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Most Democrats would at least privately admit that they would eventually like to turn Obamacare into Medicare for all.

What Republicans are not admitting, however, is that they would like to do the opposite--eventually turn Medicare into Obamacare--but only for those over 65.

Republicans may not openly admit it, but that’s exactly what Paul Ryan’s budget seeks to do.

First, it seeks to repeal the ACA for everyone under 65.

Then, it seeks to repeal the single-payer system of Medicare for those over 65, replacing it with what is essentially an ACA-like exchange--vouchers, paid for by means-tested subsidies. Participants over 65, with our without subsidies, could then choose their health insurance plans on the open market.  

I know the ACA is a complicated law with many popular reforms.  But in terms of the big picture way of how health care insurance is provided under the ACA, Ryan's GOP budget plan seems to be eerily similar to how the ACA works now--except that the Ryan GOP budget limits this "service" to those over 65 and replaces a single payer system already in effect.

I wonder if Ryan plans to have that "open market" available on a consolidating website, or if he would prefer seniors to gain the "freedom" of being part of a high-risk group that is chronically ill with pre-existing conditions and trying to figure out for themselves what plan best suits their needs.

And since he's going to repeal the ACA, does that mean that insurance companies will be able to refuse health insurance to seniors with pre-existing conditions? (And as an aside, why is no one asking him this question?)

Perhaps he would say that Seniors with pre-existing conditions (the vast majority?) could remain with the Medicare option.

At this time, Ryan’s budget keeps traditional Medicare in his “exchange”—in other words, unlike the ACA he does provide a “public option.”  

As ThinkProgress noted on April 1, 2014,

Ryan’s new Medicare proposal hews to the same basic structure as his previous premium support plans — in essence, a system of insurance vouchers. Under the plan, future Medicare beneficiaries would have the option of choosing between traditional fee-for-service Medicare or a list of private health plans and receive a subsidy to help pay the chosen policy’s premium.
However, again according to ThinkProgress this option will end up being extremely expensive:
Ryan emphasizes that his proposal still gives seniors the choice of remaining in regular Medicare. But what he doesn’t mention is that his plan makes Medicare so expensive that millions of seniors will likely be forced to switch into the private plans. While Ryan employs a different type of bidding system for private health plans under his 2015 blueprint that softens his plan’s topline effect on beneficiaries’ costs, an earlier Congressional Budget Office (CBO) analysis of Medicare premium support systems found that plans such as Ryan’s would increase traditional Medicare premiums by a staggering 50 percent.

Ironically,Republicans also say that the ACA is a problem because it creates uncertainty in the market and an upheaval in the health insurance industry.

So why would they seek to create more uncertainty in the market, just as we are on a path to stability?

Why would Republicans want to turn Medicare--a widely popular program, even with their base--into the ACA--the type of system that is currently much less popular, a system that  they continue to insist is unworkable and indeed doomed?

Why would Republicans want to turn Medicare into a system that is exactly like the one that they’ve already voted to repeal--over 50 times?

It's my job is to report and I'll let you decide.

But I will say one thing.  If Democrats don’t pick up this ball and run with it, they really don’t want to win in 2014.

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Comment Preferences

  •  So the GOP want to turn Medicare into Obamacare. (7+ / 0-)

    Is that so they can repeal it?

    The highest form of spiritual practice is self observation with compassion.

    by NCJim on Tue Apr 08, 2014 at 11:08:42 AM PDT

  •  medicaid is expanded (6+ / 0-)

    to include everyone who does not earn enough to sign up on the exchanges.  Medicare insures the over 65's. There is the VA insurance.  

    What makes sense is to let anyone sign up for medicaid and pay for it, and let the private insurers compete with that.  

    it's coming.  

    The Republicans like the idea of more business for insurance companies and everyone paying for their insurance.  but they rightly realized that reform would remove the gigantic profits and lead to a public option, which would leave the insurance companies to reduce profits even more or get out of the business.  

