Until Mitt Romney announced Wisconsin Republican Representative Paul Ryan as his running mate on Saturday, he had already promised deep spending cuts to the federal budget if elected president.
As with his tax returns, Romney has refused to elaborate on just what those spending cuts would be, but now we know: Ryan’s budget would starve the government of pretty much all funds that keep America’s most vulnerable citizens from – well, starving.
Before we get to the axes Ryan’s plan takes to Social Security, Medicare and Medicaid, let me be clear: you, I and other elders are not the only people who would be harmed by Ryan’s budget plan: your children, your grandchildren and successive generations would suffer even more.
Ryan’s overall budget plan retains the Bush tax cuts for rich people, reduces them further, raises taxes on the middle class, cuts anti-poverty programs and many government services.
But today, let’s examine how it would effect elders.
First, in one of his few definitive statements about anything, Romney has said outright that as president he would repeal Obamacare, and so would Ryan’s budget.
They can’t do it on their first day in office as Romney has said he would – they need the help of Congress – but here are some of the things that would happen immediately to you and me and other elders if the Affordable Care Act ended:
• All free preventive screenings and tests would end
• The free annual wellness examination would end
• The prescription drug doughnut hole would immediately return to its full original size, increasing drug costs to millions of elders
• Elders with Advantage plans would again be charged more than those with traditional Medicare for some medical procedures
• States would again be able to cut elders from Medicaid
But those changes would hardly matter because the Ryan budget essentially kills Medicare and Medicaid. All the reporters and pundits use the qualifying phrase, kills Medicare “as we know it.” That’s just journalistic “fairness” horse pucky. It KILLS Medicare. Here’s how.
All the details, qualifiers and bureaucracy aside, the underlying promise of Medicare is that it is a guarantee that works amazingly well for most of us. That guarantee would end with Ryan’s plan which would create, instead, a voucher program for elders to buy private plans which no expert believes would cover premiums. Plus, out-of-pocket costs would increase.
It is estimated that average cost for elders would go up by at least $2500 per year. Millions cannot pay that.
Traditional Medicare would remain as an option among private choices. However, if it winds up costing more than the government voucher, the elder pays the difference.
The other big Ryan money-saving idea is to increase the eligibility age for Medicare from 65 to 67 over twelve years beginning in 2023 with people born in 1958. Every year, fewer and fewer employers offer health coverage so millions of 66- and 67-year-olds would be without coverage for that period.
I went through that when I couldn’t get coverage at age 64 and I lived in terror of getting sick or hit by a truck every day. It was just dumb luck that I stayed healthy and safe. Not everyone does.
Ryan would turn Medicaid, which mostly serves elders and the disabled, into a block grant directly to states, removing the federal guarantee, under a formula that predicts huge cuts. From The New Republic:
“According to estimates commissioned by the Kaiser Foundation [pdf] and made by researchers at the Urban Institute, the end result would that between 14 and 27 million low-income Americans lose health insurance.
“That’s above and beyond those who are supposed to get insurance from the Affordable Care Act, starting in 2014, but would not because Ryan wants to repeal the law’s coverage expansion.”
During the 2004 presidential campaign, Paul Ryan was a leading proponent of privatizing Social Security, a proposal that President Bush unsuccessfully tried to sell the nation in 2005.
The idea was so overwhelmingly rejected by the people that Ryan has taken a different tack with spending cuts in his latest plan.
First, Ryan rejects raising the salary cap on payroll taxes along with any other proposal that would have rich people contribute a percentage of all their income as most Americans do. He also rejects any other proposal whatsoever to increase Social Security revenue in any way.
Ryan’s plan instead adopts Simpson-Bowles ideas (Ryan served on that Commission) which proposed to cut Social Security benefits to the majority of recipients, weaken connections between earnings and amount of benefits and to decrease the COLA. In past versions of his budget plan, Ryan has backed private accounts and so that possibility remains should Romney/Ryan be elected.
All conservatives (and President Obama) who want to slash Social Security use as their reason that the program is, as Bush kept repeating in 2005, “broke.” Of course, that is not true. There is more than $2 trillion in the trust fund and eliminating the salary cap would insure the program could pay full benefits for the next 75 years.
A further argument holds that the trust fund is empty because every administration has borrowed the excess replacing it with U.S. Treasury bills now said by those who want to kill Social Security to be worthless.
That is true only if you believe that the financial instruments China and other countries purchase are not backed by the “full faith and credit” of the federal government. Obviously, since those countries continue to purchase U.S. treasuries, they reject that notion and expect to be paid interest which regularly occurs.
The federal government is no less beholden to the debt in the Social Security trust fund than to the debt China holds. Default is not an option in either case.
There are many more details to the Ryan proposals for Medicare, Medicaid and Social Security that along with the rest of his budget and taken together pretty much threaten what little security the 99 percent still possesses while greatly increasing the wealth of the one percent.
At The Elder Storytelling Place today, Joanne Zimmermann: Movin’ In