Politico’s Darren Samuelsohn reported this weekend:
Interviews with more than a dozen House and Senate lawmakers, many of whom are primed to start whipping votes, underscored the reality that the lame-duck session could still end in tax hikes and across-the-board spending cuts.“I wouldn’t want to put a percentage on it, but it certainly could happen,” said Rep. Jeff Flake, the Arizona Republican who next month will be sworn in as a senator.
“It’s absolutely possible. We’ve seen it happen before,” added Colorado Rep. Diana DeGette, a chief deputy whip for House Democrats.
For Boehner to be successful, DeGette said the speaker needs to remember during his negotiations with Obama that a sizeable number of Republicans are expected to jump ship on any tax agreement with the White House – whether it’s a short-term deal or something much bigger.
“The Republican leadership is going to have to realize they have to work with us,” she told POLITICO.
The delicacy of this situation for Speaker John Boehner really can’t be overstated. Given the likelihood that many conservative Republican House members will balk at any deal that violates their no-new-revenue ideological principles, Boehner will have to turn to Democrats to win House passage of any reasonable budget compromise. The problem with that, of course, is that Boehner could endanger his speakership if he arranges the passage of legislation that would be palatable to Democrats. Who he would in this scenario need to pass anything.
And remember, if nothing passes, Republicans take the blame for the resulting automatic budget cuts and tax hikes on everybody. Also, they say Democrats create a “culture of dependency?” Wait until Doug Lamborn realizes those cuts to military spending are an actual possibility.
We can’t tell you exactly how Boehner intends to thread this needle, but he has more to lose.
Medicare/Medicaid is the elephant in the room.
raise the medicare tax by .5% and means test it. No medicare if income greater than $150K.
Social Security, remove the cap, means test. Remeber Al Gore’s advice? Follow it. Put Social Security and Medicare revenues in a “lockbox”.
Medicaid a bit more complex but not as tough as defense spending. To start I’d remove probably 20% defense spending and apply half to debt and half to medicaid
The idea that Lamborn takes a hit on this is laughable, he voted against the deal from the start.
I must say that when “progressive” Democrats speak like this, I am reminded of a line from Macbeth:
.
Macbeth Act 5, scene 5, 27-28
that “blame” will fall onto Repubs. It all depends on Obama’s presentation and tone.
Still: If the alternative is a bad deal, jump!
Younger, healthier, less needy participants would widen the pool, lowering individual beneficiary costs.
Too bad that’s not the major problem. The big problem with Medicare is not the individual participant’s cost (because of his/her age, health, wealth, etc.) it’s the cost of care delivery that’s rising more rapidly than our ability to pay: drugs, hospitals, doctors, insurance premiums, inefficiencies, waste, fraud, standards (lack thereof), duplication, etc.
Any fiddling with age eligibility just shifts the overall costs from the fed to states, employers, providers and the beneficiary him/herself.
http://www.washingtonpost.com/…
Save a phony federal $5.7B to increase overall societal costs by $7B? Bad policy. Bad politics.
Besides, I think raising the eligibility age is a negotiating non starter as well as a policy non starter. Obama won’t fall for it (fingers crossed).
would result in either a whole bunch of people dying prematurely, or big increases on everyone else’s insurance bills because they’ll be forced to cover the costs of treating the uninsured.
Your choice.
Medicare may be in worse shape than a simple .5% tax increase; same with Medicaid.
Agree on the lock box, though – those are our taxpayer investments being stolen for someone’s military boondoggle or pork barrel project.
I oppose means testing–a publicly administered annuity program should be open to all citizens and the even old rich people have expensive illnesses.
Regarding Medicare and means testing. Once you start down this path, Medicare is eventually doomed. Every year the system doesn’t balance. Lower the threshold (or just don’t increase it to keep up with inflation).
The fundamental difference between the easy fix of SS v. hard fix Medicare is health care inflation. Medicare insolvency is a byproduct of medicare inflation.
How do you fix medicare inflation? Single payor might help, but is probably to big a lift. I would start with reform of the Drug and drug company regulation.
