Clinton Brings Medicaid into the Mix
In his 50-minute convention speech last night, former president Bill Clinton warned that Mitt Romney and Paul Ryan’s plans for Medicaid are worse than the Medicare provisions of their budget.
Now, folks, this is serious, because it gets worse. And you won't be laughing when I finish telling you this. They also want to block grant Medicaid and cut it by a third over the coming 10 years. Of course, that's going to really hurt a lot of poor kids.
But that's not all. A lot of folks don't know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.
Clinton’s right to highlight the GOP ticket’s plans for Medicaid. Although Romney hasn’t given a number for Medicaid cuts, Paul Ryan did in the 2013 House Budget. Over the next 10 years, in dollar terms, those cuts would be significantly greater than the corresponding Medicare cuts.
Ryan would cut projected Medicaid spending by roughly $1.5 trillion over the course of 2012-2022, according to House Energy and Commerce Democrats' interpretation of Congressional Budget Office data. Of that total, $810 billion would come from block granting the program, and $643 would result from repealing the planned expansion under Obamacare.
In comparison, Ryan’s plan only calls for less than a trillion dollars of Medicare savings over that same time period, including the cuts made by Obamacare that Ryan would retain. And Romney has excluded those cuts from his campaign’s plan. While the Romney/Ryan Medicare premium support plan savings might be greater than the Medicaid cuts in the years after 2022, they would be smaller in the medium term. And, given that almost anything can change in 10 years, the medium-term should be given more attention.
To review, then, Romney and Obama say they’ll spend the same amount on Medicare over the next 10 years. On the other hand, Republicans want to drastically scale back Medicaid, while President Obama wants to increase it dramatically.
So does each side spend far more time attacking the other on its Medicare plans than drawing attention to the stark differences between the two on Medicaid? The simplest answer is probably that Medicare recipients are far more politically active, in general, than Medicaid recipients.
Medicare, of course, is an old-age entitlement. Older Americans turn out in far higher numbers than the general population: in 2008, about 70 percent of 65-plus Americans voted, versus roughly 45 percent of the general public.
Medicaid also benefits older folks, as Clinton mentioned in his speech, many of whom are eligible for both programs. But Medicaid is directed at lower-income folks, who are less politically active in general. Furthermore, about 30 million of Medicaid’s 50 million enrollees are children. Medicaid’s beneficiaries just aren’t as important a political bloc.
One side note: directly after the passage excerpted above, Clinton proclaimed that “It's going to end Medicare as we know it.” It’s not perfectly clear what the meaning of the word “it’s” is. But in context, it seems as though Clinton meant the Romney/Ryan Medicaid block-grant plan, and intended to say “Medicaid” instead of “Medicare” – both the sentences before and after that one refer to Medicaid.
The cliche “end [x] as we know it” is one of Clinton’s own creation, and wasn’t originally meant as a criticism. In 1992, Clinton made the promise to “end welfare as we know it” a central part of his presidential campaign. He’s claimed credit for ending welfare as we knew it ever since the 1996 welfare reform law. Without reading too much into his use of the phrase last night, it’s interesting that Clinton intended it as a pejorative.
