP proposal would phase out direct payments to doctors and hospitals under Medicare, scale back the Medicaid program for the poor and disabled, and throw out government insurance subsidies that the new healthcare law is to make available to millions of Americans starting in 2014. That would force seniors to pay more for their healthcareand would likely make states cut back their Medicaid programs, the Congressional Budget Office concluded.” LINK

Roll Call: Ryan’s Plan “Would Still Add More That $8 Trillion To The National Debt.” “House Budget Chairman Paul Ryan’s budget blueprint released Tuesday morning cuts $6.2 trillion in spending and $1.8 trillion in taxes relative to President Barack Obama’s 10-year plan, setting up a major clash over Medicare, Medicaid and domestic spending.Still, while the plan envisions paying off the national debt sometime after 2050 principally by squeezing spending on health care and other programs, it would still add more than $8 trillion to the national debt over the next decade — reaching $23 trillion in 2021. Indeed, the plan does not come close to balancing the budget in any year over that span.” LINK

Dana Milbank, Washington Post: Ryan’s Proposal “Isn’t A Serious Budget,” “Fails At The Central Mission Of Ending The Deficit.” “The document released by the chairman of the House Budget Committee isn’t a serious budget proposal because it fails at the central mission of ending the deficit and taming the debt. Without question, Ryan makes some severe cuts: Taking hundreds of billions of dollars from Medicaid, ending the Medicare entitlement,and slashing planned spending on transportation, energy, education, veterans benefits, agriculture payments, counterterrorism and more. Yet for all these cuts, the Republicans’ plan increases the federal debt by more than $8 trillion over the next 10 years, and it continues federal budget deficits until nearly 2040. Under the proposed balanced budget amendment to the Constitution that Ryan and his Republican colleagues claim to support, Ryan’s budget wouldn’t be in compliance for at least the next quarter century.” LINK

Kaiser Health News: CBO: Seniors Would Pay Much More For Medicare Under Ryan Plan. “Seniors and the disabled would pay sharply more for their Medicare coverage under a new plan by House Republicans aimed at curbing the nation’s growing deficit, a Congressional Budget Office analysis shows. For example, by 2030, under the plan, typical 65 year olds would be required to pay 68 percent of the total cost of their coverage, which includes premiums, deductibles, and other out-of-pocket costs, according to CBO.  That compares with the 25 percent they would pay under current law, CBO said. The GOP budget proposal also would raise the eligibility age for the politically popular program – and repeal big chunks of the health care overhaul law approved by Congress last year.” LINK

Talking Points Memo: Paul Ryan’s Absurdly Optimistic Budget Projections Draw Widespread Ridicule. “Even as Rep. Paul Ryan (R-WI) proudly touted his ‘fact-based budget’ and decried Democrats’ ‘budget gimmicks’ yesterday, he prominently cited the think tank’s absurdly rosy numbers, drawing widespread mockery from economists, budget experts, and health care wonks. Even the developer of the model that Heritage used to crunch the numbers can’t figure out how Heritage reached its conclusions. ‘The Heritage numbers are insane,’ MIT economist Jonathan Gruber said in an interview with TPM. As Paul Krugman put it, Heritage’s take ‘depends an awful lot on unicorn sightings — a belief in the impossible.’” LINK

Politico: Ryan’s Plan A Predicament For GOP. “Either a sudden surge of studiousness is sweeping through battleground districts, or these Republicans can smell the danger. There’s plenty of reason to be cautious: An NBC News/Wall Street Journal poll last month showed fewer than a quarter of Americans supported cutting funds for Medicare and fewer than a third wanted to cut Medicaid — numbers that Republican pollster Bill McInturff called a ‘huge flashing yellow sign to Republicans.’” LINK

National Journal: GOP Hopefuls “Walking a Political Tightrope” Away from “Radical” Medicare Cuts. “Nowhere are the reforms more radical than on Medicare, and already the field of prospective Republican presidential candidates is walking a political tightrope in reaction to Ryan’s sweeping proposal to convert Medicare into a voucher-based system for people younger than 55. … a clear position on the Medicare reform proposal in 2011 could sink them and the party’s chances in 2012.” LINK

“This budget proposal is more proof that Republicans have declared war on Medicare and Social Security, programs on which millions of seniors in Nevada and across the country depend. Americans rejected President George W. Bush’s attempt to privatize Social Security, and they will reject this latest plan from Republicans to end Medicare as we know it. The Republican’s plan is a boon to insurance companies at seniors’ expense. While we must cut wasteful spending and excess, Nevadans cannot afford this irresponsible proposal that will force seniors to pay more for health care at the same time that it gives tax breaks to millionaires and billionaires and protects government giveaways to big oil companies and corporations that ship American jobs overseas.”

