Paul Ryan Doubles Down on Medicare

After Republicans lose New York's special election over his plan, the House Budget Chairman pitches a fresh blueprint to sell it

Republicans lost a special election in New York's 26th Congressional District last night largely on the issue of House Budget Chairman Paul Ryan's (R-Wisc.) ideas about Medicare. Today, Ryan released a video charging ahead with that proposal.

In New York, Democrat Kathy Hochul blasted her opponent, Republican Jane Corwin, for supporting Ryan's plan to end Medicare's fee-for-service system and replace it with "premium support" payments to help seniors buy their own private insurance plans. If there's anything the election taught us, it's that Republicans need to better prepare for these attacks and better articulate what Ryan's plan does and why they think it's necessary. It's safe to assume that no one wants to radically change Medicare if we don't have to.

Corwin admitted this week that she didn't do a good enough job confronting Hochul's attacks or explaining why she supports Ryan's plan. She took a while even to land on a talking point, saying in the end that Ryan's plan is about saving Medicare.

Today, Ryan sought to give Republicans a blueprint for how to sell his plan:

It shouldn't surprise us that Ryan's plan will be a tough sell on the campaign trail, and Republicans could be forgiven for feeling a bit queasy about how the public will react to it between now and 2012. In an April 14-17 ABC News/Washington Post poll, 65 percent said Medicare should remain as it is instead of shifting to a voucher system, which is very close to what Ryan is proposing.

Ryan's argument rests on this unpleasant notion: that Medicare is simply unsustainable. Either we drastically reduce its costs, or we go completely bankrupt. Ryan's video is packed with graphics explaining the long-term budget problem, along with some talking points about competition among private insurers, and how he sees that driving down costs.

That case was partially borne out by the Congressional Budget Office, which, in addition to finding that Ryan's plan will require seniors to pay far more for their own health care, reported in April that under current law, health care entitlement spending would balloon from 5.5 percent to 7.25 percent of U.S. GDP by 2022, while under Ryan's plan it would remain steady. The picture for 2050, which seems quite speculative given the long timeline, painted current law as far less sustainable than Ryan's plan.

Democrats may have found a campaign blueprint in New York: tell voters "my opponent wants to wreck Medicare, and I'll fight to save it." Ryan now hopes to give Republicans a blueprint of their own: tell voters "Medicare is unsustainable, and I'll fight to save it by keeping costs down."

Whether voters buy the idea of a looming Medicare doomsday is something we'll have to wait to find out.