Summary
The Democratic National Committee says in a TV ad that "Republicans voted to abolish Medicare." Not true.
The ad refers to a proposal endorsed by most House Republicans as part of the alternative budget they presented earlier this year. In fact, the GOP plan actually called for:
- Preserving the current Medicare program for anyone now receiving it, or within 10 years of qualifying for it.
- For those now under age 55, converting Medicare to a system of private, government-approved health insurance plans purchased mostly with government payments.
The proposal is similar to one endorsed a decade ago by the National Bipartisan Commission on the Future of Medicare. It is controversial, to be sure: Most Democrats don’t like it, and not all Republicans do either. It’s a plan to change Medicare significantly but not to "abolish" it.
Analysis
The DNC released the ad at the start of the Labor Day weekend. Besides claiming that Republicans "voted to abolish" Medicare, it also claims that "Republicans want to end Medicare" and that its leaders are now calling "for killing it."
The DNC also unveiled similar ads aimed at GOP House members, including Minority Leader John Boehner of Ohio and GOP Whip Eric Cantor of Virginia and eight others: Reps. Erik Paulsen of Minnesota, Jean Schmidt of Ohio, Paul Ryan of Wisconsin, Don Young of Alaska, Mary Bono Mack of California, Patrick Tiberi of Ohio, Lee Terry of Nebraska and Michele Bachmann of Minnesota, claiming in turn that each of them "voted to abolish Medicare" and is "no friend of seniors."
DNC Ad:
"Republicans Want To End Medicare"
[TET ]
Announcer: Republicans want to end Medicare. You heard right: Republicans actually voted to abolish Medicare for future generations.
One of the most important programs for seniors. America’s seniors have relied on Medicare for over 40 years, and Democrats are working to strengthen Medicare. But the plain truth is Republicans have opposed Medicare from the start. Their leaders have called for cutting Medicare, and now for killing it. The Republican party: No friend of seniors.
The Democratic National Committee is responsible for the content of this advertising. [/TET]
The ad is aimed at countering Republican claims that Democratic health care proposals would be paid for by reductions in Medicare benefits to seniors. (That claim made our list of "Seven Falsehoods About Health Care.") The DNC’s Communications Director Brad Woodhouse said: "You know that Republican attempts to lie and mislead the public have reached the height of absurdity when the GOP … tries to portray itself as an ally to this country’s senior citizens."
We’ve criticized Republicans and we’ve criticized Democrats for making scary, false accusations about Medicare. This latest round of ads just continues a pattern of partisan warfare by both sides that relies on false claims and appeals to fear.
"Voted to abolish?"
The DNC offered no factual back-up for its claims on its Web site. The TV ad itself cites House vote number 191 from March 20, 2009, as justification for the claim that Republicans "actually voted to abolish Medicare." But that was not a straight up-or-down vote on the existence of Medicare. Rather, it was a vote on a Republican alternative to the annual budget resolution that Congress passes to set targets for federal spending and revenues, to guide the appropriations and tax-writing committees. The GOP alternative budget contained a "policy statement on Medicare" calling for gradual conversion of Medicare from government insurance to government-subsidized and government-approved private insurance.
The statement set down a policy of enacting legislation "to ensure the Medicare benefit continues to provide health care coverage for seniors" through a new method "to make the program solvent and fiscally sustainable." It specifically called for legislation that "preserves the current Medicare program for individuals 55 and older." For younger persons, it called for the government to provide subsidies, equivalent to "100 percent of the cost of the Medicare benefit," for the purchase of private insurance "from a menu of Medicare-approved plans, similar to options available to Members of Congress."
The full debate on the GOP budget alternative, formally known as "amendment number 4" to House Concurrent Resolution number 85, may be read in the Congressional Record of April 2, 2009, starting on page H4469 and continuing through page H4487. The "Policy Statement on Medicare" appears on page H4474, and we have excerpted the full text of that statement here:
SEC. 301. POLICY STATEMENT ON MEDICARE.
