Politics

Is Mitt Romney Right to Want to Repeal Obamacare's Medicare Cuts?

Avik Roy and Josh Barro debate the question.

  1. Last week, I wrote a piece for my Forbes blog, The Apothecary, pointing out that Obamacare cuts Medicare by $716 billion from 2013-2022, hampering Democrats' efforts to demagogue Republican proposals to reform the program.
  2. My friend and former colleague at the Manhattan Institute, Josh Barro, sees this as a betrayal of fiscal hawkishness. "What Romney and Ryan are up to is simple: They want to have it both ways on Medicare," he wrote at Bloomberg View. "They are for Medicare cuts, because Medicare is expensive and the federal budget needs to be controlled. And they are against Medicare cuts, because Medicare cuts are unpopular. The political impulses behind this strategy are clear. Why any policy experts would try to offer a substantive defense of it is not."
  3. I responded over at Reihan Salam's blog at National Review, where I explained that not all Medicare cuts are created equal. Budget resolutions that promise to reduce Medicare spending, without actually introducing any structural reforms to the program, haven't worked in the past, and are unlikely to work in the future.
  4. Josh wasn't buying it. "By saying we don't need any cuts for ten years and can even rescind those contained in PPACA, Romney signals that Medicare's cost crisis isn't so dire. We can even afford to spend $700 billion more on it than the President wants to! This will undermine the case for reform in the future, not bolster it."
  5. On Thursday, Josh and I debated the subject over Twitter.
  6. @aviksaroy how does doing nothing to Medicare for ten years make it easier to fix it later? Makes no sense except as a political dodge.
  7. RT @lheal: Obamacare purports to slow spending growth with price controls, reimbursement rate cuts, and other top-down fantasies that never work.
  8. @aviksaroy so if we had never passed the SGR law, Medicare spending today would be lower?
  9. @jbarro Global budgeting of entitlement spending does not yield predicted results, and harms access to care.
  10. @aviksaroy what I'm not seeing in your post is two things.
  11. @aviksaroy one is any defense of Ryan's choice to show the Obama medicare savings with no mechanism to achieve them.
  12. @aviksaroy the other is an explanation of why abandoning any effort (not just Obama's) at near-term Medicare savings helps long-term efforts
  13. @aviksaroy Romney's position is that he's not even going to try to control Medicare costs until 2022, and then only for new entrants.
  14. @jbarro (2) I explained why IPAB is bad policy in the piece. (1) Ryan is bound by CBO budgeting conventions. I am bound by good HC policy.
  15. @aviksaroy if premium support is the only way to control costs (not true, but I'll stipulate) then Romney needs to implement it sooner.
  16. @aviksaroy don't blame CBO. If his policies spend more on Medicare than the baseline shows, he needs to show that in his budget.
  17. @aviksaroy you offered an argument that IPAB is useless, not that it hinders long term reforms that phase out the program it governs.
  18. @jbarro Re implementing it sooner, I personally would favor that, but the public needs to as well.

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Avik S. A. Roy

Senior Fellow at the Manhattan Institute. Healthcare policy writer for Forbes & National Review. Romney advisor. Independent healthcare investment analyst.

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