7 Reasons Why Romney-Ryan's Desperate Attempts to Spin Medicare Won't Work
In May, the Romney team promised a laser-like focus on the economy. But that was then and this is now. This week, Romney changed the conversation when he caved to his right flank and chose Paul Ryan as his running mate, a man known for a budget proposal that's so toxic voters in focus groups,“simply refused to believe any politician would do such a thing.”
Now, the Romney team is trying to avoid a backlash against the Ryan plan's most loathesome feature (replacing traditional Medicare coverage with a private insurance voucher that would pay for a dwindling share of seniors' healthcare bills over time) by following the old adage that if you can't dazzle them with your brilliance, then just baffle them with your bullshit.
So the Romney campaign and its surrogates are doing everything they can to muddy the waters, hoping – and not without reason! – that lazy political reporters will find all of this wonky stuff so boring and confusing they'll just report what both sides say and we'll end up in a draw over the issue come November. But there are a number of good reasons why this strategy is unlikely to succeed.
1. The Big Lie
The Romney camp's big lie is that Obama “raided” $700 billion from Medicare to pay for his healthcare scheme. There are two big problems with this story. The first is that Obama hasn't taken a single red cent out of Medicare benefits,and the second is that the Ryan plan has the exact same $700 billion in cuts. Even the laziest political reporter can grasp the hypocrisy of attacking your opponent for something you've proposed yourself.
Here's the scoop on Obama's (and Ryan's) “cuts.” They're not really cuts so much as reductions in how fast Medicare costs will increase over the next decade, and they come out of the hides of private insurers, hospitals and other service providers, not seniors. As healthcare analyst John McDonough wrote in the Boston Globe:
[But] none of these reductions were financed by cuts to Medicare enrollees' eligibility or benefits; benefits were improved in the ACA. Cuts were focused on hospitals, health insurers, home health, and other providers. Except for insurers, all the affected groups publicly supported the reductions to help finance the ACA's expansion in health insurance to about 32 million uninsured Americans.
The key difference is what Obama and Ryan do with those savings. The Democrats use them to pay for Obamacare, which expands healthcare to millions of uninsured, and, according to the CBO, contains a bunch of provisions that actually make Medicare's long-term finances more sustainable. Here's a chart based on the CBO's numbers, courtesy of the Center for Budget and Policy Priorities:
Romney and Ryan say they'd use the money to reduce the deficit, but on that point Ryan's numbers just don't add up. Ryan says he'll reduce the deficit, but his tax cuts for big corporations and the wealthy are so steep that there aren't enough loopholes in the tax code to offset them – in order to pay for them, he'd have to gut the entire government other than Social Security, public healthcare and military spending by 2050, which is not going to happen. That's why the Ryan plan will, as Alex Hern noted in the New Statesman, “inevitably lead to skyrocketing deficits.”
2. The Inescapable Reality
Ryan's cuts don't stop there. And there is simply no way to get around the fact that Ryan's plan saves the government money on Medicare by shifting the burden directly onto the backs of seniors over time. The reason is so simple even a Beltway political reporter can grasp it: as they're intitially phased in, the vouchers will cover the costs of an average private insurance plan, but their value will increase at the rate of overall inflation, while healthcare costs grow much more quickly.
(At this point, you may have noticed that at the heart of Ryan's plan is an individual mandate that seniors buy private health insurance – with the help of some taxpayer dollars. This is the worst form of "tyranny" when a Democrat does it but apparently it's totally OK for a Republican.)
How much of the burden would be shifted onto seniors? The Congressional Budget Office compared Ryan's original “roadmap” (more on that below) with the way Medicare works now, and found that in 2022, each beneficiary would be spending $6,359 more out-of-pocket under Ryan's plan. And this would save the government a grand total of just $615 per person. (He later sweetened his vouchers a bit, so the number would now be smaller, but the inescapable reality of his plan's structure persists.)
Now, Ryan says that the magic of the free market will bring healthcare costs down, but he hasn't offered any specifics in that area, so we are left with only what the CBO analysis tells us.
