GOP's Medicare Message Might Not Be Fixable

Overhauling Medicare is now tied to political defeat

Republicans are vowing to tweak their Medicare message to make it an easier sell to voters in the wake of the party's defeat in New York's 26th Congressional district special election. The problem is not what's in Rep. Paul Ryan's plan, they argue, but how they sold it. "If we'll just stay with our argument and do a better job developing it, we’ll be fine," Rep. Tom Cole told The Hill's Molly K. Hooper and Russell Berman. "I think we need to be stronger in marketing who we are and our message," Rep. Allen West agreed. But anonymously, some Republicans are "grumbling" that "you don't piss off senior citizens," The Hill reports, and some are even talking of "revisiting" Ryan's overhaul. That might be even more tempting, given that a one-time massive change to the system might be politically impossible, Politico's Jason Millman reports.

The Hill reports that Republicans are "frustrated that their leadership failed to prepare them for the outrage" over the Medicare propsal. Lawmakers "know that this was handled badly, that there was no messaging, that Ryan's not making his case and they are all looking down the road thinking, 'Oh my God, it’s coming,'" a source familiar with internal discussions said. Another lawmaker said that while some have been considering rethinking the plan, "How serious it is... don’t know."

Republicans' midterm strategy focused on attacking President Obama's health care overhaul for cutting Medicare--and it sowed the seeds of their defeat on this issue, Reason's Peter Suderman argues. "[T]he GOP--Rep. Ryan and a handful of others excepted--helped ensure that the Democrats' current Medicare message would be popular and effective. One of the reasons Ryan knew what was coming, it's safe to say, was that his own party had been there before."

The New York Times' Ross Douthat agrees that "the Republicans' decision to make Mediscare arguments against Obamacare was a classic 'win the battle, lose the war' maneuver--and worse, they didn't even win the battle!" He continues:

By trumpeting absurd Heritage Foundation growth projections while staying vague... on how its rate-lowering tax reform would be paid for, the budget made it easy for liberals to claim that the Republicans weren't just cutting Medicare, but that they were doing it to pay for voodoo economics and tax cuts for the rich. These claims were unfair: The Ryan budget didn’t base its deficit projections on the Heritage numbers, and Ryan's Medicare reforms assumed revenue-neutrality in the tax code even it the budget didn't specify how that neutrality would be achieved. But politics is rarely fair, and by packaging an inevitably-unpopular Medicare reform with sweeping cuts in tax rates and then garlanding it with a supply-side fantasy about the likely consequences for economic growth, the House Republicans essentially wrote the Democratic Party an extra set of talking points.

Millman reports that the New York special election might have made a big change to Medicare impossible. Health care experts explain that it's better to make small changes to Medicare than sweeping reform--something more like the proposal offered by Sen. Pete Domenici and Alice Rivlin, Bill Clinton's budget chief. Their idea was making premium support--subsidies for seniors to buy insurance--voluntary, instead of mandatory like in Ryan's proposal. But now even that proposal has been tainted by the Ryan plan, so now "premium support equals Ryan plan equals political defeat," the Concord Coalition's Robert Bixby told Millman.