Members of the right-wing media have promoted the claim that President Obama has “gutted” Medicare in order to fund health care reform, while GOP vice presidential candidate Paul Ryan is attempting to preserve the program. In fact, though Obama and Ryan have advocated similar spending reductions, the Affordable Care Act would not affect Medicare benefits, while Ryan's plan is projected to harm current and future seniors' care.
Right-Wing Media: Obama Has “Gutted” Medicare ...
Fox's Tantaros: “Democrats Have Already Gutted” Medicare. On the August 14 edition of Fox News' The Five, co-host Andrea Tantaros claimed “you cannot simultaneously be a supporter of Obamacare and a protector of Medicare.” From the program:
TANTAROS: I think people are finally relieved that there's someone with the political courage to have this discussion. No one's had the guts to do it until Paul Ryan actually came along. I'd like to say Brit Hume, high-five for coming out of retirement - he's like the Michael Jordan of political analysis - for scoring this interview. And I think it's important because he's able to explain and clarify his position that has been so misrepresented, which is: He is not trying to gut Medicare, he's trying to save it. And the Democrats have already gutted Obamacare. That is something that happened already, Dana, they raided --
DANA PERINO: (co-host): You mean Medicare, to pay for Obamacare.
TANTAROS: To pay for Obamacare, correct. You cannot simultaneously be a supporter of Obamacare and a protector of Medicare, and Paul Ryan makes that very, very clear, and I think he has to keep doing this. [Fox News, The Five, 8/14/12]
National Review's Lowry: Obama Made “Meat-Axe Cuts” To Medicare. On Fox News' Hannity, National Review editor Rich Lowry said that "$700 billion in cuts on current seniors" have been made to Medicare, adding, “These are meat-axe cuts that the president passed to fund another unaffordable entitlement right now.” [Fox News, Hannity, 8/14/12]
Fox's Hannity: “There's Only One Candidate In This Race That Gutted Medicare.” On his Fox News show, Sean Hannity said, “There's only one candidate in this race that gutted Medicare. Who is it?” Hannity later said, “There's only one guy that cut Medicare, $741 billion, and that was Barack Obama.” [Fox News, Hannity, 8/14/12]
Mark Levin: Obama “Stole” Medicare Money “In The Biggest Raid In History.” On Fox News' Your World, radio host Mark Levin said that Obama “stole” money from Medicare “to spread the wealth under Obamacare. And seniors need to understand -- who've paid into Medicare -- that he went into Medicare, their trust fund, took out $700 billion in the biggest raid in history, to take that money to fund Obamacare and spread the wealth to people who haven't paid into anything.” [Fox News, Your World, 8/13/12]
Fox's Varney: Medicare Cuts Mean “You're Cutting A Billion A Week, Every Week, For 10 Years.” On his Fox Business show, Stuart Varney said that “Obamacare calls for $564 billion in cuts to Medicare over the next 10 years.” He added: “I did the math. You want to cut $564 billion from Medicare over 10 years, you're cutting a billion a week, every week, for 10 years.” [Fox Business, Varney & Co., 8/13/11]
... While Ryan Is Trying To Preserve It
Fox's Perino: Ryan Plan “Doesn't Even Affect Anybody That Is Currently 55 Or Under” And “Preserves The Program In The Future.” On the August 14 edition of Fox News' The Five, co-host Dana Perino suggested that Paul Ryan's Medicare plan will not affect current or future seniors:
PERINO: If you're 53 years old and you know that you're going to have the current plan -- so it doesn't even affect anybody that is currently 55 or under -- or by the time it gets past 53 and under -- but it preserves the program in the future for the people that are under 55 and for your children. [Fox News, The Five, 8/14/12]
Fox's Tantaros: Ryan "Is Not Trying To Cut Medicare, He Is Trying To Save It." Later on The Five, co-host Andrea Tantaros suggested Paul Ryan's Medicare plan has been “misrepresented” by Democrats. Tantaros went on to suggests Ryan “is not trying to cut Medicare, he is trying to save it.” From the show:
TANTAROS: I think people are finally relieved that there is someone with the political courage to have this discussion. No one has had the guts to do it until Paul Ryan actually came along.