3. Yes, The Ryan Plan Does Hurt Current Retirees
Republicans have been trying to insulate themselves among seniors by stressing the fact that current retirees can keep their Medicare just the way it is. The Ryan plan, they say, will only effect people 55 and under. There are two problems with this: first, it's simply untrue. Second, seniors are not as selfish as the GOP believes them to be.
While Ryan's plan exempts current Medicare enrollees from his voucher scheme, it also repeals the Affordable Care Act, and the ACA has benefits that current enrollees are seeing right now. Jonathan Cohn of the New Republic explains that “if somebody is 'stealing' from seniors here, it's not Obama”:
[ACA helps seniors] pay for prescription drugs, by filling the "donut hole" in Medicare Part D coverage. It also eliminates out-of-pocket costs for annual wellness visits, some cancer screenings, and other preventative services. Those benefits have actually started already: In the first six months of this year, according to the Department of Health and Human Services, more than 16 million seniors took advantage of the free preventative care provision.
Ryan's budget—which, again, Romney has repeatedly embraced and said he would sign—actually takes those new benefits away. The Part D donut hole would open back up. Access to free preventative care would vanish.
This one hasn't caught on with the media yet – they've been uncritically repeating the claim that Ryan's plan wouldn't impact current retirees – but it's early yet, and Democrats say that this will be the next (and accurate) line of attack as the campaign progresses.
The other gross miscalculation cynical conservatives have made is in their belief that seniors only care about their own Medicare benefits. But as one retiree interviewed at a Florida retirement home by NPR this week put it, "He's not going to do away with Medicare for seniors, but he will for Medicare for my kids and my grandkids." The reality is that older Americans really like Medicare, and want it preserved for their progeny, and the polling bears this out – a CNN poll last year found that while 58 percent of Americans didn't like Ryan's Medicare scheme, a whopping 74 percent of seniors opposed it.
4. Another Big Problem for Romney: Ryan's Specificity
Ryan's plan is anything but “brave” – studies by political scientists like Princeton scholar Larry Bartels (PDF) have found that politicians' votes line up with the interests of the wealthiest Americans, “while the opinions of constituents in the bottom third of the income distribution have no apparent statistical effect” on their decisions. Ryan's plan fits that pattern to a T, and he's reaped a fundraising windfall as a result.
But the kernel of truth is that while the details of Ryan's plan aren't complete, it is an actual plan with enough meat on its bones for wonks to analyze. That does take some bravery, because Americans have always been suspicious of “government” in the abstract, but quite fond of the specifics – of the services it provides. This is why conservatives always prefer to avoid the details of their plans and talk instead about airy notions of “freedom” or “liberty,” or how rich people are supposedly “job creators.” Ryan's problem, and now Romney's, is that while the numbers in his budget don't add up, Ryan does in fact provide a bunch of them (courtesy of the right-wing Heritage Foundation).
5. It Will be Hard to Have Their Cake and Eat It Too
This leads to a big problem: Romney took on Ryan, in part, to get dimwitted pundits to applaud the “seriousness” of his proposal, but at the same time he's also trying to distance himself from the roadmap.
Ultimately, it really depends on when you ask him. In interviews this week, both Romney and Ryan insisted that Romney: A) has a plan that differs from Ryan's “roadmap,” and B) they will not release any details of that plan until after the election. Meanwhile, Romney has said that if he's elected he'll sign Ryan's plan, and that his ideas to “reform” Medicare “mirror” those in Ryan's roadmap.
That indecisiveness led to these two headlines appearing on Think Progress on August 14:
The campaign is flailing, and that will result in two issues for Romney as the campaign goes forward. First, the absence of a detailed “Romney roadmap” leaves Ryan's plan as the only place where anyone can find any details. As an ABC News “fact-check” put it, “the Romney campaign says it has an even newer plan...[but] there are no long-term reviews for this updated Romney-Ryan plan yet — or specific published details – so it appears the 2011 CBO report on Ryan’s original budget proposal is the only thing we have to go on.”
The Romney campaign will surely complain that looking at Ryan's roadmap is terribly unfair, but just as claims about his tax returns can be cleared up by releasing them, all the campaign has to do is offer some of its own specifics, which is something that Romney insists he won't do.
