Monday, February 4, 2013

Medicaid is Safe. Medicare? Not so much.

So this is so perverse in so many ways, but it appears Medicaid won't face cuts because it has become such an integral part of Obamacare. Which is good, but is also awful because it "being part of Obamacare" is clearly the larger factor at work in the administration's thinking rather than "how many people would cuts to this policy kill". Jon Walker:
The one upside to the Supreme Court making the Medicaid expansion in the Affordable Care Act optional is that it has stopped the Obama administration from trying to cut it. Senior economic adviser Gene Sperling confirmed that the administration sees taking Medicaid completely of the table as necessary to make Obamacare function; but since President Obama is still obsessed with deficit reduction, he will instead focusing on cutting Medicare. The Hill:
“We have come to believe that it is not the time to make even those savings,” Sperling said, referring to the cuts the White House had proposed. “Not when this is the critical moment in implementing the Affordable Care Act.” [...]

But the administration has decided to accept a fight over Medicare in order to protect Medicaid, Sperling said.

“It means we’re going to have to look harder for Medicare savings, and those savings may be more difficult politically because of he choices we’ve made,” Sperling said. “If you decide you are going to protect Medicaid more, it means you’re going to have to make some tough choices in other places.”
Given that our health care system is bloated, it would be possible to cut Medicare spending without hurting beneficiaries, but there seems to be little interest in Washington for doing that. Instead, everyone seems to be only focused on “tough choices,” i.e. looking tough by making older people poorer regardless of how little it would change overall spending.
The Obama administration is clearly going to be floating benefit cuts to medicare every chance they get. They've done it quite consistently so far during his presidency, and there's no reason to believe he'd stop trying now. All we can do is be prepared to take him on next time he puts the idea out there.

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