What becomes of Medicare and Medicaid after the presidential election?

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In an opinion piece for the Wall Street Journal, Drew Altman, president of the Kaiser Family Foundation discusses the possible consequences of House Speaker Paul Ryan choosing not to run for president. Altman makes the case that Ryan is likely to rally Republicans around further privatizing Medicare and Medicaid. And, it’s a compelling argument.

Republicans have long been fighting to privatize Medicare and Medicaid in ways that would cap federal spending on these programs and shift more costs onto older adults and people with disabilities. These programs now cover 121 million people and represent 23 percent of federal budget. And, that will only grow as the population ages.

Altman notes that Republicans have already come a long way in privatizing Medicare and Medicaid. Today, nearly one in three people with Medicare are enrolled in a Medicare Advantage plan. And, more than one in two are in a private Medicaid managed care plan.

To be clear, privatization not only is likely to shift more costs onto older adults and people with disabilities, but it also brings a lack of transparency to Medicare and Medicaid; commercial health plans are prone to claim that the bulk of their data is proprietary. Privatization also makes it harder for the federal government to drive large scale system change to improve health care value.

And, at least with Medicare, privatization has meant higher per capita health care costs. Commercial insurers offering Medicare Advantage plans have not been able to negotiate as good rates with providers as the Centers for Medicare and Medicaid Services and their administrative costs are far higher than the government’s.

In sum, Speaker Ryan will determine the nature of the Republican Medicare and Medicaid agendas, as well as whether Republicans will continue to try to repeal and replace the Affordable Care Act. But, so long as the President is a Democrat, Republicans should not be able to move their agenda. And, any attempts to undo traditional Medicare and impose higher costs on older adults could shift support of older adults away from Republicans.

Here’s more from Just Care:

And, this, Medicare and Commercial Health Insurance: The Fundamental Difference, which I authored with Theodore Marmor, on the Health Affairs Blog

Affordable Care Act Medicaid Medicare Policy

Comments

16 responses to “What becomes of Medicare and Medicaid after the presidential election?”

April 23, 2016

gary davis

We need very low cost or free (regardless of income) National Universal Healthcare. No more VA, Medicare, Medicaid, for profit clinics and hospitals or the myriad of ‘insurance plans’ or any of the profits generated in any of the above. We need a medical care system that is compassionate and patient oriented. Not one that determines if you are too sick to care for. It needs to be all encompassing to include medical, dental, vision, re-hab and clean healthy long term care. A time when the patient and family need not fight with ANYONE for proper health care. Taxes to support such a system should be welcomed and the system to be closely monitored for compassion and astute up to the minute care. After all it is a Government “Of the people, by the people and for the people”. The “people” should demand it.

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April 23, 2016

Marc McGuire

THE “PROBLEM” WITH PAUL RYAN IS THAT HE “HATES” THE SENIORS, HE “HATES” THE “POOR” AND HE “HATES” PROGRAMS THAT WORKS, LIKE, MEDICARE, MEDICAID, AND SOCIAL SECURITY!
THE AMERICAN PEOPLE “HATES” POLITICIANS LIKE PAUL RYAN WHO “SITS” ON HIS ASS MAKING A LIVING OUT OF BEING “STUPID AND KISSING A$$!!!!!!!”
THE SENIORS, “WHO DO LIVE LONG ENOUGH TO ENJOY THEIR BENEFITS” “HAD TO BUST” HIS OR HER’S A$$ TO “EARN” THESE BENEFITS. ALL WE SENIORS ASK FOR: “IS TO LIVE OUT THE REST OF THEIR LIVES IN PEACE, AND WITH SOME DIGNITY”, BUT NOW, WE SENIORS ARE BEING FORCED TO GO UP AGAINST A$$HOLES LIKE PAUL RYAN, AND THE REST OF THE
REPUBLICAN AND DEMOCRATIC ESTABLISHMENTED POLITICIANS WHO ONLY WANTS TO TAKE THEM AWAY FROM US!!!!!!!!!!
IT USED TO BE A GOVERNMENT “OF” THE PEOPLE, “BY” THE PEOPLE, AND “FOR” THE PEOPLE!
BUT NOW, IT IS A GOVERNMENT “OF” THE LOBBYIST, “BY” THE “LOBBYIST” AND “FOR” THE CORPORATIONS!
IT IS NOW THE UNITED CORPORATION OF AMERICA INSTEAD OF THE UNITED STATES OF AMERICA!!!!!!!!!!!!!!!!!!!!!!!!!!!!!!
“WHAT EVER HAPPENED TO THE AMERICAN PEOPLE????????” ( DUH! )

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1. April 23, 2016
  
  L Marble
  
  I couldn’t have said it better. We need some Henry Fords and F. D. Rr’s. You know, people that care.
  
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2. April 23, 2016
  
  Robert Grandmaison
  
  You are so right. The voters of Ryan’s district need to get their heads out of their asses and VOTE HIM OUT!
  
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3. April 23, 2016
  
  Margaret Goodwin
  
  I totally agree!
  
  Reply
April 23, 2016

Margaret Goodwin

The GOP are trying to destroy Medicare!

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1. April 24, 2016
  
  joe sixpack
  
  theyre also trying to skip out on $3 TRILLION they owe Social Security!!!
  