REPUBLICAN PLAN TO SHUTDOWN MEDICARE WILL RAISE SENIORS’ PREMIUMS AND CUT BENEFITS FOR MORE THAN 20 MILLION AMERICANS

Democrats want to cut federal spending and require government to live within its means, and favor a responsible approach to reducing the deficit that will strengthen our economy.  The new Republican budget reflects upside-down priorities – it protects special interest subsidies and tax breaks for those at the top, and cuts deep into the heart of the programs that are essential to the health of our seniors.  The Republican budget ends Medicare as we know it– converting it into a voucher-type program. While providing a windfall for the health insurance industry, it would force seniors to pay much more for health care. If Republicans get their way, premiums for more than 20 million seniors will skyrocket and they will all lose their guaranteed health benefits. Democrats are committed to protecting Medicare benefits for all, and are focused on cutting waste, fraud and abuse in Medicare without hurting seniors.

20 Million Near-Elderly Will Not Have Medicare When They Retire. Starting in 2022, Medicare will be eliminated for new beneficiaries and converted instead into a voucher program.  There are more than 20 million near-elderly Americans who are now ages 50-54 who would not get Medicare when they retire but instead only get a coupon to purchase private health insurance.  This approach would transfer control of Medicare to insurers and there would be no guaranteed benefits, essentially ending Medicare.  Moreover, the voucher will fail to keep pace with increases in the cost of health care so its value will decline every year, meaning that future seniors won’t be able to get the benefits they need or even end up uninsured.  [CBPP 3/22/11; Census 2010 data]

CBO: Voucher Proposal Will Double Health Care Costs for Seniors. The voucher will fail to keep pace with increases in the cost of health care.  As a result, seniors will be forced to pay higher premiums in order to access the same benefits they would receive under the current system.  According to the CBO, a typical senior will spend more than twice as much of his or her own income on health services under the Ryan proposal as compared to the current Medicare system. [CBO, 4/5/11]

Under the Republican Plan, Seniors Will Lose Guaranteed Benefits. Under current law, all seniors have guaranteed access to life-saving health benefits, including screenings for colon cancer, diabetes, and prostate cancer, as well as flu shots.  If the Republican plan becomes law, seniors that were eligible for guaranteed health benefits last year could lose their benefits. [Kaiser State Health Facts, accessed on 3/31/11]

Republican Proposal Could Force Seniors to Pay $3,500 More for Prescription Drugs. The proposal would “reopen” the prescription drug donut hole, requiring that seniors pay full price for prescription drugs.  As a result, on average, seniors would pay $3,500 more for their medications over the next ten years.  Seniors and people with disabilities who have high prescription drug costs could pay an additional $12,300 over the next 10 years. [HHS, 11/4/10]

CBO: Ryan Plan Means “Most Elderly People Would Pay More For Their Health Care.” In their initial analysis of the Ryan Medicare plan, the non-partisan Congressional Budget Office determined, “Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system… Under the proposal, the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the traditional program…That greater burden would require them to reduce their use of health care services, spend less on other goods and services, or save more in advance of retirement than they would under current law.” [CBO, 4/5/11]

“In order to protect our long-term economic growth, we must get serious about cutting federal spending and ensuring the government lives within its means. However, a plan that puts our seniors’ safety and health at risk is not a plan about long-term security, but about political ploys and instigating fear. If Republicans would join me and my colleagues at the table, I am confident that we could get a real budget plan that not only reduces our deficit, but also ensures that the economy is growing, businesses are thriving and our seniors are protected.”

“The Ryan Republican budget has three pillars: reduce Medicare benefits by more than half; reduce Medicaid benefits for seniors in nursing homes; and reduce taxes on the wealthiest Americans. America can resolve its budget crisis without punishing the elderly and poor while rewarding the very rich.”

Full analysis:

http://www.cbo.gov/ftpdocs/121xx/doc12128/04-05-Ryan_Letter.pdf

“Independent experts agree the House Plan would make deep cuts to the Medicare benefits seniors count on. It would end Medicare as we know it and funnel Medicare dollars directly into private insurance companies’ pockets.  Under the House plan, seniors’ coverage would be cut drastically, benefits would no longer be guaranteed and seniors’ costs would skyrocket.  We can’t allow the House to balance the budget on the backs of seniors and we won’t – not on my watch.”

“Shutting down government is apparently not enough, now Republicans have taken aim at shutting down Medicare as we know it. The bottom line on the Republican plan is that it would dismantle Medicare for tens of millions of Americans. I’m also deeply concerned that the Republicans’ budget seeks to meet their ‘moral obligation’ to cut the deficit by cutting health care for children on Medicaid. We must do everything we can to responsibly reduce our nation’s debt and keep our economy on the path to prosperity, but we draw the line at penalizing seniors and children for an economic mess they did not create.”

“Next year’s Republican budget is a thinly veiled attempt to dismantle Medicare for tens of millions of Americans.  We need to do everything possible to responsibly reduce our debt, but we should do that by holding government accountable and eliminating programs that aren’t working, not by putting all of the burden on middle class families and seniors.  Pulling the rug out from under seniors who have paid into Medicare and Social Security their entire lives is wrong, and extreme plans that dismantle benefits seniors have earned will not pass the Senate.”

