Mitt Romney

Mitt Romney Doubles Down On Medicare Distortions

Sahil Kapur | April 5, 2012, 6:14AM

Mitt Romney

Mitt Romney made a series of claims Wednesday that distort President Obama's positions on Medicare, an indication that he's sticking with an earlier, misleading line of attack as he gets closer to winning the Republican nomination for president.

"I'd be willing to consider the president's plan, but he doesn't have one. That's right: In over three years, he has failed to enact or even propose a serious plan to solve our entitlement crisis," Romney said in a speech to the Newspaper Association of America in Washington, D.C. "Instead, he has taken a series of steps that end Medicare as we know it. He is the only president to ever cut $500 billion from Medicare. And, as a result, more than half of doctors say they will cut back on treating seniors."

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House Republicans

GOP's Gambit To Alienate Dems On Medicare Savings Board

Sahil Kapur | March 22, 2012, 5:22AM

Republicans have lost some, if not all, of the bipartisan cover they once had for their effort to repeal a key piece of President Obama's health care law. Could they have done so on purpose?

One health policy insider thinks that's possible -- and sees a political upside to putting all Democrats on the wrong side of powerful interest groups.

"It's an election year," the industry lobbyist and former GOP aide told TPM in an email. "One doesn't need legislative victories ... just tough votes for the other team!"

At issue is the House's Thursday vote to repeal a powerful Medicare cost-cutting panel created by the Affordable Care Act. Many Democrats also dislike the so-called Independent Payment Advisory Board (IPAB), and were set to join the GOP repeal effort. But that was before the GOP proposed paying for the cost of repealing it with a medical malpractice reform bill.

That will cost Republicans the support of dozens of Democrats who were otherwise on board to eliminate IPAB, House Minority Whip Steny Hoyer told reporters. Repeal is also nonstarter in the Senate and faces a veto threat from the White House.

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John Boehner

Tea Party Questions Constitutionality Of GOP Bill Repealing Medicare Reform Provision

Sahil Kapur | March 20, 2012, 5:25AM

Rep. John Boehner (R-OH) and Rep. Eric Cantor (R-VA)

The right is giving House GOP leaders a collective headache.

They were already under fire from conservative members for taking a piecemeal approach to repealing the health care law. Now conservative activists are after them for abandoning Tea Party principles at the same time.

Caught in the middle of these related attacks is President Obama's Medicare cost-cutting panel -- the Independent Payment Advisory Board (IPAB), which was created by the health care law.

The House is poised to vote this week to repeal IPAB. A small but vocal contingent of dissatisfied, all-or-nothing Republicans worries that this strategy is too timid, and will lead the public to conclude that some parts of the law are acceptable.

But Tea Party activists are upset about something else entirely. GOP leadership has opted to fund the $3.1 billion cost of repealing IPAB with legislation written by Rep. Phil Gingrey (R-GA) that would reform medical malpractice laws. That's a problem not just for the handfuls of House Democrats who want to scrap IPAB, but also for conservatives who believe federal malpractice award caps are unconstitutional.

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Health Care

GOP Leaders Take Conservative Fire For Health Care Repeal Strategy

Sahil Kapur | March 19, 2012, 10:04AM

When top House Republicans advanced a bill this month aimed at repealing one of the most contentious parts of President Obama's health care law, they didn't see much downside. More bad press for health care reform, a splintered Democratic House minority and a consolidated Republican Party. They didn't look hard enough.

Not only have they managed to alienate some Democratic allies on the bill, slated for a floor vote this week, they're also facing heat from the right for targeting just the one provision of "Obamacare," instead of the law in its entirety.

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Medicare

House GOP Losing Dem Support For Quashing Medicare Cost-Saving Panel

Sahil Kapur | March 13, 2012, 5:38AM

Rep. John Boehner (R-OH) and Rep. Eric Cantor (R-VA)

Republicans have had no luck convincing Democrats to adopt their controversial plan to convert Medicare into a subsidized private insurance system. But they have had some success convincing Democrats to abandon President Obama and his plan for making Medicare spending sustainable. At least until now.