    We could then keep our doctors, but not our insurance companies. Sad?

  •  Millions will lose their Doctors. (4+ / 0-)
    Recommended by:
    NCJan, MKinTN, anna shane, notagain

    Like Obamacare millions of people will lose their current coverage under the GOP plan for Medicare.  

    Unlike Obamacare the new coverage will be worse not better.  

    And they will be forced to pay more for their coverage.  A Congressional Budget Office (CBO) analysis of the GOP Medicare premium support systems (aka GOPcare) found that plans such as Ryan’s would increase traditional Medicare premiums by a staggering 50 percent.

    Many seniors will be forced to change doctors because the private insurance policies will be able to dictate which doctors you see and the prescriptions and coverage you are allowed.

    The highest form of spiritual practice is self observation with compassion.

    by NCJim on Tue Apr 08, 2014 at 11:16:04 AM PDT

    •  However, this is how doctors and other providers (0+ / 0-)

      are pressured to accept lower payments.  This is how ACA is designed, it is not a bug.

      Patients losing "their doctor" or "their hospital" means they lost customers due to price.  They can regain customers and patient can regain doctors if they lower what they will accept as payment.

      The most important way to protect the environment is not to have more than one child.

      by nextstep on Tue Apr 08, 2014 at 12:11:45 PM PDT

      [ Parent ]

    •  all of us (0+ / 0-)

      And that idea about doctors is also retro, I have never had one I felt the desire to keep, they're not pets or family members, they're doctors.  Now dentists, I can see that.

      Just one means they'd miss the same thing every time, not keeping your old doctor equals second opinion.

      •  I would do anything to keep my Dr. (1+ / 0-)
        Recommended by:

        She knows me and knows that I only want a "fix" if I really need it.

        The highest form of spiritual practice is self observation with compassion.

        by NCJim on Tue Apr 08, 2014 at 01:30:31 PM PDT

        [ Parent ]

      •  You may not need a family doctor (1+ / 0-)
        Recommended by:

        but people with chronic illnesses and disabilities do. My GP has been my doctor since September 2005. He treats not only my general medical state - everything but my kidneys  and my transplant, basically - but is my diabetes care physician. I need to continue seeing this particular doctor. Going over the last nearly 9 years of an extremely complicated medical history with someone new? I shudder. The knowledge that my GP has of me, my conditions, my history, my medical needs, can't really be replaced, even if another doctor were to sit down and go through the hundreds of pages of my history. It was my GP who found my kidney disease. It was my GP who diagnosed Charles' diabetes and who now treats his diabetes as well as mine. It was my GP who insisted on multiple batteries of tests, including an MRI, which found my cervical spinal stenosis, and he's repeated the MRI over the years. My general physical includes a well-woman gynecological exam. Who does it? My GP.

        The only other doctor with whom I have anything approaching as lengthy and involved a professional relationship is my nephrologist, who has followed me since three months after I was diagnosed with kidney disease and who does my regular transplant care these days, too. He followed me throughout my dialysis years and got me into the transplant program. That professional relationship only goes back 7 years as of this month. Again, it is a situation nearly impossible to replicate, even within the same institution.

  •  Which speaks volumes about the ACA (1+ / 0-)
    Recommended by:
    anna shane

    "When dealing with terrorism, civil and human rights are not applicable." Egyptian military spokesman.

    by Paleo on Tue Apr 08, 2014 at 11:18:46 AM PDT

  •  This article is 8 years old, but sadly ... (4+ / 0-)
    Recommended by:
    NCJim, NCJan, sulthernao, offgrid

    it shows just how clueless the 'get the government off my medicare crowd can be':

    GERSTER, Mo. - Gary Ruckel, like most rural Missourians, backed Matt Blunt for governor last fall and voted other Republicans into legislative seats.

    Ruckel agreed with Blunt on issues such as gun control and gay marriage, but he was not considering a subject that hit much closer to home: medical care.

