It’s finally here. After a long week of teasing and hint-dropping that kept much of Washington wondering, Paul Ryan has released a new budget. Now, that we can finally see what’s in Ryan’s budget, it’s a bit of a let down. Ryan trots out most of the same old ideas, some of which have actually gotten worse with age. And what’s new is the same shallow shift in “tone” that Republicans apparently still believe will win over the voters they alienated in 2012. Beyond that, not much has changed.
Ryan’s 2012 “Path to Prosperity” was really a “Roadmap to Ruin.” This year’s “Path to Prosperity” takes a few unexpected turns that are probably intended to disorient Americans in hopes that we don’t notice Ryan’s “new” budget (soon to be the GOP’s “new” budget) arrives at the same destination.
Let’s start with what hasn’t changed.
Health Care Reform
Just like last year, Ryan’s budget calls for the repeal of the Affordable Care Act. After more than 30 failed attempts at repealing the law and a Supreme Court decision upholding it, this is such a non-starter that even fails the laugh test with Fox News anchors. Almost no one in hell gives this a snowball’s chance in hell of happening, nor is it popular with voters. Americans may be somewhat ambivalent about the health care reform law as a whole, but only 33% support repealing the law.
So, why would Ryan even mention it in his budget? The simple answer is that it’s probably de rigiuer in the GOP at this point. If it wasn’t in the bill, the tea party Caucus of the House GOP would almost certainly insert it in the budget before House Republicans inevitably and overwhelmingly approve Ryan’s budget.
There’s another answer that I’ll get to in a bit.
Once again, Ryan’s budget ends Medicare as we know it.
This year’s “Path to Prosperity” again proposes the creation of a Medicare “premium support” system starting in 2024, which ensures that no one 55 or older will be affected. Ryan reportedly toyed briefly with the idea of increasing the Medicare cut-off age to 56, but backed down when the idea infuriated Republicans in Congress, Never mind alienating the one the few remaining groups Republicans can still count on.
“Premium support” is called “competitive bidding” now, but future seniors would still be forced to choose between traditional Medicare-as-we-know-it, and the new voucherized version that would offer them a fixed amount to buy private health insurance. But that “fixed amount” would increase with the rate of inflation, not the rate of health care inflation. So, seniors will be left holding vouchers that are worth less and less each year.
Medicare comes in for the same block grant treatment it received in Ryan’s previous budget, giving the states more “flexibility” to administer their Medicaid programs, by slashing their Medicaid rolls. This amounts to the same kind of “catastrophic success” as “Welfare Reform” of the 1990’s, which Ryan cited as the model for his budget.
See, there’s the problem with this is that the welfare reform of the late 1990s was not a success. Not unless you’re a conservative. And even then it was at best a “catastrophic success” — defined here as “success” that’s actually catastrophic for those it’s purported to help. That’s also what makes it a success. That is, if you’re a conservative.
What makes it a success? Well, in a sense, failure. It works if it doesn’t work, in other words, especially if it doesn’t work for the right people — because the right people are the wrong people. Follow me? No?
… In the unlikely event that Ryan’s budget proposal became actual policy, it’s going to have the same effect as the late 90s welfare reform that Ryan uses as his model. The primary measure of its success will be the declining numbers of people receiving services from the programs Ryan is targeting.
It’s highly unlikely that those people — the elderly, the disabled and children — will be better off. That goes for their families, too. As DailyKos’ Joan McCarter points out, a quarter of Medicaid spending pays for long term care for the elderly. Without Medicaid, families who are already taxed more under Ryan’s plan, have to pick up those costs. That’s an added burden for middle class families.
… But that’s why it will be a success. Making people better off, by reducing their need for assistance, isn’t the point of conservative welfare reform. The point of conservative welfare reform is reducing the fewer people receiving help, not the reducing the need for help. That’s why it’s so successful, if you’re a conservative like Paul Ryan. Because all you have to do is cut.
Ryan’s new budget has the same catastrophic results for American families where Medicaid is concerned.
The GOP’s cuts to Medicaid would have disastrous consequences for countless American families.
An overview of the likely impact gives a 10,000 foot view of the collateral damage that’s likely to be the result of the kind of cuts Republicans want to inflict on Medicaid.
- Up to 44 million could lose health coverage. Federal spending on Medicaid would fall by $1.4 trillion, or 34% by 2021. States would receive $243 billion less per year. Cuts would produce decreases in Medicaid enrollment, resulting in 31 million to 44 million to lose coverage.
