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House GOP leadership
Good luck selling this one, Speaker John Boehner, Rep. Paul Ryan, and the rest of the leadership team. (Jonathan Ernst/Reuters)
The Republican Medicare plan, which does indeed end Medicare as we know it (just a little bit slower than the Paul Ryan budget they adopted last year) isn't finding much support outside the party, despite the fact that the "premium support" Ryan included in the budget is derived partly from a plan he cooked up with Sen. Ron Wyden (D-OR).
The effort until now had focused mainly on Clinton administration officials and Sen. Ron Wyden (D-Ore.), who co-authored a Medicare reform proposal with Rep. Paul Ryan (R-Wis.) last year. This past week, however, the Ways and Means Committee changed tactics after unearthing a 2003 vote in favor of premium support by the chairman of the Democratic Congressional Campaign Committee.
Wyden has said that he doesn't support this iteration of the plan, that the caps it places on growth in Medicare spending are too drastic, and he's opposed to raising the eligibility age for Medicare, as the Republican budget would. So they can't really get away with using him any more. So what they're trying to do now is equate Democratic votes for the Medicare prescription drug bill to what they're calling "premium support" in their plan. The originator of premium supports, Harry Aaron from the Brookings Institute, says that's not what this plan is.
Aaron said Republicans are free to use the term “premium support” now that it's in the public domain, but stresses that what he had in mind when he coined it was far different. He said his model had three characteristics to distinguish it from vouchers, which would lose their value over time: linking the premium support to a health cost index; limiting plan offerings to a small number, “so that beneficiaries could have a shot at rational choice”; and “rigorous regulation of sales together with effective risk adjustment to minimize competition based on risk selection.”
Those characteristics are not in this plan, which is essentially vouchers that do lose their value over time while reducing government spending on Medicare and shifting costs to Medicare enrollees, while setting up a system that will create adverse risk selection with older and sicker people siloed into the traditional Medicare. Others the Republicans are trying to co-opt, including former Clinton officials, who have been previous premium support champions, essentially say this is just cost-shifting that will hurt the elderly.

Which is the message a current Republican congressman, running a high profile race for the Senate in Montana, sent by voting no on the budget plan.

U.S. Rep. Denny Rehberg was one of 10 Republicans voting “no” Thursday on the GOP leadership’s budget proposal, saying he couldn’t support a proposal that might put the Medicare program in jeopardy.
That's actually the mostly telling reaction to the plan. Rehberg knows the fodder that this vote would have provided Sen. Jon Tester against him, because he knows it puts Medicare in jeopardy and wants no part of that. So good luck to the Republicans in finding support outside the party, when they can't consolidate it inside.

Originally posted to Joan McCarter on Mon Apr 02, 2012 at 08:26 AM PDT.

Also republished by Daily Kos.

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