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April 23, 2016

DFPA

A critical comment here is that attempts to alter traditional Medicare may be a catalyst to drive seniors–typically staunch supporters (and they vote)–away from the Republican Party. The extreme agenda of Republicans has finally alienated me at age 70 and a lifelong registered R to a point where I’m changing my affiliation to Independent. There’s no longer a place for moderates in the party. The fact that a zealot like Ted Cruz is the best they can come up with as an alternative to Donald Trump tells you a lot about where the Republican Party is headed. I have no interest in being associated with that while the Democrat’s go too far in the other direction (free everything, we’ll worry about paying for it later) to suit me.

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1. April 24, 2016
  
  joe sixpack
  
  HilLIARYs a closet Republican looking to raise taxes and the retirement age!
  
  Bernie isnt giving away Medicare for free. He wants to eliminate the cap which we the people have been demanding for decades.
  
  Why should someone who makes a million $$$ a year pay SS taxes on only 10% of their income while someone who makes less than $118k a year pay SS taxes on 100% of their income?
  
  Single payer also eliminates BIG insurance and Advantage plans! Single payer also gives Medicare recipts the power they need to negotiate BIG phama prices!
  
  Neither Universal Health care, nor the ACA does that! They both keep BIG insurance & BIG pharma in business and raising costs!
  
  DC had no problem taking $900 million from these funds for ACA and no problem funding 12 years of Bush tax cuts for the wealthy paid for by Social Security on the backs of the working poor & whats left of the middle class!
  
  Eliminating the cap and having the government pay back the $3 TRILLION they stole from Social Security would make these funds liquid for many decades to come!
  
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  1. April 24, 2016
    
    joe sixpack
    
    btw DFPA…I was also a registered voting republican for 35+ years. I was also a graduate with Honors from the Rush Limbaugh University for Advanced Neanderthal Studies!
    
    No more!!!
    
    Reply
April 23, 2016

BC Shelby

…he and his pals from Wisconsin, Scooter Walker and Ron Johnson, must be all eating from the same block of rancid cheese. They will bend over backwards for corporations and their wealthy cronies while taking everything they can from disabled and elderly citizens, public education, and the working poor (the latter whom in his state, Walker seems intent on keeping poor). Having been born and grown up in Wisconsin, I am embarrassed by these cheesebrains.

When I was young and able to work, I could walk into nearly any shop in Milwaukee and get hired at a decent wage as it was a union town. One job I worked at paid 6.85$ an hour – a wage that today would be nearly 40$ an hour. In contrast, I recently left a job in the same line of work that had far more responsibility than that one 44 years ago, which paid 11.50$ an hour (about 2.20$ in 1972 terms). This is what Republican union busting gave us, jobs that once offered workers a living wage which now pay next to nothing. Meanwhile, costs for everything keep rising, particularly rent, which has been allowed to skyrocket to obscene levels in many cities. Walker in fact defended his position on the minimum wage claiming that anyone in the state can make it on 7.25$ an hour. In the early 1970s that was true, not four and a half decades later.

The state of Wisconsin’s motto is supposedly “Forward”. With heartless, spineless individuals such as these three in control, that motto should be changed to “Backwards” as that is where they want to take all of us.

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April 24, 2016

Paul Richey

It’s a shame that a once progressive state of Wisconsin has turned into the hole
in the ground that it is. As one of the chief advisors for digging Wisconsin into
the ground Paul Ryan is an abysmal pretense of a leader. He just doesn’t fit into
the Ayn Rand mold at all. Time will pass; Paul Ryan will pass and Americans will
shore up the damage. We have to do just that.

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April 24, 2016

gary davis

It’s a comfort to know that other citizens of Wisconsin and the United States share some real concerns about our future. There’s a lot of common sense out there; I just wish we had more of it in Congress.

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1. April 28, 2016
  
  Lynn Vander Meer
  
  That’s why we need a NEW Congress. Retire that bunch of fools now sitting; they are all millionaires and won’t suffer, and start running some candidates that will represent the people. It is PUBLIC SERVICE..
  
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April 24, 2016

gary davis

I was a stockbroker for 4 years, in the early ’90’s. I, indeed, believe in the power of the stock market, even though stock prices are mostly emotion and, much of the time, reflect little about a companies real worth but, it’s all we have. Can you imagine FDR, after seeing the Great Depression, first hand and the chicanery from the inside out, assigning Social Security contributions to a giant “Index Fund” (if there had been such a thing back then). First of all, Roosevelt would have balked at the very idea. He didn’t know America would grow so very much. He wanted to be on the safe and solid side of things. But the Soc. Sec. ‘fund’ would have grown into the $quadrillions by now and every politician would have salivated like and lions and wolves at the pile of money to “borrow” from. We would have needed a REAL Lockbox to keep the greedy nuts away but, it would have been adequate to nearly fund the entire Government let alone just us retirees, ‘periodic market crashes’ included. I still prefer what we have to any right wing suggestion, at this point in time, of ‘privatizing’ anything about it, though. That time has long past. Yes, we could have ‘jumped in’ at critical points along the way but, who would pick the ‘points’ and how would it have been handled ?? The thoughts for that are too scary. Eliminate ALL caps for contributions, regain lost off shore tax dollars get SSI reimbursed for all so called ‘borrowings’.

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April 28, 2016

Kathi Geukes

Paul Ryan will not have any influence in the next Presidential cycle because the Dems will take back the Senate and the House will be evenly split……his machinations will never come to fruition because he will have NO power….as John Boner found out……..he will be ignored…as he should be……Wisconsin will wake up and elect some Dems…..as will MI…….where I live……and my governor will wind up in prison where he belongs…….for poisoning our people……

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