With Rep. Paul Ryan's ascendancy to the Republican presidential ticket, Democrats Henry Waxman and Frank Pallone wanted to be sure that every member of Congress, and every voter, understand the impact that the Ryan plan would have back home. To that end, they've done the
analysis, district by district, of what Ryan's cuts would mean to health care access. They released this information with a
letter [pdf] to their colleagues reinforcing those policy changes:
The Republican plan to end Medicare as we know it, raises costs for seniors and individuals with disabilities, reduces their benefits, and puts private insurance companies in charge of seniors' health care. For current beneficiaries, important benefits—such as closing the hole in Medicare's drug coverage—would be immediately eliminated. For individuals age 54 and under, Medicare's longstanding guarantee of comprehensive coverage would be replaced with an inadequate federal subsidy to buy private health insurance. By design, this federal contribution will not keep pace with medical costs, shifting thousands of dollars in costs onto individuals.
Similarly, the Republican Medicaid plan eliminates Medicaid 's guarantee of coverage. Medicaid would be turned into a block grant, and the federal contribution to Medicaid would be slashed by nearly $800 billion over the next decade. Other changes proposed by House RepUblicans would allow states to eliminate coverage for seniors, nursing home care, individuals with disabilities, children, pregnant women, and others currently enrolled in Medicaid. These changes would have a profound impact on Medicaid's ability to provide health coverage to millions of Americans, and will shift tens of billions of dollars in costs to state taxpayers.
That's the big picture, but let's drill down a little bit to the district level. What, say, would these cuts do in Paul Ryan's district, Wisconsin 1? It's a long list. First, for
Medicare, the Ryan plan, in his own district, would:
- Increase prescription drug costs for 9,700 Medicare beneficiaries in the district who enter the Part D donut hole, forcing them to pay an extra $95 million for drugs over the next decade.
- Eliminate new preventive care benefits for 112,000 Medicare beneficiaries in the district.
- Deny 550,000 individuals age 54 and younger in the district access to Medicare’s guaranteed benefits.
- Increase the out-of-pocket costs of health coverage by over $6,000 per year in 2022 and by almost $12,000 per year in 2032 for the 127,000 individuals in the district who are between the ages of 44 and 54.
- Require the 127,000 individuals in the district between the ages of 44 and 54 to save an additional $29.7 billion for their retirement—an average of $182,000 to $287,000 per individual—to pay for the increased cost of health coverage over their lifetimes. Younger residents of the district will have to save even higher amounts to cover their additional medical costs.
- Raise the Medicare eligibility age by at least one year to age 66 or more for 70,000 individuals in the district who are age 44 to 49 and by two years to age 67 for 419,000 individuals in the district who are age 43 or younger.
The Medicaid cuts are even harsher, with 12,800 seniors and disabled people who are covered by both Medicare and Medicaid potentially losing the Medicaid assistance; 47,000 children potentially losing coverage under Medicaid; and nursing home care jeopardized for 1,900 people covered by Medicaid. Additionally, it could eliminate as much as $1.4 billion in Medicaid spending that contributes to the district's economy, throwing heath care workers out of jobs.
How about John Boehner's district, Ohio 8? Let's look at some highlights: 8,100 Medicare recipients paying higher drug prices; 99,000 losing the new preventive care benefits; residents under 54 would have to save an average of $182,000 to $287,000 per individual to make up for increased health care costs; Medicaid for 52,000 children, including 2,900 newborns each year, would be at risk; 2,300 nursing home patients could lose coverage; the district would lose $1.2 billion in Medicaid spending.
It doesn't get any better in any district you look at, because there isn't a district in the country that doesn't have older people on Medicare and Medicaid, or low-income families with children on Medicaid, or a population of near-retirees who already have to figure out how they can possibly retire when their 401(k)s have tanked, they're underwater on their house, and their income hasn't kept up with the cost of living for the past few decades. They just don't have access to the hundreds of thousands of dollars they'll need to save to make sure they can have health care in their old age.
That's the vision Mitt Romney and Paul Ryan have for all of America. Well, 99 percent of America. "You people."