Tread carefully on Medicare

There are two essential facts about the current debate over Medicare reform. The first is that without fundamental reform of Medicare, the country will go broke. The second is that fundamentally reforming Medicare is political suicide, if one party decides to go alone.

After venturing bravely on a budget vote on the path to reform of the 47-year program, House Republicans have sent conflicting signals about whether they are going to venture even further in the committees of jurisdiction. House Ways and Means Chairman Dave Camp (R-Mich.) told reporters last week that he wasn’t interested in proceeding, in his committee, on a controversial package only to see it die in the Senate. 

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Some conservatives have criticized Camp for his nod to common sense, but I think the chairman is right to call for a pause. House Republicans have to proceed with all due caution on this political powder keg. A misstep could prove devastating to the careers of dozens of new Republicans who don’t appreciate the minefields that lay in wait for them on this issue.

In 1995 and 1996, congressional Republicans took on Medicare reform as part of the effort to balance the budget. Newt Gingrich knew well how potent the issue was with voters, and he devised a communications strategy dedicated to winning the issue. He detailed Dan Miller, a Florida Republican who represented thousands of concerned seniors in his district, to devise the strategy, which included making certain that voters knew that Republicans weren’t actually cutting Medicare, but were only slowing its growth. 

While Republicans didn’t actually win the issue back then, they did fight President Clinton to enough of a draw that it didn’t factor into the next election. Both Republicans and Clinton were able to reach agreement on a balanced budget, and as a result, they both stayed in power.

The dynamics in this battle over Medicare are, of course, far different. Medicare growth is an even bigger threat to the budget than it was back then, and Ryan’s reform plan is far more revolutionary than the Gingrich plan. House Speaker John Boehner (R-Ohio) also can’t count on a Republican-led Senate to move forward on a reform plan, because, well, he doesn’t have a Republican-led Senate. Senate Majority Leader Harry Reid (D-Nev.) can’t even produce a budget to mark up, let alone a budget to pass, and hasn’t even bothered for two years. It is highly doubtful that he will pass a Medicare reform plan without a lot of prodding from the White House.

I don’t think Republicans should give up on Medicare reform. Nor should they wait for a Republican president to somehow sweep in and save the day a year from this coming November. There is no evidence that one-party government will be able to reach a grand bargain to fundamentally reform this program.

Republicans should do three things as they proceed with all due caution on this issue. 

First, they should train their members how to talk about the issue back home to their constituents. These members need to go beyond the talking points and really learn the issue, because, I guarantee you, seniors know the program cold. Boehner think about bringing Dan Miller back in out of retirement to help devise a good program.

Second, they should bring all the stakeholders in and find out what is actually doable and what is a nonstarter. That includes seniors groups, hospital groups, the business community, doctors and nurses. They all have a role to play in reform, and they all know that the current system doesn’t work. 

Third, they need to use all of their leverage on the debt ceiling to force the White House to come to the table on a process to reach  an agreement on Medicare reform. They probably won’t get a deal by August, but they might be able to agree to a process that gets to a deal by the end of the year.

Feehery is president of Quinn Gillespie Communications and spent 15 years working in the House Republican leadership. He is a contributor to The Hill’s Pundits Blog and blogs at thefeeherytheory.com