TANTAROS: [Ryan] is able to explain and clarify his position that has been so misrepresented, which is: He is not trying to cut Medicare, he is trying to save it. [Fox News, The Five, 8/14/12]
But Obama's Medicare Reductions Are To Future Growth, Not Current Spending
FactCheck.org: Affordable Care Act “Stipulates That Guaranteed Medicare Benefits Won't Be Reduced.” FactCheck.org noted that the Affordable Care Act “does not slash the current Medicare budget by $500 billion. Rather that's a $500 billion reduction in the future growth of Medicare over 10 years”:
As we have written many times, the [Affordable Care Act] does not slash the current Medicare budget by $500 billion. Rather, that's a $500 billion reduction in the future growth of Medicare over 10 years, or about a 7 percent reduction in growth over the decade. In other words, Medicare spending would continue to rise, just not as much. The law stipulates that guaranteed Medicare benefits won't be reduced, and it adds some new benefits, such as improved coverage for pharmaceuticals.
Most of those savings come from a reduction in the future growth of payments to hospitals and other providers (not physicians), and a reduction in payments to private Medicare Advantage plans to bring those payments in line with traditional Medicare. (MA plans have been paid more per beneficiary than traditional Medicare.)
And it assumes they actually happen. There's good reason to think that some of those reductions won't be implemented. The law calls for cuts in the future growth of reimbursement payments to hospitals and other health care providers -- that accounts for $219 billion of the Medicare savings in the law. But Congress has consistently overridden similar scheduled cuts in payments to doctors. [FactCheck.org, 6/28/12]
PolitiFact: Reduction Is "An Attempt To Curtail Future Medicare Spending." From PolitiFact:
This is a standard conservative talking point after the passage of the president's health care bill, focusing on a $500 billion reduction in projected spending that is an integral part of the federal health care law. These reductions include the amount of annual increases health care providers would receive from Medicare, administrative changes and alterations to Medicare Advantage.
The difference, PolitiFact has repeatedly ruled, is that these don't represent cuts, but rather an attempt to curtail future Medicare spending. The program is still projected to grow, the Congressional Budget Office predicts, just at a slower rate under the so-called Obamacare guidelines.
Those savings, which the commercial says are being taken to fund “other government programs,” are alterations to the way health coverage is paid for. One of those ways is to increase the scope of Medicaid. Another is to expand coverage of prevention services. A third is to help cover the Medicare Part D “doughnut hole” for prescription drugs.
American Commitment claims Bill Nelson voted to slash $500 billion from Medicare to fund other programs. Our previous rulings have shown that there is no vast well of money already allocated that is being cut, and the programs being funded are a part of government health care services, of which Medicare is the largest.
Yet again, we rate this claim as Mostly False. [PolitiFact Florida, 7/5/12]
And Ryan Adopted The Exact Same Method Of Reducing Medicare Growth
Washington Post: “Paul Ryan's Budget Keeps Obama's Medicare Cuts. Full Stop.” In an August 14 post on The Washington Post's Wonkblog, Ezra Klein noted, “Since the Romney campaign wants to run against President Obama's cuts to Medicare, it's something of a problem for them that Paul Ryan's budget includes those very same cuts to Medicare.” From the post:
What they're doing is switching between two questions very quickly. The first question is: “How much money are you cutting from Medicare?” The second question is: “How much overall deficit reduction is contained in your plan?” And the second question isn't getting answered.