- By 2013, 400,000 would lose vital health care services by 2013, according to the CBO.
- By 2016, 1.7 million children will lose health insurance. If the Republican plan becomes law the CBO estimates that 1.7 million children will lose health insurance by 2016, as half the states could eliminate their CHIP programs, and remaining states could roll back coverage.
- As many as 15 million could be forced off Medicaid rolls, according to state-by-state analysis.
- Cuts would seriously impact seniors and people with disabilities. Some 14 million seniors and people with disabilities depend on Medicaid to pay for nursing home care and assisted living — which costs about $72,000 a year, on average. In fact, 70% of nursing home patients are Medicaid recipients. Deep cuts would mean less coverage for nursing home residents, shifting more of the cost on to the elderly and disabled beneficiaries and their families. Sharp reduction in the quality of nursing home care is another likely result. Many elderly and disabled recipients would be unable to obtain coverage elsewhere because of pre-existing conditions.
Economy, Safety Net, Etc.
The rest of Ryan’s new budget pretty much follows the same “Roadmap to Ruin.”
- Fannie Mae and Freddie Mac still get replaced by private secondary mortgage lenders. Ryan’s budget proposes “winding down” Fannie and Freddie’s key role in enabling millions of middle- and working-class Americans to become homeowners, and replacing them with private lenders who have played a key role in evicting middle- and working-class Americans from their homes.
- The Supplemental Nutrition Assistance Program, aka “food stamps,” still gets converted to a state block grant program in the model of 90s-style “welfare reform,” with the same catastrophic for American families.
- Pell Grants still get reduced, this time to what they were for the 2009-2010 school year, and targeted towards the “truly needy.”
- The wealthy and corporations still get huge tax cuts, costing the government $7 trillion revenues.
So what’s different this time around? Varying degrees of cynicism and sanity.
Ryan cynically adopts in his budget the same Obama policies he campaign against in 2012, including: the Medicare savings Ryan dishonestly denounced as “cuts”; the savings from ending the wars in Iraq and Afghanistan, which Ryan once called “phantom savings”; and the revenue from the fiscal cliff deal, which Ryan opposed.
And in the sanity dept., Ryan’s budget is as reality-challenged as anything else we’ve seen from the Republicans. The insanity becomes evident upon realizing that Ryan and the GOP actually hope voters will be taken in by a “bait and switch” strategy designed to incite fears the deficit and government spending, and draw attention away from what Ryan’s budget is really about: dismantling government.
As with his previous budget plans, this year’s “roadmap” is an elaborate justification for his vision of minimalistic government. His call to balance the budget has less to do with putting the federal government on a sustainable path—as Ross Douthat points out for The New York Times, “Modest deficits are perfectly compatible with fiscal responsibility”—and everything to do with his narrow ideological agenda. “The reality,” notes Ed Kilgore at the Washington Monthly, “is that he’d be promoting the same policies even if the budget were in balance.”
If there’s anything worth noting about this new budget, it’s the extent to which it shows a Republican Party unchastened by the 2012 elections. Nearly every Republican—from Mitt Romney down to Senate and House candidates—ran on ideas promulgated by Ryan. And while it’s hard to attribute a win or loss to any given policy, there’s no question these ideas are unpopular with the public. Despite this, and despite the fact of Republican losses at all levels of government, the party is roaring back with the same approach to spending and taxes, with little in the way of adjustment.
It’s true that when asked in the broadest sense if they would prefer to reduce the deficit mostly by cutting government programs instead of mostly by raising taxes, Americans chose cutting 53-37 percent.
But when asked about specific kinds of government programs, respondents chose raising taxes over cutting Medicare, Medicaid, Social Security, education and transportation. They said they would rather cut spending only when it comes to energy, the military and unemployment benefits.
Do you hear that, Mr. Ryan? A lot of Congressional Republicans want to cut jobless benefits, but they don’t want to balance the budget at the expense of military contractors or the oil companies.
Paul Ryan’s “new” budget sports some notable changes on the surface, shifting focus from denouncing the president’s policies to shrieking about the deficit. But, the more Paul Ryan’s budget changes the more it stays the same. It’s still about shrinking government, cutting taxes of for the 1 percent, making the elderly pay more for health care, and taking health care coverage for more than 30 million Americans.
Paul Ryan has presented, and Republicans will almost certainly embrace, another budget that no one wants. That much hasn’t changed.