GOP divided on Medicare overhaul

GOP divided on Medicare overhaul
© Greg Nash

Congressional Republicans are divided on whether to push forward with an overhaul of Medicare long championed by Rep. Paul RyanPaul RyanThe Hill Interview: Budget Chair Black sticks around for now Gun proposal picks up GOP support GOP lawmaker Tim Murphy to retire at end of term MORE (R-Wis.).

The House budget includes Ryan’s proposal to convert Medicare into a premium support system in 2024, giving new beneficiaries the option of enrolling in private insurance.

Republicans have long seen Medicare reform as a key ingredient in getting Washington’s spending under control, and are under pressure now that they control both chambers of Congress to put their beliefs to the test.

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The problem is that Senate Republicans must defend 24 seats in 2016 to keep their majority, and they are not excited about jumping into a battle with Democrats over a sensitive entitlement program ahead of the election, particularly when President Obama might veto the proposal in the first place.

Sen. Lindsey GrahamLindsey Olin GrahamDurbin: I had 'nothing to do' with Curbelo snub Republicans jockey for position on immigration Overnight Health Care: House passes 20-week abortion ban | GOP gives ground over ObamaCare fix | Price exit sets off speculation over replacement MORE (R-S.C.) insisted he’s “up for” reforming Medicare, but said Senate Republicans are unlikely to embrace the House’s plan.

“I think that might be difficult to get through our conference,” said Graham, a possible presidential candidate next year. “Probably some people disagree with the concept [and] some people are up for reelection.”

Sen. Rob PortmanRobert (Rob) Jones PortmanOvernight Cybersecurity: Equifax security employee left after breach | Lawmakers float bill to reform warrantless surveillance | Intel leaders keeping collusion probe open Reddit hires first lobbyists Senate panel approves bill compelling researchers to ‘hack’ DHS MORE (R-Ohio), who could face a difficult re-election race against former Gov. Ted Strickland (D-Ohio) next year, also deferred on the Ryan plan.

He said he wants to stick with the Senate’s budget proposal, which would find $430 billion in Medicare savings requested by Obama, but leave the traditional program intact.

“My sense is the Senate approach — which takes the president’s number on Medicare and then provides flexibility to the authorizing committees of jurisdiction — is the way the Senate would like to go,” Portman said.

“That’s the way I would prefer to go because I think that enables the committees to be able to do their work, hopefully on a bipartisan basis.”

Republicans are going to have to make a decision at some point in the budget process, but it’s unlikely to happen when House and Senate GOP negotiators merge their two blueprints this month. A final budget adopted by both chambers would trigger a budget procedure that would leave major policy decisions up to committees this summer. 

The GOP hopes to get to a deal in the next few weeks.

Democrats have long viewed the Medicare plan as an albatross for the GOP, and are all but daring the party to make it part of their 2016 message.

“Plain and simple, the House Republican budget makes it harder to retire, particularly through plans to privatize Medicare. And by ramming this reckless, irresponsible and destructive budget through, every Republican on the ballot will have to answer for it in November,” said Meredith Kelly, press secretary for the Democratic Congressional Campaign Committee.

Still, it’s far from guaranteed that embracing Medicare reform would be a political liability for the GOP.

Democrats had similarly predicted that Medicare would be election poison for Republicans in 2014, only to see their party lose control of the Senate in a disastrous showing that gave Republicans a historic House majority.

In 2012, Democrats used Ryan’s Medicare plan for campaign ammunition, but picked up only eight seats in the House, far short of the 25 they had targeted.

“When it comes to Medicare, one thing has been abundantly clear over the past several elections — seniors aren’t buying the deceptive scare tactics that Democrats have been peddling,” said Ian Prior, press secretary for the National Republican Campaign Committee. 

“They know that it was Democrats who voted to cut $700 billion from Medicare when they passed ObamaCare. As the effects of those cuts continue to mount, Democrats will find it even harder to win over seniors in the 2016 election and beyond," he added.

Some Senate Republicans up for reelection in 2016 are signaling that they are open to the House Medicare plan, arguing major changes are needed to protect the program for years to come. 

Sen. Ron JohnsonRonald (Ron) Harold JohnsonGun proposal picks up GOP support GOP lawmaker to unveil bill banning gun bump stocks Senate Homeland Security chairman backs bump-stock ban after Las Vegas shootings MORE (R-Wis.), one of the most vulnerable Republican senators up for reelection next year, suggested he wouldn’t mind a premium support model, but wants to examine the House proposal more closely.

“I think long-term that’s the direction we’re going to have to go,” he said. “Bring more free-market competition into it to actually limit costs and improve the quality of customer service.”

Opposition in the Senate to changing Medicare, however, was likely reflected in a 2013 vote on a non-binding budget amendment that would protect Medicare benefits and prohibit changing the system into a voucher program.

Ninety-six senators voted for that amendment, with only Sens. Rand PaulRandal (Rand) Howard PaulHouse bill set to reignite debate on warrantless surveillance Authorizing military force is necessary, but insufficient GOP feuds with outside group over analysis of tax framework MORE (R-Ky.) and Ted CruzRafael (Ted) Edward CruzWhatever you think the Alabama special election means, you’re probably wrong This week: Congress gets ball rolling on tax reform Week ahead: Senators work toward deal to fix ObamaCare markets MORE (R-Texas), who are running for president, and Sen. Mike LeeMichael (Mike) Shumway LeeWhatever you think the Alabama special election means, you’re probably wrong How the effort to replace ObamaCare failed Overnight Regulation: Trump temporarily lifts Jones Act for Puerto Rico | Bill would exempt some banks from Dodd-Frank | Senators unveil driverless car bill MORE (R-Utah), who is up for reelection next year, voting against it.

For now, the GOP’s next step in the budget process is matching up the topline spending numbers in their budget blueprints. Negotiators will hold a public meeting Monday, but much of the work will occur behind closed doors.

If Republicans reach a deal and pass it through both chambers, it would trigger the reconciliation process. The budget procedure, which only requires a majority vote in the Senate, would issue instructions to committees to find savings within their areas of jurisdictions.

Republicans have made clear their priority is to repeal ObamaCare, but they could choose to use the process to shore up Medicare.

“It’s likely that if they’re going to make sweeping changes in the Medicare program, they would use a reconciliation vehicle,” said Katherine Hayes, director of health policy at the Bipartisan Policy Center. “I think it would be difficult to do in reality. Once the committees of jurisdiction start putting legislation together, I think it would be harder to pass in the Senate than the House.”

Democrats are clearly savoring the chance to attack Republicans on Medicare again.

On the House floor last week, House Minority Whip Steny Hoyer (D-Md.) asked House Majority Leader Kevin McCarthy (R-Calif.) if Republicans plan to use reconciliation to replace seniors’ Medicare guarantee with a premium support voucher.

McCarthy repeatedly said he didn’t want to get ahead of the budget negotiations.

“I know that you don’t want to anticipate,” Hoyer said, “but obviously our members are concerned about what they ought to be considering and planning for.”