by Kenneth T. Walsh

May 9, 2011

There is much at stake in the debate over Medicare and Medicaid

One of the biggest battlegrounds in the ongoing war over the budget focuses on winning support from seniors. And increasingly, all sides are playing upon fear.

The political upshot is that the Republicans are in danger of jeopardizing what had been a strong position with seniors going into the 2012 campaign. GOP candidates carried a majority of voters 65 and older in the 2010 elections. But the Republicans' position could be eroded because the new GOP budget in the House includes a controversial overhaul of both Medicare and Medicaid, two programs that are very popular with the elderly. This gives Democrats a huge target as the 2012 campaign begins.

The GOP budget blueprint, endorsed by the Republican majority in the House, would make Medicaid, which goes mostly to the poor, into a block grant program with the federal government sending money directly to the states, which would then decide how to spend it. The GOP plan also would make Medicare, the main medical program for retired people, into a voucher system in which the government would provide subsidies or vouchers aimed at encouraging people to buy private health insurance. This would replace the current government-run system.

But polls show that most older voters support little or no change in these programs. And the opposition extends well beyond the elderly. Seventy-eight percent of all Americans oppose cutting spending on Medicare in order to reduce the national debt and 69 percent oppose cutting Medicaid, according to the latest ABC News/Washington Post poll.

An example of the hot rhetoric came from Rep. Debbie Wasserman Schultz of Florida, the incoming chairwoman of the Democratic National Committee. She recently said the GOP's budget proposal represents a "death trap" for seniors. Wasserman Schultz said the changes would put seniors' lives at risk because they couldn't get the care they need. More broadly, the DNC and some organizations representing government employees and retired people have been attacking the House GOP's economic blueprint for unfairly targeting seniors. These groups say seniors would have to pay much more for inadequate medical coverage under the overhaul.

This drumbeat of criticism will only get more intense. And President Obama is doing his part to keep up the pressure.

"Medicare is one of the most important pillars of our social safety net," he said during a town hall meeting at Northern Virginia Community College last week. He referred to an estimate by the nonpartisan Congressional Budget Office that under the GOP plan "seniors would end up paying twice as much for their healthcare as they are currently. At least twice as much. . . . Now, I think that is the wrong way to go. That would fundamentally change Medicare as we know it, and I'm not going to sign up for that."

Meanwhile, the Republicans say it is Obama and the Democrats who are on the wrong track for failing to do enough to keep Medicare and Medicaid solvent and for planning to raise taxes. Rep. Paul Ryan of Wisconsin, chairman of the House Budget Committee , says seniors will be in big trouble under the status quo supported by Democrats because the current system is going broke. Ryan, who authored the House GOP's plan, aims to cut the deficit by $6 trillion over 10 years and includes cuts in both Medicare and Medicaid spending. "This is the only way these programs can hope to survive and function into the future," Ryan said. Reince Priebus, the new chairman of the Republican National Committee, said Medicare will go bankrupt in nine years but Obama's budget proposals continue to put Medicare and Social Security on "unsustainable" paths.

Republicans have made similar arguments before in taking on entitlement programs, and their efforts have often been futile.

President George W. Bush tried to partially privatize Social Security during his second term and expended considerable political capital, but got nowhere.

All sides know that seniors vote in high numbers and their votes will be critical both nationally and in swing states such as Florida, Pennsylvania, Michigan, Ohio, and Virginia.

That's why there is so much at stake in the debate over Medicare and Medicaid.

It could determine not only the shape of these two basic social programs, but also the next president and who controls Congress for the foreseeable future.

 

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