Raise the caps on both to where they are actuarially balanced.
If you means test, rich people have no reason to support the programs. And means testing does not save much money (there are not that many rich people – remember “1%”?)
may not be the easy answer it’s touted to be.
My retired neighbor pointed this out yesterday. He has substantial net worth, multiple seven figures in-fact, that he put into savings prior to retirement. His income since retirement is very modest. His opinion is that somehow any means testing should and would need to include net-worth, not just income — which can be manipulated and deferred by the wealthy in myriad ways not available to folks who live more month to month.
When you start talking about means testing to net worth, things become very charged and arguably intrusive . . .
The wealthy are healthier and use less medical resources.
Where does a 70 year old with income > $150K buy insurance? How much would that cost? What is the fair share of retirement income to be spent on health insurance?
There is no medicare tax cap. I even knew that… How about, “create a new high-income medicare marginal tax rate”.
Means testing benefits is the wrong way to do it. It is cumbersome and will create a bureaucratic nightmare as we try to avoid fraud.
I suggest we means test the contributions. Make the Medicare tax progressive and tax all income rather than just wages. This would have the rich paying more for their benefits than the rest of us without undermining the universality of the benefits.
Just remove the cap – no means test.
0%?
Joining the rest of the 21st century civilized world with a public single payer health care package is the only way we’re going to stop having inferior care that costs twice as much as quality care in all other comparable countries. Sadly, you’re right that it’s not going to happen any time soon.
Nothing will give Americans access to quality affordable health care for all short of single payer. Everything else is pretty much fiddling while Rome burns.
If the medical inflation rate continues to outpace the general inflation rate, then nothing can fix it long term. I’d add to your drug company costs (I think they’re the most profitable industry), eliminating unnecessary procedures. There’s a ton of procuderes regularly practiced that are of no use.
But experience tells me that no one is going to be happy with the results. I only hope the results are effective and don’t short change our long term prospects.
A lot of the suggestions above are exactly what we need (raising the cap, controlling medicare costs — but not by cutting benefits, and raising the eligibility seems to be highly counter-productive).
If Obama pulls off a debt-ceiling deal too, then he will have finally become an accomplished negotiator.
Social Security, AKA Col Mustard, is the murderer in the drawing room. It was done swiftly, with the candle holder.
Nock me Amadeus, he’s back to provide insight.
in your first sentence
Instant portability. Yeah, I know, “Medicare for All” is just Single Payer by another name.
But it sure would put a crimp in medical costs and medical inflation rates.
That, and negotiating for drug discounts, cutting out overlap between uncoordinated care between Medicare and Medicaid programs, better computerized records, etc.
But no, all I read about in the news is “raise eligibility!” “Cut benefits!” ”Why aren’t we implementing the Romney/Ryan agenda?” http://www.politico.com/story/…
That would really open up the exchange to competition. Really good idea. I wonder if, as the ACA is written, it’s a legal option for the states to include in their exchange pool of insurers. It is if a state has been given a waiver in order for it to come up with a completely different, but compliant, program. Vermont? New Hampshire? One of them received a waiver and is going the whole single payer route.
Here’s a really exciting thought. What if Medicare or similar single payer were included in the federally set up exchanges in those states who have refused to set up their own? Instantly: over half the states have single payer and we’re on our way to Medicare for all, throughout the country. Nah, too easy.
Anybody heard any hints of what Colorado’s contemplating? Maybe it’s time to contact our state representatives and air our views.
But some states have health care programs that reach beyond Medicaid, and those plans could be altered to fit on the exchange.
Re: single payer… Vermont has single payer; I think Hawaii also has a public health care plan. Vermont needs a waiver because they won’t be implementing the exchange – they’ve got single payer instead.
Medicare had statutory limits on who it accepts; I don’t think the Obama Administration can include it on the exchange list without the approval of Congress (aka fat chance). But if Colorado wanted to step in with a state-run plan it could. Unfortunately, that wouldn’t offer the cost savings of a nationwide plan.