Myth: Health reform will cost $2.6 trillion over a ten year period

Reality: The nonpartisan analysis from CBO estimates that the Affordable Care Act will cost $930 billion and reduce the deficit by $210 billion over a ten year period.[CBO, 2/18/2011]

Republicans contend that CBO utilized a number of “gimmicks” to underestimate the cost of the law, overestimate the savings, and therefore misrepresent its impact on the budget.  Senate Republicans have gone as far to claim that the law will cost close to three times the CBO estimate, $2.6 trillion over a ten year period, and add $701 billion to the deficit. [GOP Report, 2/7/2011]  Republicans are misrepresenting facts and their claims are unfounded.  This DPCC Fact Sheet aims to address their most commonly cited arguments regarding the cost of the law.

Republicans incorrectly claim that CBO double-counts savings to Medicare. Republicans contend that CBO counts savings to Medicare both for extending the solvency of the Hospital Insurance (HI) trust fund and reducing the impact of new programs on the deficit.  As a result of their interpretation, Republicans claim that $398 billion in CBO projected savings are erroneous. [GOP Report, 2/7/2011]

• The Affordable Care Act slows the growth in Medicare spending while simultaneously extending the solvency of the HI trust fund for an additional 12 years.  [Berwick, 8/5/2010]
• In the past, CBO projected Medicare savings to both extend the solvency of Medicare and reduce the deficit for the Balanced Budget Act of 1997 and the Deficit Reduction Act of 2005.  The Republican controlled Congresses did not object to CBO scoring at that time or suggest that CBO was double-counting savings to Medicare [Center on Budget and Policy Priorities, 3/25/2010]

• The Center on Budget and Policy Priorities reiterated this point before the House Committee on the Budget:  “There’s no double-counting involved in recognizing that Medicare savings improve the status of both the federal budget and the Medicare trust funds.  In the same way, when a baseball player hits a homer, it both adds one run to his team’s score and also improves his batting average.  Neither situation involves double-counting.”  [Center on Budget and Policy Priorities, 1/26/2011]

Republicans add the cost of permanently fixing the sustainable growth rate (SGR), commonly known as the “Doc Fix,” to the overall cost of the Affordable Care Act.As a result, Republicans add $208 billion to the cost of the law. [GOP Report, 2/7/2011]

• Over the past eight years, Republicans and Democrats have repeatedly enacted a number of temporary fixes for SGR.  These temporary fixes have historically been bipartisan efforts to ensure that seniors and military families have continued access to healthcare services.
• In 2003, President Bush signed the Medicare Prescription Drug, Improvement, and Modernization Act into law following passage by a Republican Congress.  Although the law included a temporary SGR fix, Republicans did not include the cost of the fix as part of the new law. [CBO, 7/21/2004]
• On December 10, 2010, the Senate passed a one-year SGR fix costing $14.9 billion by unanimous consent.  [CBO, 12/7/2010] The House passed the same bill by a vote of 409 to 2 and the President signed it into law on December 15, 2010.
• Without any precedent, Republicans add the cost of permanently fixing SGR to the cost of the Affordable Care Act.  This cost would be incurred with or without health reform. If the Affordable Care Act had not been enacted, Democrats and Republicans still intended to fix SGR.
• Since 2007, when Democrats took control of Congress, every temporary SGR fix has been paid for with mandatory savings or revenue increases. Republicans are wrong to assume that the SGR costs should be added to the Affordable Care Act without assuming commensurate savings.
• During an interview with Ezra Klein, Rep. Paul Ryan reiterated his commitment to fix SGR, “Oh yeah! I think we should fix the thing. Don’t get me wrong.” [Ezra Klein, 3/5/2010] Rep. Ryan voted for the one-year SGR fix with 188 of his Republican colleagues less than ten months later. In fact, Rep. Ryan voted for temporary SGR fixes five times. [Ezra Klein, 3/5/2010]

Republicans exaggerate the costs of implementing and administering the Affordable Care Act.Republicans contend that an additional $115 billion over ten years will be required in discretionary spending to fully implement and administer the Affordable Care Act. [GOP Report, 2/7/2011]

• Republicans are selective in their interpretation of a CBO analysisregarding the discretionary funds required to implement Affordable Care Act.  Although the CBO analysis states that the law will require an additional $100 billion in discretionary funding over ten years, the analysis includes $85 billion are for “activities that were already being carried out underprior law or that were previously authorized and that PPACA authorized forfuture years.” [CBO, 2/18/2011]  Therefore, the law will require an additional $1.5 billion each year in discretionary funds, not $10.5 billion as the Republicans contend.

Republicans make misleading claims about the Community Living Assistance Services and Support (CLASS) program.CBO projects that the CLASS program will reduce the deficit by $86 billion between 2012-2021. [CBO, 2/18/2011]  These savings are a result of generating more revenue from premiums than spending on benefits.  Republicans contend that the program is not fiscally responsible because, over time, the surpluses initially generated by these additional revenues will be used to pay benefits.    They also claim that the program is not actuarially sound.  Both claims reflect misunderstandings about the program.

