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 Ryan8th graders refuse to take photo with Paul Ryan Dems plot recess offensive on ObamaCare President Trump needs to make some huuuge changes, and soon 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 GrahamGraham: Calling climate change a 'hoax' bad for GOP Graham: Comey should be held accountable for acting on bad intel Trump got harsher GOP reception than Bush on budget 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 PortmanRob PortmanSens submit bill to 'Hack the DHS' CBO score underlines GOP tensions on ObamaCare repeal Senate panel could pass new Russia sanctions this summer 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 JohnsonRon JohnsonOvernight Healthcare: Senate GOP to start writing its healthcare bill Senate staff to draft health bill during recess Divisions emerge in the Senate on pre-existing conditions 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 PaulRand PaulSenate gears up for fight on Trump's 0B Saudi Arabia arms sale Paul: 0B Saudi arms deal ‘a travesty’ Senate feels pressure for summer healthcare vote MORE (R-Ky.) and Ted CruzTed CruzFranken explains why he made an exception to diss Cruz in his book FEC faults Cruz on Goldman Sachs loans in rare unanimous vote CBO score underlines GOP tensions on ObamaCare repeal MORE (R-Texas), who are running for president, and Sen. Mike LeeMike LeeRepublicans go to battle over pre-existing conditions Senate gears up for fight on Trump's 0B Saudi Arabia arms sale Senate feels pressure for summer healthcare vote 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.”