The bigger problem is how this hide-and-seek strategy reinforces the narratives that the Obama campaign has been advancing about their opponent. Elections tend to feature "meta-narratives," and when team Romney appear all over the map like this, it only advances the perception that their candidate is easily swayed by his hard-right base, has no core values and will say whatever you want to hear in order to get elected. And his refusal to release any details of his own plan is not likely to play well with the 63 percent of voters who think he should release more tax returns – it will only strengthen the perception that he's got something to hide from the American public.
6. Issue Ownership
In 1961, when Medicare was first proposed, Ronald Reagan issued a stern warning, sounding much like Rush Limbaugh does today. If Medicare were to pass, he said, “the sun will come up tomorrow and behind it will come other federal programs that will invade every area of freedom as we have known it in this country until... one of these days we are going to spend our sunset years telling our children and our children’s children, what it once was like in America when men were free.”
It's a story that conservatives have told ever since. In 1995, Bob Dole, the GOP's 1996 presidental nominee, bragged: “I was there, fighting the fight, voting against Medicare ... because we knew it wouldn’t work in 1965.” And today, seemingly every day, a conservative rails against the perfidy of “entitlements,” including Medicare.
Here's why that's relevant. First, because that rhetoric has largely fallen on deaf ears -- Americans like Medicare, and by a two to one margin they say that it's worth the costs to maintain.
Second, while, again, the Romney team is trying to obscure the issues by saying that it's actually Obama who wants to “raid” Medicare, that's going to be a heavy lift because of a concept known as “issue owership.” Political scientist John Sides explained why “this will be an uphill battle for the GOP.”
Democrats are more trusted to handle the issue of Medicare. That is, they “own” the issue... To cite some more recent data, a February GW Battleground Poll found that 52% of respondents trusted Democrats to handle “Social Security and Medicare,” while 43% trusted Republicans. A June 2011 poll found that 47% of respondents had “more confidence” in the Democrats’ ability to handle Medicare, while 40% had more confidence in Republicans.
Second, although perceptions of which party owns an issue can change, they usually will not change during the short window of a campaign. Take 1988 for example. In this election, Michael Dukakis tried to emphasize national defense. George H.W. Bush emphasized jobs and declared that he would be the “education president.” Both were attempting to “trespass” on the other party’s territory. How’d that work out for them?
Voters tended to attribute Bush’s slogans and promises about education and jobs to Dukakis, and attribute Dukakis’s promises about national defense to Bush. They relied on stereotypes of issue ownership—“if someone wants to improve education, he must be a Democrat”—rather than pay attention to the specific promises of Bush and Dukakis.
In other words, if the Romney team does manage to muddy the waters about who favors what, long-held perceptions about which party has opposed Medicare since even before it became law should give Democrats an edge.
Republicans have convinced themselves that the opposite is true, and this is based largely on a single data-point: Republicans ran ads in 2010 attacking Democrats for “raiding” Medicare, and they won big in the midterms. But that's a dubious claim because while those Medicare ads were part of the mix, they ran their campaign against the healthcare law and on the difficult economy, and they enjoyed a significant cash advantage. Since then, Democrats managed to win a series of special elections for House seats that they were expected to lose, and they did it running against Ryan's roadmap.
7. Context: Mitt's 1% Tax Bill Problem
Similarly, while we're talking about Medicare right now – and it will be a crucial issue throughout the election season for older Americans – that debate will ultimately be viewed through the lens of voters' larger perceptions about the candidates, and those perceptions are in turn shaped by an array of issues, from Romney's experience outsourcing jobs at Bain to Ryan's fringe views on abortion.
According to CBS' latest poll, “Sixty-four percent of all Americans, and 68% of independents, think Romney favors the rich over the middle class.” Only 18 percent say the same of Obama.
And that brings us to what may be the most significant number in the entire debate over Ryan's roadmap: if Ryan's plan were the law of the land, then according to the only tax return Mitt Romney has released (for 2010), Romney, sitting on a fortune estimated at over $200 million, would have paid an effective tax rate of just 0.82 percent. That's less than a tenth of the sales tax charged in New York City.
And embracing a plan that gives you that kind of whopping cut makes it awfully tough to argue that you're just looking out for grandma's best interests.