Category: Economics

http://www.huffingtonpost.com/entry/paul-ryan-obamacare-medicaid_us_58d01716e4b0be71dcf6d5a7

Ryan Grim writes:

“Speaker Ryan and others often argue to governors that a Medicaid per capita cap is about more flexibility (even though states already enjoy expansive flexibility in their Medicaid programs) rather than what it is really about: a way to achieve big federal spending cuts and cost-shifts to states,” Edwin Park, a health policy analyst for the Center on Budget and Policy Priorities, said in an email. “The House bill makes that starkly clear: $880 billion in federal Medicaid spending cuts over 10 years by ending the expansion and imposing a per capita cap without any new flexibility.”

Ryan’s plan would cut taxes by some $275 billion over the next decade, mostly for the rich, and is setting the stage, he told Fox News’ Tucker Carlson, for a much bigger tax cut to come. That’s what’s going on here.

When Ryan refers to seeing “the forest through the trees,” he is arguing to conservatives that they should swallow elements of the Obamacare repeal-and-replace bill that they don’t like in order to seize the once-in-a-half-century opportunity to destroy a major federal entitlement program. Everything else is just trees.

Ryan is right that it is an enormous forest. Some 11 million seniors and people with disabilities are covered by both Medicare and Medicaid, according to a new report from the Kaiser Family Foundation. That’s one in every five Medicare beneficiaries. Forty percent of those are under age 65 with permanent disabilities. Two out of three Medicare beneficiaries who are in nursing homes have their care covered not by Medicare, but by Medicaid. Many who get home-health care are similarly covered by Medicaid.

Social insurance organized by the government is a relatively new phenomenon. Before the New Deal, society dealt the the elderly and infirm by shunting them away in “poorhouses,” or by moving parents in with their children. “I can remember the terror that existed with regard to those county poor farms,” said former Rep. John Dingell Jr. (D-Mich.), who left office in 2015 after serving six decades.

Dingell’s father, also a prominent House Democrat, was an architect of the Social Security Act. It had a tangible benefit to the Dingell home.

“Social Security — this is one of the things of which my dad was very proud — closed 1,100 old folks’ homes in New York. Eleven-hundred. And that was just one example, but it tells you what it did all over the country,” Dingell said in an interview for an article on poorhouses.

Before Social Security, he said, “everybody and his second cousin piled in with their families. I had relatives that came to stay with my dad and mom I didn’t even know were relatives. To tell you the truth, I’m not sure they are. And my grandad on Dad’s side, who threw Dad out of the house, came to live with Dad. Dad was the only one of his kids who’d take care of him. He was, quite frankly, the only one who could afford to do so, because Pop was making a fairly decent living during the war, but he was supporting a whole tribe of Dingells and Selmerses and a whole bunch of others who had other Polish names, but were related.”

Paul Ryan, in fact, got Social Security benefits himself; he was 16 when his father died. “It was a tough time for our family, and Social Security was there to help us when we needed the help,” Ryan has said.

Ryan saved much of to pay for school at Miami University of Ohio, where ― who knows? ― a few dollars of it may have gone to pay for the kind of keg he would crowd around to fantasize with buddies about destroying Medicaid, which was created as part of the Great Society program in the 1960s.”

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The competition for “King of the Swamp” is going to be fierce this year. But, certainly, the Speaker is building his credentials with his unrestrained enthusiasm for shorting the needy to enrich the rich.

PWS

03/21/17