• The law is explicit in stating the CLASS program must be able to pay for benefits over the long-term only using the premiums it takes in.  Secretary Sebelius reiterated, “No taxpayer dollars will be used to pay for CLASS benefits.  This is non-negotiable, and it has been the starting point for every conversation we’ve had about this program.” [Kaiser Family Foundation, 2/7/2011]
• During debate on the legislation, CBO assumed premiums would be set to ensure the CLASS program is actuarially sound. To provide additional guarantees of its soundness, Secretary Sebelius and her team are currently considering a number of regulatory modifications—including adjusting the work and income eligibility requirements—to ensure that the program will be on solid financial footing.
• While today they complain about a program that will require not a single taxpayer dollar, many Republicans, in 2003, led an effort to expand health coverage while increasing the deficit: CBO scored the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 as adding $395 billion to the deficit during a ten year period.

This DPCC Fact Sheet addresses some of the flawed arguments made by Republicans to incorrectly increase the cost of the Affordable Care Act to $2.6 billion.  Please find additional resources related to these and other arguments below.

Center on Budget and Policy Priorities: http://www.cbpp.org/cms/index.cfm?fa=view&id=3134

Factcheck.org: http://factcheck.org/2011/01/a-budget-busting-law/

Ezra Klein: http://voices.washingtonpost.com/ezra-klein/2010/03/the_true_cost_of_the_health-ca.html

Myth: Health reform will kill 800,000 jobs over a ten year period

Reality: Independent, nonpartisan analyses demonstrate that ACA will grow our economy, empower small businesses, and benefit families.

Republicans are blatantly misrepresenting CBO Director Douglas Elmendorf’s recent testimony before the House Ways and Means Committee, claiming that the Affordable Care Act will “kill” jobs. Republicans are twisting his testimony for political gains. [GOP Report, 2/7/2011] These tactics come after months of Republicans ignoring other CBO projections demonstrating the benefits of the law, including that it will reduce the deficit by $210 billion between 2012 and 2021. [CBO, 2/18/2011]

I. Clarifying CBO Projections

The CBO analysis is more nuanced than the Republicans have articulated.CBO projects that that the Affordable Care Act will slow the growth rate of health care costs while providing access to affordable insurance coverage for individuals, families, and small businesses.  Because less of their hard-earned income will go to pay their insurance premium, the CBO tells us that millions of Americans will have increased financial resources by 2021.  Since they’ll be able to keep more of their own money, rather than paying it out in insurance premiums, some individuals may have decide to leave the labor market earlier than initially anticipated. [CBO, 8/1/2010]

• “The Congressional Budget Office (CBO) estimates that the legislation, on net, will reduce the amount of labor used in the economy by a small amount—roughly half a percent—primarily by reducing the amount of labor that workers choose to supply.” [CBO, 8/1/2010]

For the segment of the population considered in the CBO projection, the amount of labor that workers choose to supply will be impacted by subsidies reducing the cost of health insurance obtained through the state exchanges and the expansion of Medicaid eligibility.

• “The expansion of Medicaid and the availability of subsidies through the exchanges will effectively increase beneficiaries’ financial resources. Those additional resources will encourage some people to work fewer hours or to withdraw from the labor market.” [CBO, 8/1/2010]

New consumer protections, including prohibitions on insurance plans from varying premium prices based on age, will allow more older Americans to purchase plans outside of the workplace and retire earlier than they otherwise would. Additionally, individuals living with pre-existing conditions may no longer have to work two jobs in order to have access to health insurance.

• “As a result, some older workers will choose to retire earlier than they otherwise would.” [CBO, 8/1/2010]

At the same time, CBO projects that the Affordable Care Act could remove some disincentives for Medicaid beneficiaries to work.

• “In contrast, another feature of the Medicaid expansionremoves an existing disincentive to work formany low-income individuals…The health care legislation willallow parents to work and still qualify for Medicaiduntil their income exceeds 138 percent of the FPL.Moreover, parents whose income exceeds the new,higher threshold may be able to work and receive thetax credits and cost-sharing reductions for insurancepurchased through the exchanges.”  [CBO, 8/1/2010]

Although CBO does project that some employers’ decisions could be impacted by the legislation, they conclude that employers will be as likely to hire additional workers as not hire additional workers resulting from the law.

• “Employers with 50 or more employees will be required to pay a penalty if they do not offer insurance or if the insurance they offer does not meet certain criteria and at least one of their workers receives a subsidy from an exchange. … However, firms generally cannot reduce workers’ wages below the minimum wage, which will probably cause some employers to respond by hiring fewer low-wage workers. Alternatively, because firms are penalized only if their full-time employees receive subsidies from exchanges, some firms may instead hire more part-time or seasonal employees.” [CBO, 8/1/2010]
• “Since the law contains dual mandates that most individuals must obtain health insurance coverage and most employers must offer it by 2014, ‘the effect on employment is probably zero or close to it,’ said Amitabh Chandra, a professor of public policy at Harvard University.” [McClatchy Newspapers, 1/17/2011]

As discussed above, Republicans ignore important components of the CBO analysis.  Director Elmendorf had an opportunity to clarify his response during the House Ways and Means hearing.

