By
|
The Tampa Tribune
Published: August 19, 2012
Updated: August 19, 2012 - 10:00 AM
In the week since Mitt Romney chose Wisconsin Rep. Paul Ryan as his running mate, a single issue has dominated in Florida ? Medicare.
There's no mystery why.
The nation's top swing state has 3.4 million Medicare beneficiaries, 18 percent of its population. Nearly a third of its registered voters are 60 or older, on Medicare or approaching it.
Can Romney win with a running mate who Democrats charge ? and Republicans deny ? has made it his goal to "end Medicare as we know it"?
Since the announcement, Democrats and the Obama campaign wasted no time making it their top campaign theme.
It started with a state tour by national Democratic chairman Debbie Wasserman Schultz to blast "the Romney-Ryan plan." Then came a television ad, four Web videos, media events and phone banks with elderly supporters in Gainesville, Sarasota and Tampa, plus half a dozen news conference calls.
"It's absolutely going to be a critical issue and could be a decisive issue," Obama campaign spokesman Ben LaBolt said in one of the conference calls.
After a shaky start, Republicans have come back on the offensive, as if to show they're not afraid to debate the subject.
Romney at first distanced himself from the budget plans produced by Ryan over the past several years, saying he had his own plans that the ticket would run on. Ryan disappeared from Romney's bus tour of Florida on Monday.
But then Romney embraced the Ryan Medicare proposals, saying in a television interview Wednesday, "Paul Ryan and my plan for Medicare, I think, is the same, if not identical ? it's probably close to identical."
Saturday, Ryan made his first public appearance in Florida as running mate, defending his proposals in The Villages, a heavily Republican community of more than 50,000 retirees.
University of Central Florida political scientist Aubrey Jewett doesn't think the issue will decide the outcome in Florida.
"In the end, I think the election will still primarily be about the economy and jobs," he said. "But the more the debate is on Medicare, the better it is for President Obama, because it takes the focus off the economy."
Jewett said the choice of Ryan "opened an opportunity for Democrats. They were on the defensive over Obamacare, and this gives them something to fire back."
Romney can't afford to lose Florida's senior citizens.
In 2008, Obama won Florida with a big majority among young voters, while seniors sided with John McCain, 53 percent to 45 percent.
A recent Public Policy Polling survey showed Romney with a similar lead among Florida seniors, 52 percent to 44 percent, while an AARP poll gave him a smaller margin, 46 percent to 44 percent.
The heart of Ryan's plan is replacing traditional Medicare with what Democrats call "vouchers" and Republicans call "premium support" ? subsidies senior citizens can use to buy private health insurance.
Recently, Ryan has softened the plan, offering beneficiaries a choice of staying with traditional Medicare coverage.
The plan also wouldn't apply to anyone 55 or older when it takes effect.
"My mom has been on Medicare for over 10 years," Ryan told The Villages audience Saturday. "She planned her retirement around this promise that the government made her. ? That's a promise we have to keep."
Ryan may have borrowed that idea from Sen. Marco Rubio, who used his own older parents as examples in arguments for entitlement reform in his 2010 campaign ??and won.
But some elderly Democrats say the age cutoff doesn't persuade them.
"I'm insulted when they say I won't lose anything ? like I don't care about anybody else," said Norma Bean, 76, of Tampa, in an Obama news conference Friday.
Democrats also note that if Romney repeals Obama's Affordable Care Act, as he promises, it will affect current recipients, reversing the law's expansion of benefits to include free preventive care and closing the "doughnut hole" in prescription drug coverage.
Some experts say the changes to the program could affect its ability to provide care even to those not directly affected.
Health care policy analyst Henry Aaron of the Brookings Institution said separation of beneficiaries into private plans and traditional Medicare would lead to a disaster: Insurance companies would sell plans to the younger, healthier seniors, leaving older, sicker people with potentially huge end-of-life costs to be paid by the traditional Medicare program, rendering the program non-viable.
The result: A Congressional Budget Office study last April said elderly people would end up spending $6,300 per year more out-of-pocket for health care by 2022.
"Insurance companies don't want to insure seniors ? they can't make money doing that. The Medicare program was created back in the '60s to deal with that," said Max Richtman of the National Committee to Preserve Social Security and Medicare, in a Democratic response to Ryan on Saturday.
Rea Hederman, health care expert at the conservative-leaning Heritage Foundation, acknowledged, "Aaron's right, there's a risk."
But he said some of the latest revisions in Ryan's proposal would lessen the problem by basing the voucher amounts on gross domestic product instead of the Consumer Price Index, which typically lags far behind health care cost increases.
Hospice benefits and "risk adjustment models," which alter the amount private companies are paid, could help solve the problem, he said.
Before choosing Ryan, Romney had endorsed a premium support plan for Medicare, announcing in December that as president he would have signed the budget pushed by Ryan and passed by the U.S. House on a party-line vote.
He and Republicans have gone on the offensive with their own television ads and campaign rhetoric accusing Obama of "gutting" Medicare by cutting more than $700 billion from its projected future growth.
"The $716 billion is what the president takes out of the Medicare trust fund to help pay for Obamacare. I think seniors will be outraged to learn that money they put into Medicare is going to be siphoned off to pay for ? a risky federal takeover of health care," Romney told ABC News in an interview Wednesday.
He didn't mention that the Ryan budget he would have signed included the same limits on Medicare spending growth, and therefore the same "cuts."
Romney also said his administration would restore the cuts, apparently announcing a major difference between his plan and Ryan's: eliminating the Ryan plan's savings.
If Ryan and Obama cut the same amount, they cut it differently, said Aaron.
The Affordable Care Act projects savings from cutting fraud and waste and reducing payments to health care providers ? particularly the Medicare Advantage plan, in which recipients have private insurance paid for by Medicare.
Aaron said the Advantage plan was found to be spending 14 percent more per recipient than traditional Medicare. Private insurers, he said, "were getting this windfall, this bonanza."
The Ryan plan savings come "through competition," as insurance companies compete for the premiums provided by Medicare, said Rea Hederman, a policy analyst with the conservative-leaning Heritage Foundation.
Each side says the other's approach is unrealistic.
"The problem with the president's approach is no one thinks it's sustainable," said Hederman.
Ryan said at The Villages that hospitals and nursing homes would go out of business if provider payments are cut.
Aaron counters, "Competition hasn't led to reduced costs" in the past, citing the Advantage plan ? "It costs more than traditional Medicare."
Democrats also say the savings under the Ryan plan, instead of providing preventive care and closing the doughnut hole, would simply allow for tax cuts that would mostly benefit the wealthy.
"The hypocrisy of Congressman Ryan is shameful," said Rep. Jan Schakowsky, D-Ill. in the Obama campaign response Saturday. "His budget included the very same $716 billion in Medicare cuts, but none of it would go back into benefits."
Republicans counter that some significant change is the only way to preserve Medicare, and opposing change means arguing for the demise of the program through financial insolvency.
"Everybody, no matter what side you're on, recognizes that Medicare is going to change, and we're going to have to reduce costs in the future," Hederman said. "The question is how do you do it."
roseanne barr president green party day 26 gronkowski new hunger games trailer sasquatch david choe
No comments:
Post a Comment
Note: Only a member of this blog may post a comment.