With help from some Democrats, House committees last week cleared legislation that would repeal the Independent Payment Advisory Board (IPAB), the Medicare cost-saving board created by Obama's health care law, and the GOP-led chamber is poised to pass it next week. But their new plan to pay for the bill with a medical malpractice reform measure is already costing them Democratic votes -- and thus weakening their claim that Obama's vision for Medicare faces bipartisan opposition.

It's the latest jab in the congressional shadowboxing over Medicare's future.

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Medicare

How The Affordable Care Act Could Quash The GOP's Dream Of Medicare Privatization

Sahil Kapur | March 12, 2012, 5:40AM

President Barack Obama and Vice President Joe Biden

What if "Obamacare" not only helped save Medicare from fiscal doom, but also quashed the GOP's longstanding goal of privatizing the program? It's too early to know what will ultimately happen, but new evidence suggests that nightmare scenario for conservatives is within the realm of possibility.

In a development with potentially profound implications -- both for Medicare itself and for the broader ideological fight between the two parties over the role of government -- researchers writing in the New England Journal of Medicine believe that the growth in per patient Medicare costs has slowed, contra earlier projections that spending would soar at an unsustainable rate. More importantly, the researchers believe this trend will hold over time, thanks largely to the Affordable Care Act's sweeping cost-control policies.

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IPAB

Liberals Push Back Against GOP's Latest Salvo In Battle Over Medicare

Sahil Kapur | March 6, 2012, 6:00AM

President Barack Obama speaks on the economy in Shaker Heights, OH on January 4, 2012.

House Republicans are set to advance legislation to repeal a key plank of President Obama's health care law -- the cost-cutting Independent Payment Advisory Board -- and have enlisted several Democrats for a cause that's central to the conservative goal of phasing out traditional Medicare.

On Tuesday, the powerful House Energy & Commerce Committee is set to pass repeal of IPAB. The Ways & Means health subcommittee will also hold a hearing on it, bringing the measure closer to a floor vote, and advancing an ongoing fight about whether the government or private insurers should parcel finite health care resources.

While progressive health care reformers have effectively attacked the GOP's vision of a subsidized private health insurance system for seniors, they've been slow to close ranks around the health care law's competing vision of a leaner, more efficient Medicare. But there are signs this is changing.

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Independent Payment Advisory Board

Will Dems Help GOP Quash Obama's Plan To Save Medicare?

Sahil Kapur | February 29, 2012, 5:31AM

Republicans are poised to advance repeal Wednesday of a critical provision in the health care reform law designed to preserve traditional Medicare -- and they've enlisted a number of key House Democrats for the cause. Victory isn't imminent, as Senate Dems aren't biting, but the growing defections help the GOP's long-term push to privatize Medicare.

With Medicare's trust fund set to be empty by about 2024, dramatic cost-cutting measures will ultimately be required. Republicans want to achieve this by transforming Medicare into a "premium support" program in which seniors are given a voucher to buy their own private insurance. President Obama has a different idea, and has already enacted the framework for it: a panel called the Independent Payment Advisory Board (IPAB), set to take effect in 2014, comprising 15 appointed experts tasked with holding down Medicare payments to providers -- without cutting benefits.

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Independent Payment Advisory Board

Why Republicans Are Fighting To Repeal Obama's Medicare Cost-Cutting Board

Sahil Kapur | February 28, 2012, 5:29AM

House Republicans are poised to advance legislation this week to repeal President Obama's Medicare cost-cutting board, a provision enacted in the health care reform law. The Energy & Commerce Committee is set to mark it up this Wednesday, and the repeal bill already has enough cosponsors to pass the House. It's not expected to survive the Senate or Obama's veto pen, but the debate over this provision cuts to the heart of the battle over how to save Medicare in the long run.

Some background: The Independent Payment Advisory Board (IPAB) is set to take effect in 2014, and would comprise 15 President-appointed and Senate-confirmed experts charged with holding down Medicare per-beneficiary spending by restricting reimbursements to providers. It is forbidden from cutting payments to beneficiaries. Congress can override the panel is by passing an alternate way to save the same amount of money, or with a three-fifths Senate majority. The health care industry has been outspoken in its hatred for IPAB. Republicans are united in their effort to kill it, and even some House Dems are on that page.