• Rep. Chris Van Hollen (D-Md.), the ranking member on the Budget Committee, asked Elmendorf to explain clarify his response.  ‘One of the impacts you said was that there will be some individuals who, because they can get their health care through the exchange … would now have the freedom to choose to not get a job simply because they needed the health care,’ Van Hollen said, according to a transcript from CQ. ‘Isn’t that correct?’ ‘Yes, that’s right,’ Elmendorf replied.” [The Hill, 2/10/2011]

II. Independent, nonpartisan analyses demonstrate that ACA will grow our economy, empower small businesses, and benefit families.

ACA will grow our economy:

• Since the Affordable Care Act was signed into law, the economy has created over 1.5 million private sector jobs.  The unemployment rate in February 2011 was 8.9%, lower than it was in March 2010—9.7%. [WH, 3/4/2011]
• With the addition of 220,000 private sector jobs in February, sectors with the largest payroll employment growth were professional and business services (+47,000), and education and health services (+40,000).  [WH, 3/4/2011]
• By slowing the growth of healthcare costs for employers and individuals and increasing demand for healthcare goods and services, ACA could create as many as 400,000 new jobs this decade.  [CAP, 1/2011]
• In a letter to the House Education and Workforce Committee, prominent economists and distinguished scholars argue that, “leaving in place the Patient Protection and Affordable Care Act of 2010 will significantly strengthen our nation’s economy over the long haul and promote more rapid economic recovery in the immediate years ahead. Repealing the Affordable Care Act would cause needless economic harm and would set back efforts to create a more disciplined and more effective health care system.” [Letter to EW, 1/26/2011]

ACA will empower small businesses:

• Research from the Small Business Majority “shows that without reform, small businesses would pay nearly $2.4 trillion over the next 10 years in healthcare costs for their workers; 178,000 small business jobs, $834 billion in small business wages, and $52.1 billion in profits would be lost due to these costs; and nearly 1.6 million small business workers would continue to suffer from ‘job lock.’” [Small Business Majority, 1/26/2011]
• ACA “reduces small businesses’ health care expenses by giving them $40 billion worth of tax credits, and through the creation of new, competitive state-based insurance Exchanges.  Exchanges will enable individuals and small businesses to pool together and use their market strength to buy coverage at a lower cost, the same way large employers do today, giving them the freedom to launch their own companies without worrying whether health care will be available when they need it.” [WH, 1/7/2011]
• “Augustine Faucher, the director of macroeconomics at Pennsylvania-based Moody’s Analytics, said that the law’s deficit savings should ‘bring down interest rates and free up more capital for private firm investment, and therefore could boost long-run growth’ and create more jobs.”  [McClatchy Newspapers, 1/17/2011] It is estimated that 4 million small businesses that provide health care to their employees are eligible for tax credits through the Affordable Care Act starting this year. [WH, 4/1/2011]
• The Main Street Alliance, a national network of small business coalitions, supports the Affordable Care Act, writing that “rolling back the provisions of the Affordable Care Act would be bad business for small business.” [Main Street Alliance, 1/18/2011]

ACA will benefit families:

• “The law widely expands coverage to Americans, thereby reducing the hidden tax of about $1,000 that families with insurance pay each year in additional premium costs to cover the uncompensated costs of the uninsured.” [WH, 1/7/2011]
• “Caps what insurance companies can require families to pay in out-of-pocket expenses, such as co-pays and deductibles, prohibits lifetime limits on how much insurance companies cover if beneficiaries get sick, and regulates the use of annual limits to ensure access to necessary care, until 2014 when annual limits are prohibited.” [DPC, 4/1/2010]
• “Requires premium rate reviews to track any arbitrary premium increases, cracks down on excessive insurance overhead by applying standards on how much insurance companies can spend on non-medical costs, such as bureaucracy and advertising, and provides consumers a rebate if non-medical costs are too high. Provides sliding scale premium tax credits for families that cannot afford quality health insurance.”  [DPC, 4/1/2010]

This DPCC Fact Sheet demonstrates how Republicans blatantly misrepresent CBO Director Douglas Elmendorf’s testimony.  Please find additional resources related to these and other arguments below.

Washington Post: http://voices.washingtonpost.com/fact-checker/2011/02/playing_games_with_cbo_testimo.html

Factcheck.org: http://factcheck.org/2011/01/a-job-killing-law/

White House: http://www.whitehouse.gov/blog/2011/01/07/repealing-affordable-care-act-will-hurt-economy

Myth: Medicaid expansion under the Affordable Care Act will bust state budgets.

Reality: Independent, non-partisan analyses suggest that the Affordable Care Act will produce savings and increased revenues for states.