    So when Blunt proposed cuts in Medicaid last month that could cost Ruckel and his wife, Vivian Ruckel, some services, the couple had second thoughts about backing Republicans.

    "It kind of jumps back and kicks you in the teeth, is what it does, because I wasn't planning on this," said Ruckel, who lives about 50 miles north of Springfield. "If they cut back on Medicaid, it's going to crucify us, because we don't make that much."


    Ruckel and his wife, both 64, said they were among those in need. Ruckel, a former police officer and prison guard, has emphysema, arthritis, a spinal defect and other ailments. His wife is in worse shape, suffering heart and lung ailments, and kidney disease. She tires quickly and cannot do much outside the home. Ruckel is on nine medications; his wife is on 21.

    With a combined income of $1,357 a month, mostly from Social Security, they qualify for full payment of medical and pharmacy bills through Medicaid. Both are classified as workers with disabilities because Ruckel works on lawn mowers and his wife does sewing, making about $60 a month combined, he said.

    .... (link is long dead)

  •  Refusing seniors with pre-existing conditions (3+ / 0-)
    Recommended by:
    NCJan, paulex, a2nite

    such as ... age!

    Yes, DailyKos DOES have puzzles! Visit us here Saturday nights @ 5:00 PDT (easier puzzles) and Sunday nights @ 5:00 PDT (more challenging) for a group solving. Even if you just pop in and comment while watching the fun, everybody is welcome. uid:21352

    by pucklady on Tue Apr 08, 2014 at 11:51:28 AM PDT

  •  Medicaid for all is more likely (1+ / 0-)
    Recommended by:

    With Medicaid expansion, increasing portions of the population covered can be increased by changing income limits.  In addition, this approach mostly expands benefits in order of most pressing financial need.

    The most important way to protect the environment is not to have more than one child.

    by nextstep on Tue Apr 08, 2014 at 12:07:57 PM PDT

  •  For the record... (3+ / 0-)
    Recommended by:
    greenbell, RabbleON, Kitsap River

    I'm extremely pleased with traditional Medicare and don't want to see any changes. I can see any doctor I want to see and since I have Medicare Supplemental insurance I rarely have to pay anything beyond my monthly premiums. So I absolutely do not want to see Medicare evolve into anything remotely like Obamacare.

    The thing that scares me is that I can see how Obama might be convinced to go along with this kind of privatization plan. If he could get the Republicans to support a tax increase in exchange for replacing Medicare it just might happen and that would be a total disaster for seniors.

    My invisible imaginary friend is the "true" creator

    by Mr Robert on Tue Apr 08, 2014 at 12:15:15 PM PDT

    •  Spot on! I fear the centrists making the ACA (3+ / 0-)
      Recommended by:
      RabbleON, Mr Robert, a2nite

      a Trojan Horse to slowly transform Medicare into something much less it is today.  The increased means testing in Obama's budget is aimed at making Medicare considerably more expensive for middle class seniors.

      •  Get rid of means testing (2+ / 0-)
        Recommended by:
        Mr Robert, greenbell

        Means testing is always the death knell of any popular program.  It just a way to turn universal programs into welfare programs.

        Why can't you just tax those of "means" more on the front end, and give everyone the same benefit? Wouldn't that accomplish the same thing--only better?

        History is a guide, not a destination.

        by NCJan on Tue Apr 08, 2014 at 01:06:35 PM PDT

        [ Parent ]

  •  Just Met W/ WA State Reps & Our State Senator..... (2+ / 0-)
    Recommended by:
    NCJan, Kitsap River

    My question to them in our Democratic study group was
    "What are your views on the Affordable Care Law"?

    All three raved about it & it's success in Wa state.  They said it paved the way for single payer, that Republicans would be saying it was their idea in 10 years & that it had
    been hugely successful in our state & in the country.

    No running away from it at all.  I'm beginning to think the tide has turned.  Next month, we'll be meeting w/ our national Rep Denny Heck.  I can't wait for that one.  Last month he said "it needs to be fixed".  We'll see where Heck is at now.  

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