Here's what everyone agrees on: Ryan and Obama include the same cuts to the Medicare program itself. So if you're an insurance company participating in the Medicare Advantage program, you're getting the same cut no matter who wins the election. So the answer to the first question is, “the same amount as the Obama administration.” [Washington Post, 8/14/12]
Slate: Ryan's Budget Has “The Exact Same Medicare Cap As The Obama Plan.” In an August 13 post on Slate, David Weigel pointed out that Ryan's budget has “the exact same Medicare cap as the Obama plan.” From Slate:
Remember, Obamacare is supposed to save $700 billion by capping the rise in Medicare spending from GDP growth plus 0.5 percent. The Ryan budgets in 2012 and 2013 don't alter Medicare for anyone entering it before 2022--a buffer that lets current retirees breathe easy. After 2022, it turns all of Medicare into a premium support plan like Medicare Advantage. At that point, “an annual competitive bidding process” is supposed to push providers to provide lower rates. “The per capita cost of this reformed program for seniors reaching eligibility after 2023,” explains Ryan in his budget guide, “could not exceed nominal GDP growth plus 0.5 percent.” So, if it works, it's got the exact same Medicare cap as the Obama plan. [Slate, 8/13/12, emphasis in original]
ABC: Ryan Endorsed Medicare Cuts In His Budget Plan, Which Romney Said He'd Sign As President. From an ABCNews.com Political Punch blog post:
One way or another, Barack Obama, Paul Ryan and Mitt Romney all have supported the $700 billion in cuts to Medicare spending now in place under the Affordable Care Act.
But you wouldn't know that by listening to the current debate.
The Romney-Ryan campaign in its latest TV ad assails Obama for approving the cuts in 2010. “Obama has cut $716 billion dollars from Medicare,” says the narrator. “The money you paid for your guaranteed health care...is going to a massive new government program that's not for you.”
Voters might be left with the impression that Romney and Ryan have both opposed the cuts. The truth is that Ryan himself endorses them in his signature budget plan -- the same plan Romney has said he would sign as president if it reached his desk.
Those Medicare savings -achieved through reduced provider reimbursements and curbed waste, fraud and abuse, not benefit cuts - appear in the House Republicans' FY 2013 budget, which Ryan authored. [“Poltiical Punch”, ABCNews.com, 8/14/12]
But While Obama's Medicare Plan Would Not Affect Seniors' Benefits...
Washington Post: The Affordable Care Act Would Not “Change The Basket Of Benefits That Patients Have Access To.” In an August 14 post on The Washington Post's Wonkblog, Sarah Kliff pointed out that it's “worth noting that there's oen area these cuts don't touch: Medicare benefits.” From the post:
The Medicare Advantage cut gets the most attention, but it only accounts for about a third of the Affordable Care Act's spending reduction. Another big chunk comes from the hospitals. The health law changed how Medicare calculates what they get reimbursed for various services, slightly lowering their rates over time. Hospitals agreed to these cuts because they knew, at the same time, they would likely see an influx of paying patients with the Affordable Care Act's insurance expansion.
The rest of the Affordable Care Act's Medicare cuts are a lot smaller. Reductions to Medicare's Disproportionate Share Payments -- extra funds doled out the hospitals that see more uninsured patients -- account for 5 percent in savings. Lower payments to home health providers make up another 8.8 percent. About a dozen cuts of this magnitude make up the green section above.
It's worth noting that there's one area these cuts don't touch: Medicare benefits. The Affordable Care Act rolls back payment rates for hospitals and insurers. It does not, however, change the basket of benefits that patients have access to. [The Washington Post, 8/15/12]
FactCheck.org: The Affordable Care Act “Stipulates That Guaranteed Medicare Benefits Won't Be Reduced.” In a June 28 post, FactCheck.org noted that the “law stipulates that guaranteed Medicare benefits won't be reduced.” From the post:
As we have written many times, the law does not slash the current Medicare budget by $500 billion. Rather, that's a $500 billion reduction in the future growth of Medicare over 10 years, or about a 7 percent reduction in growth over the decade. In other words, Medicare spending would continue to rise, just not as much. The law stipulates that guaranteed Medicare benefits won't be reduced, and it adds some new benefits, such as improved coverage for pharmaceuticals.