On March 1, 2011, Republicans released an erroneous report on the costs to states of the Medicaid expansion under the Affordable Care Act. The DPCC Fact Sheet provides information demonstrating how Republican projections are flawed and provides information on recent Administration efforts to ensure state flexibility during implementation.

I. Background on Medicaid Expansion:

The Affordable Care Act fixes our health insurance system while dramatically increasing access for families to affordable, high-quality coverage.  By 2021, the Affordable Care Act will reduce the number of Americans under age 65 without insurance by about 33 million, meaning that 95 percent of legal residents under age 65 will have health insurance coverage. Approximately 23 million of these newly insured Americans will purchase their health insurance through new health insurance Exchanges.  [CBO, 2/18/2011]

The remaining newly insured will obtain coverage through Medicaid and the Children’s Health Insurance Program (CHIP).  Under the Affordable Care Act, Medicaid will be expanded to all individuals under age 65 with incomes at or below 133% of the federal poverty level, thus creating a minimum standard eligibility across states.  All Americans over age 65 will continue to be covered by Medicare.

II. What Percent Do States Actually Pay?

The federal government will cover 100% of the costs to states for the newly eligible population for the first three years, between 2014 and 2016.  The federal government will then cover 95% of all costs costs in 2017, 94% in 2018 and 93% in 2019.  In 2012 and for every year following that, the federal government will pay 90% of all costs for the newly covered Americans.

States will only pay a tiny fraction of the costs to cover the newly insured population. According to the CBO, states will pay only eight percent of the total cost of the 18 million people who will be covered by Medicaid and the Children’s Health Insurance Program between 2012 and 2021, as a result of the new law.  CBO further found that the federal government will pay 92 percent of the $734 billion total cost for this coverage.  CBO has previously found that the entire cost of the legislation, including changes to Medicaid, is fully paid for and reduces the deficit by more than one trillion dollars over the next two decades.  [CBO, 2/18/2011]

III. Republican Accusations on State Medicaid Costs:

Republicans estimated that the expansion will cost state taxpayers an additional $118.4 billion through 2023.  The Republicans’ assertion is about twice the independent Congressional Budget Office estimate of $60 billion through 2021.  The Congressional Budget Office has long been the independent, official scorekeeper of the effects of Congressional legislation. [Republican Congressional Report, 3/1/2011]

What are outside groups saying about the Republicans Accusations?

• The report ignores independent, non-partisan analyses that account for the savings and increased revenues the Affordable Care Act will produce.  These savings could amount to more than $160 billion across all states. [Lewin Group, 12/1/2010]
• Republicans projections cherry-pick “worst-case scenarios from various studies that use different time frames and rely on flawed assumptions.” [CBPP, 3/1/2011]

IV. Rationale for Variation of State Medicaid Costs:

While Republicans highlight an inflated estimate regarding the Medicaid expansion cost to states, other independent, non-partisan analysis showsasavings of $106.8 billion. [Lewin Group, 12/1/2010] According to Kaiser, “There are a number of reasons why the estimates of the ACA on states varies so widely. Expanding Medicaid naturally costs more in states where there are more uninsured residents with Medicaid income levels, and the magnitude of the estimates tend to be larger in high-population states. Moreover, the estimates use different methodologies in projecting costs of new enrollment and in including or omitting other costs, savings, or revenues.” [Kaiser, 2/1/2011]

Republican Projections Exclude Health Reform Savings and Revenue to States

• Republicans projections fail to account for reductions in state support for uncompensated care,“ACA-driven increases in coverage will reduce uncompensated care, especially for public hospitals and clinics, along with private safety net institutions. States could share in the associated savings by making changes in the various ways that they support localities and safety net institutions. No state report estimates savings of this type, perhaps in part because of the complexity of funding flows, although two of our five recognize that they will occur… The national estimates from the Lewin Group and from Dorn and Buettgens projected very large savings of this type, up to $100 billion over ten years, enough to generate overall net savings to states under the ACA, although savings will vary by state.” [Kaiser, 2/1/2011]
• According toRep.  Henry Waxman (D-Ca.), ranking member of the Energy and Commerce Committee, “All of these estimates overstate state costs because they do not include savings from reductions in states’ payments for uncompensated care. For hospitals alone, the spending for uncompensated care in 2009 was estimated to be $40 billion.” [NJ, 3/1/2010]

• Republican estimates do not account for revenue to states from taxes on insurance premiums. According to Kaiser, “Such revenues will be higher because the extent of insurance coverage will rise under the ACA. Maryland’s revenue estimate found that this would generate over two-thirds of the net savings that the state projected.” [Kaiser, 2/1/2011]

• Republican projections do not account for savings tostate programs. According to Kaiser, “The expansion of coverage and benefits under the ACA will very likely mean that people will seek much less care from existing state and local programs, such as those now funded through public health or mental health departments. States that operate high-risk pools should also see reduced demands and therefore savings in these programs.” [Kaiser, 2/1/2011]

