It’s too late now, given that the election is almost here, but I’m looking back at the 2010 Medicare Trustees report from 2010, and I see this:
The outlook for Medicare has improved substantially because of program changes made in the Patient Protection and Affordable Care Act as amended by the Health Care and Education Reconciliation Act of 2010 (the "Affordable Care Act" or ACA). Despite lower near-term revenues resulting from the economic recession, the Hospital Insurance (HI) Trust Fund is now expected to remain solvent until 2029, 12 years longer than was projected last year, and the 75-year HI financial shortfall has been reduced to 0.66 percent of taxable payroll from 3.88 percent in last year’s report. Nearly all of this improvement in HI finances is due to the ACA.
Democrats were so scared of being labeled by wingnuts that we lost a golden opportunity to simply say that "the healthcare bill I supported will extend Medicare’s solvency by 12 years. Republicans controlled everything for 6 years and didn’t do shit on this front – in fact, they made it worse."
All of this takes place within the deficit context: the sooner Medicare becomes insolvent, the heavier the short-term borrowing will be to cover the gaps. In other words, amid all the attacks about Obama’s healthcare spending and the resulting deficit, Democrats should have countered that healthcare reform is critical to repairing our fiscal mess – indeed, as indicated by the trustees report, it already is having an impact on deficits.
But alas, we lost the narrative. On the upside though, the report offers the recipe for continued reform. And this should be cited each and every time a Republican threatens to repeal the ACA.
The ACA makes significant progress toward making Medicare financially viable. But while it is projected that the Medicare HI Trust Fund is adequately financed until 2029, and the Social Security OASI and DI Trust Funds are adequately financed until 2040 and 2018, respectively, the significant longer term financial imbalances of the programs still need to be addressed. The sooner action is taken to address the long-run financial imbalances, the more reform options will be available, and the more time there will be to phase in changes so that those affected will have adequate time to prepare.
We need to make sure that voters understand the cost of repeal, that a rollback is self-defeating, if the goal is deficit control. If things go poorly Tuesday, I can only hope that we’ll finally learn it’s ok to be proud of our accomplishments.