Most of those savings come from a reduction in the future growth of payments to hospitals and other providers (not physicians), and a reduction in payments to private Medicare Advantage plans to bring those payments in line with traditional Medicare. (MA plans have been paid more per beneficiary than traditional Medicare.)[FactCheck.org, 6/28/12]
... Ryan's Cuts Would Directly Affect Coverage
Public Policy Professor: Ryan Plan Will Force Seniors To Choose Between Better Health Coverage And Food. From an ABCNews.com fact check:
Even if Ryan's plan isn't a “cut,” Ted Marmor, professor emeritus of public policy and management at Yale School of Management, and [Georgetown University professor of public policy Judy] Feder are worried Ryan's plan will burden Medicare beneficiaries by giving the government a smaller role in American social affairs.
“What Ryan is trying to do, and what I think more orthodox free market types have at the back of their minds is the view that medical care is actually just like a lot of other consumer services,” Marmor said, but it's not.
He said providing Medicare vouchers to pay competing private insurance companies will shift the risk and increased costs for care from Medicare to the patient. Some patients would have to choose between paying for better coverage and having more money for food and other items.
“If the bill for the hospital turns out to be much higher than expected, and the Medicare client had opted for a larger cost-sharing plan in exchange for not paying for wider coverage, they will face much bigger bills,” Marmor said.
Feder warned that competition among private companies is also problematic to Medicare beneficiaries. Under the current Medicare system, costs and risks are pooled, lowering costs for the sick and raising them for the healthy. Under Ryan's plan, private insurers will favor healthy individuals, who will favor cheaper private plans, so it could force sick beneficiaries to choose the Medicare option as a last resort, she said.
“What that does is separate the healthy from the sick,” she said, adding that if those sick people are forced to choose Medicare, it will become more expensive for them because the program would be overwhelmed with sick, costly patients.
Feder said she is also concerned Ryan's vouchers would be limited to an arbitrary rate of growth, meaning that if they can't keep up with heath care costs, Medicare beneficiaries will have to pay the difference.
She said Ryan's plan will damage Medicare's market power, yet again driving up costs for beneficiaries.
“Medicare gets much better rates from providers-who can't afford to say no to such a big pool of customers,” she said. “That's not true for private insurance plans. If you divvy up the market power among plans, they'll likely pay more.” [ABCNews.com, 8/15/12]
Bloomberg Businessweek: The Ryan Budget Would “Require Seniors To Pay More Out Of Their Own Pocket” For Medicare Services. According to Bloomberg Businessweek, “Ryan's budget would convert Medicare from a defined benefit program to a voucher system that would provide seniors with a fixed sum to buy private insurance, a sum that probably wouldn't keep pace with rising health-care costs and would therefore require seniors to pay more out of their own pocket.” [Bloomberg Businessweek, 8/13/12]
Ryan Budget Would Raise Many Current Seniors' Prescription Drug Costs. In a March 28 report, the Center on Budget and Policy Priorities (CBPP) found that the Ryan budget's repeal of the Affordable Care Act's “doughnut hole” fix would “adversely affect current Medicare beneficiaries as well as those not yet eligible.” The report explained:
Health reform has begun to close the doughnut hole -- the gap in Medicare prescription drug coverage that many seniors experienced once their annual drug costs exceeded $2,840. Before health reform, seniors had no additional coverage until their costs hit $6,448. Last year, seniors who were in the coverage gap received a 50-percent discount on brand-name drugs and a 7-percent discount on generic prescription drugs. This year, the generic discount jumps to 14 percent. Due to these improvements, five million Medicare beneficiaries have saved more than $3.2 billion, according to the Department of Health and Human Services (HHS). Health reform will close the entire donut hole by 2020. The Ryan budget would reopen it. [Center on Budget and Policy Priorities, 3/28/12]
For more about Ryan's Medicare plan, click here.