• Republicans fail to account for savings through increased efficiency or enhanced value through initiatives in care management, coordination, and payment methods.According to Kaiser, “For example, the ACA provides a new health home initiative to better coordinate care for individuals with chronic conditions with 90 percent match rate for these services. The ACA also allows states to integrate care for ‘dual eligibles,’ people jointly enrolled in Medicaid and Medicare, and thereby improve value or efficiency… Many different opportunities exist to obtain federal funding such as grants, incentive payments, or demonstration support.” [Kaiser, 2/1/2011]

Republicans Use Studies with Different Timeframes and Flawed Assumptions

• Republicans use worst-case scenarios from studies in order to project high costs to states.According to CBPP, the GOP report, “… doesn’t mention that the Urban analysis produced two sets of estimates for each state — one assuming that the Medicaid participation rate would remain at about its current level, and another assuming that it would rise significantly.  Most credible analysts use the lower estimate, but the GOP report references only the higher one.” [CBPP, 3/1/2011]

• Republicans use studies with flawed assumptions.“The report’s cost estimates for Indiana, Mississippi, and Nebraska come from misleading studies conducted by the consulting firm Milliman, Inc. that rely on flawed assumptions.  One estimate assumes that literally everyone who becomes eligible for Medicaid under health reform will sign up for it on Day 1 — something that has never happened in a means-tested public program.” [CBPP, 3/1/2011]

• Republicans extend the timeframe to manipulate the numbers. The report extends the time frame for the estimate by two years to make the numbers look larger.  This exaggeration misleads the reader by providing an apples to oranges comparison.  The standard time frame used by CBO is 10 years, from 2012 through 2021. This report uses a 12 year time frame, from 2012 through 2023, artificially raising the estimate.

• Republicans rely on studies which include costs not related to the Affordable Care Act.“For example, its Utah estimate comes from a state report that seems to assume enhanced federal funding will run out by 2014, forcing Utah to shoulder a larger portion of the expansion’s costs.  Its Florida estimate, also from a state report, not only assumes that 100 percent of newly eligible individuals will enroll but also includes the cost of raising Medicaid’s payment rates for primary care to Medicare levels after 2014 — a change the health reform law does not require.” [CBPP, 3/1/2011]

V. Other Estimates on State Medicaid Costs:

Republicans contend that the Medicaid expansion under the Affordable Care Act will bust state budgets.  They argue that this expansion will cost state taxpayers billions through 2023, with Texas ($27 billion between 2014-2023), Florida ($12.9 billion between 2014-2023), and California ($19.4 billion between 2018-2023) accounting for the majority of the costs.

The Kaiser Commission on Medicaid and the Uninsured recently conducted an analysis of these and other estimates. As demonstrated below, the estimates range from a multi-year total cost of $27 billion in Texas to savings of over $106 billion across all states. [Kaiser, 2/1/2011]

[Kaiser, 2/1/2011]

VI. Governors agree that expanded Medicaid eligibility and increased flexibility benefit states:

Testifying before the House Ways and Means Committee on the Medicaid expansion, Governor Deval Patrick stated “Federal reform is good for Massachusetts, it has given us an affordable way to extend the promise of coverage to Massachusetts residents.” [WP, 3/1/2011]

A number of states, including Connecticut, Minnesota, Washington, and the District of Columbia, have been approved to expand Medicaid eligibility ahead of the 2014 deadline.

• Minnesota Governor Mark Dayton explained the benefits of the changes, “As my first official act as Governor, I’m going to take two important steps. One is to sign an executive order, committing Minnesota to the so-called Early Option for Medicaid…This is a step that benefits all of the people of our state at no, and I repeat no, net cost to the state of Minnesota.”

VII. The Administration is working to ensure that States have the flexibility to secure savings and increase state revenue:

• Under the Affordable Care Act, States may structure their Medicaid programs to more closely resemble the private insurance coverage options available in the Exchanges. States can tailor the benefit packages based on private coverage options available in their States – such as the standard Blue Cross/Blue Shield plan, the State employee health plan, and the largest commercial HMO available in the State. States can go beyond these standards to provide additional benefits but are not required to do so.
  • Governor Martin O’Malley argues, “We in the State of Maryland greatly appreciate Secretary Sebelius’ understanding of the extraordinary budget pressures all governors now face, and her commitment to working with us collaboratively to reduce costs in our Medicaid programs… I welcome Secretary Sebelius’ offer to help us build on our existing efforts here in Maryland to improve quality of care while saving significant Medicaid dollars over the short and long term.”[Office of the Governor, 4/4/2011]

Please find additional resources below:

KFF, “State Budgets Under Health Reform”: http://www.kff.org/healthreform/upload/8149_ES.pdf

KFF, “5 Things to Know About Medicaid:” http://www.kff.org/medicaid/8162.cfm

KFF, “Medicaid Enrollment: June 2010:” http://www.kff.org/medicaid/enrollmentreports.cfm

Center for Budget and Policy Priorities: http://www.offthechartsblog.org/republican-report-inflates-state-medicaid-costs-under-health-reform/

“If Paul Ryan’s Roadmap is any indication, the House Republicans’ idea of entitlement reform will be privatizing Social Security and turning Medicare into a voucher system. Any such plans will be dead on arrival in the Senate. Democrats will fight any attempt to break our promise to America’s seniors. We want to extend the life of Social Security and eliminate waste in Medicare, but we will not go along with proposals that seek to end these programs.”