The question now is: Why is the party that's hell-bent on reining in Medicare pushing to repeal this powerful tool for doing just that? Part of it is to score political points by slicing off a key piece of the Affordable Care Act. But more importantly, Republicans don't want to keep Medicare in its current form. Many of them don't think that's feasible. They want to transition it to a privatized model a la the Paul Ryan plan, where seniors get a fixed subsidy -- or "premium support" -- to buy their own insurance on a private exchange.

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Paul Ryan

Ryan On 'MediScare' Attacks: 'Here's The Deal On Our Medicare Plan: ObamaCare Ends Medicare As We Know It'

Brian Beutler | July 5, 2011, 1:06PM

Rep. Paul Ryan (R-WI)

Rep. Paul Ryan (R-WI) just broke a land speed record for his pivot from decrying Democratic "Mediscare" attacks on the GOP budget to attacking Democrats for wanting to end "Medicare as we know it."

In an interview with WISN, a local ABC News Affiliate in Wisconsin, Ryan responded to the fact that his budget, endorsed by almost every member of the Republican party, is extremely unpopular.

"Whenever you lead and propose a solution to a complex problem, you're putting yourself out there to be distorted, to be demagogued to be lied about," Ryan said. "What's happening is the other party's chosen to try to scare senior citizens to try and get votes. Here's the deal on our Medicare plan: ObamaCare ends Medicare as we know it."

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Medicare

House Republican: Health Care Panel Means Patients 'Going To Die'

Brian Beutler | June 23, 2011, 11:55AM

Rep. Phil Gingrey (R-GA)

A House Republican says a Medicare board created by the health care law will kill people.

Reprising the "death panel" meme that cast a pall over the health care reform debate in 2009, Rep. Phil Gingrey (R-GA) charged Wednesday that the Independent Payment Advisory Board -- a panel charged with reducing growth in Medicare spending -- will cause patients to die.

"[U]nder this IPAB we described that the Democrats put in Obamacare, where a bunch of bureaucrats decide whether you get care, such as continuing on dialysis or cancer chemotherapy, I guarantee you when you withdraw that the patient is going to die," Gingrey said. "It's rationing."

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Health Care

GOP Sens Threaten To Block Key Element Of Health Care Law -- And They Can

Brian Beutler | May 24, 2011, 9:11AM

House Speaker John Boehner (R-OH), House Majority Leader Eric Cantor (R-VA) and Sen. Mitch McConnell (R-KY)

Senate Republicans are preparing to foreclose on the Democrats' single best hope for addressing the country's structural deficit without shifting a huge cost burden on to seniors and other Medicare beneficiaries. It's a testament to the deep division between the parties on the key driver of future U.S. debt -- which might not matter if debt wasn't the high-stakes issue du jour in Washington.

Broadly speaking, there are two competing schools of thought about how best to reduce federal Medicare spending. One version works much like the House GOP budget's Medicare privatization plan -- it involves capping overall Medicare spending, and outsourcing the financing of seniors' health care to private insurers. This shifts a significant cost on to seniors themselves, but Republicans like the idea for two reasons: (1) It reduces federal spending by fiat; and (2) It rations health care via the private sector -- based on what services seniors think they'll need, and what services insurers will agree to pay for.

The Obama administration's alternative is a gentle twist on government rationing. It preserves Medicare as a single-payer system but shaves off waste-creating incentives so that over time the provision of care to beneficiaries is more affordable, more efficient, more research-based than it is now without explicitly "rationing" by declining more services over time. Or at least that's the goal.

And that's where the Independent Payment Advisory Board comes in. It's the most promising of the many new cost-cutting initiatives created by President Obama's health care law. IPAB will be tasked with implementing new ways to reduce Medicare spending, and, though its powers are limited in several key ways -- for instance, it's explicitly forbidden to "ration" health care -- its recommendations take effect almost automatically.

There's just one problem: Each of the board's 15 members has to be confirmed by the Senate. That means filibusters and 60 vote requirements stand in the way of staffing a panel that Republicans decry as a government rationing board. And months ahead of the nominations, they're telling Obama "good luck with that!"

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