The Medicare cuts in the Affordable Care Act have put Rep. Paul Ryan (R-WI) in a bind that he cannot seem to escape. One minute the House budget chief decries them as unacceptable and damaging to the elderly, the next he preserves the same cuts in his own plans.
Ryan has been back and forth on the cuts, decrying them when “Obamacare” passed, then including them in his House-passed budget plans in 2011 and 2012, then campaigning against them in the 2012 election, and now backing them again in his new budget plan set to be released later today. The short version is that when he’s campaigning, Ryan opposes the Medicare cuts, but when faced with budgeting, he can’t quit them.
Here’s a timeline of his evolving positions.
Feb. 25, 2010: Ryan Against Medicare Cuts
At a televised summit with President Obama and fellow Republicans prior to passage of the health care law, Ryan railed against the damage the cuts would do.
“Now, when you take a look at the Medicare cuts, what this bill essentially does, it treats Medicare like a piggy bank. It raids a half a trillion dollars out of Medicare,” he said. “Now, when you take a look at what this does, it is — according to the chief actuary of Medicare, he’s saying as much as 20 percent of Medicare’s providers will either go out of business or will have to stop seeing Medicare beneficiaries. Millions of seniors who who have chosen Medicare Advantage will lose the coverage that they now enjoy.”
Republicans across the country would proceed to run in the midterm elections against the Medicare cuts, and win a huge new majority in the House and seats in the Senate.
April 5, 2011: Ryan For Medicare Cuts
Ryan’s first fiscal blueprint as the House’s budget chairman included the ACA’s Medicare cuts, assuming the same level of short- and long-term savings via lower reimbursements to providers, particularly hospitals, and private insurers under the Medicare Advantage program.
His reasoning? As the Wall Street Journal reported at the time, a Ryan spokesman “noted that under the Ryan plan the Medicare spending cuts would go toward deficit reduction, rather than creation of a new spending program, as the Democratic health law creates.” Ryan would continue to bash the Medicare cuts on talk shows and public appearances.
The sequel to the Ryan budget, released March 20, 2012, also kept the Medicare cuts from the Affordable Care Act as well as his previous budget. The reason was the same — the savings were valuable in helping reach his revenue and spending targets. His rationale was also the same.
August 16, 2012: Ryan Against Medicare Cuts
Tapped for his party’s vice presidential nomination by Mitt Romney, who was running strongly against Obama’s Medicare cuts, Ryan turned strongly against them again. Confronted by a reporter, he defended himself from charges of duplicity.
“It gets a little wonky but [the Medicare cuts were] already in the baseline. We would never have done it in the first place,” Ryan said. “We voted to repeal the whole bill. I just don’t think the president’s going to be able to get out of the fact that he took $716 billion from Medicare to pay for Obamacare.”
Ryan would continue to attack the cuts in stump speeches and public appearances.
“Their own actuary from the administration came to Congress and said one out of six hospitals and nursing homes are going to go out of business as a result of this,” he said during the Oct. 11, 2012 vice presidential debate with Joe Biden.
March 10, 2013: Ryan For Medicare Cuts
As was widely expected, Ryan is embracing the Medicare cuts in this year’s budget. The $700 billion savings are particularly valuable to him this time because GOP leaders promised conservatives their budget plan would align spending and revenues within a decade.
“We end the raid and we apply those savings to Medicare to make Medicare more solvent and extend the solvency of the Medicare trust fund,” Ryan said on “Fox News Sunday.”
That proposal will be introduced Tuesday morning. It’ll complete a 720-degree flip for Ryan.
Sahil Kapur is a congressional reporter for TPM. He previously covered politics and public policy for numerous publications including The Guardian and The Huffington Post. He can be reached at sahil [at] talkingpointsmemo.com.