###

Ryan’s Roadmap Would Privatize Social Security, End Medicare As We Know It.

Congressional Budget Office: “Roadmap” Will Privatize Social Security. The CBO wrote in a letter to Ryan about his roadmap, “A system of individual accounts would be established in 2012. In that year, workers who are age 55 or younger would be able to participate in voluntary individual accounts, funded with a portion of their payroll taxes.” [Congressional Budget Office, 1/27/10]

•  Roadmap Would Cut Social Security Benefits.  “The Roadmap specifies reductions in traditional retirement benefits through progressive price indexing for many workers who are age 55 or younger in 2011.”  [Congressional Budget Office, 1/27/10]

Ryan’s Plan Would Convert Medicare to a Voucher Program, Vastly Cutting Benefits. “People who become eligible for Medicare after 2020 would no longer have access to a defined set of benefits from any participating health care provider. Instead, they would receive a voucher worth $11,000 (on average) to be used to purchase private health insurance… Moreover, the Ryan plan imposes no requirement that private insurers actually offer health coverage to Medicare beneficiaries at an affordable price, or at all. Some beneficiaries, particularly the frail elderly, people with disabilities, and those with very modest incomes, could end up uninsured or heavily underinsured.” [Congressional Budget Office, 1/27/10; Center on Budget and Policy Priorities, 7/7/10]

•  Roadmap Would Raise the Retirement Age For Medicare. According to the CBO the Ryan plan would eventually raise the retirement age for Medicare from 65 to 69 ½ years old.  [Congressional Budget Office, 1/27/10]

MISPLACED PRIORITIES: PAY THE CHINESE FIRST

Under This Plan, Republicans Would Have Government Pay China Before They Provide Earned Benefits to American Veterans & Seniors. “Senate Budget Committee Chairman Kent Conrad, D-N.D., and House Budget Committee ranking member Chris Van Hollen, D-Md., came out strongly against the legislation on Wednesday, saying it jeopardizes not only the credit system but potentially basic government services. ‘I think it is a dreadful idea,’ Conrad said. ‘Basically what they are saying is, pay China first. Are we going to forget about the American public and the things that they need? Somehow they are secondary? And paying the Chinese and the Japanese is the first priority of this country? I don’t even know how to describe that idea; it’s just a very, very bad one.’ ‘What they are saying essentially is that the full faith and credit of the American government extends to a lot of foreign countries, but it doesn’t extend to the American people themselves,’ Van Hollen said.” [National Journal, 1/26/11; The Hill, 1/26/11]

KEY POINTS

• Sen. Toomey has introduced a bill that the Treasury Department says will allow the Republicans to evade responsibility for their failure to honor America’s legal payment obligations.

• Sen. Toomey and his colleagues claim that by prioritizing payment of principal and interest on our public debt, we can avoid default. But in reality Toomey’s bill is not only “unworkable”, according to the Treasury Department, but it would do nothing to protect the creditworthiness of the United States government.

• The Treasury Department says that the public debt is not our only legal obligation – we also need to make Social Security and Medicare payments, to pay our service men and women and military contractors, and distribute Americans’ tax refunds. The government would have to stop or delay making payments on these other obligations in order to ensure that it could make payments on the debt. In basic terms, these Republicans would rather insist that payments to China, Russia and Venezuela be made ahead of payments for benefits to veterans and seniors.

• The Treasury Department says that failure to make those payments will be considered a default by the U.S. government every bit as much as the failure to pay interest on Treasury bonds – it would be a statement to the financial markets and everybody who does business with the U.S. government that we aren’t willing to honor our legal obligations.

• In short, the Treasury Department says that Sen. Toomey’s bill would not avoid any of the disastrous consequences that failing to raise the debt ceiling in the first place would lead to. These include: a massive tax on all households as a result of skyrocketing interest rates, a potentially massive devaluation of the U.S. Dollar and drastic cuts to benefits that middle-class families, veterans and seniors rely on.

• Even by Sen. Toomey’s own estimate, his bill would force the U.S. to default on one-third of its legal obligations, and in reality the number is far higher.

For more information, please see the Treasury Department’s statement on Sen. Toomey’s proposal here: http://www.treasury.gov/connect/blog/Pages/Proposals-to-Prioritize-Payments-on-US-Debt-Not-Workable-Would-Not-Prevent-Default.aspx

In addition, please see Secretary Geithner’s letter to Congress regarding the debt ceiling: http://www.treasury.gov/connect/blog/Pages/letter.aspx