(a) MEDICARE POLICY.—It is the policy of this concurrent resolution that Congress will enact legislation to ensure the Medicare benefit continues to provide health care coverage for seniors by establishing a new methodology to make the program solvent and fiscally sustainable. Legislation shall be enacted that:
(1) Expands protections for seniors against catastrophic medical costs, simplifies beneficiary contributions, updates Medicare payments, increases flexibility for hospitals serving unusually high numbers of low-income patients, and reduces the prescription drug benefit subsidy for high-income seniors (household incomes over $170,000). To ensure that the cost of frivolous litigation is not passed on to beneficiaries, the medical malpractice system is reformed.
(2) Preserves the current Medicare program for individuals 55 and older. For those under 55, the resolution gradually converts the current Medicare program into one in which Medicare beneficiaries receive a premium support payment—equivalent to 100 percent of the cost of the Medicare benefit—to purchase health coverage from a menu of Medicare-approved plans, similar to options available to Members of Congress. The premium support payment is risk-adjusted to increase with age and health status, and income-related so low-income seniors receive extra support. Premiums continue to be based on an all-beneficiary average, so the phasing of the younger population into the new program will not increase premiums for the population continuing in the existing program.
During House debate, Republican Rep. Paul Ryan of Wisconsin, the author of the GOP proposal, said of the Medicare portion:
Rep. Ryan, April 2: [A]ll we’re saying on Medicare for younger people, so we can save the program, why don’t we let them have a program like the one we have in Congress. We have a good health care program. I think it’s worthy of theirs.
In short, there was no vote to "abolish," "kill" or "end" Medicare. There was a vote on a GOP budget proposal that, among many other things, called for legislation that would gradually replace the current form of Medicare with a different model – and only for those now under age 55.
Pictures Speak Louder
To give the DNC credit, the ad’s announcer does make a gesture in the direction of factual accuracy by saying that the vote to "abolish" Medicare applies to "future generations." But the announcer also said "Republicans want to end Medicare" and that their leaders now favor "killing it," without any qualification. Meanwhile, the ad shows many images – not of persons under age 55 who actually might be affected – but of persons who all appear to be over age 65 and now enrolled in Medicare, the very ones for whom the GOP plan "preserves" the current form of the program. And nothing in the ad’s images or graphics reinforces the brief qualification voiced by the announcer. Overall, we judge the ad to contain a false message aimed at today’s Medicare recipients, not those of the year 2019 and beyond.
We of course neither endorse nor reject the GOP Medicare proposal. It certainly stirs strong objections, mainly among Democrats. During debate, Democratic Rep. Robert E. Andrews of New Jersey criticized the GOP proposal, saying it would leave younger workers to "fend for themselves":
Rep. Andrews, April 2: Madam Chairman, if you ever wonder what a third Bush term would look like, this is it. This is a budget plan that maintains the tax breaks for the wealthiest people in America, pays for it by giving people 55 and under a voucher to go fend for themselves in the insurance market instead of Medicare, which I think would pay maybe 80 percent of what it costs.
Actually, the GOP Medicare plan would have brought about little if any reduction in the cost of the program over the next decade, since anyone 55 or older would go onto the current system upon reaching age 65. (The GOP policy statement was silent on how or when disabled persons, who made up 16 percent of the Medicare population last year, might be affected by the plan.)
In fact, the GOP budget projected that Medicare spending would rise 88.5 percent during the 10 years covered by the GOP budget proposal – with outlays going from just under $427 billion in the current fiscal year (which ends Sept. 30) to more than $804 billion in fiscal 2019. Remember, this is the budget plan that the DNC’s ad says amounted to a vote to "abolish" Medicare.
The ad also claims that Republicans "have opposed Medicare from the start." It’s true that Democrats were chiefly responsible for enacting Medicare legislation, which was signed in 1965 by Democratic President Lyndon B. Johnson. And many Republicans did oppose it, but by no means all of them. When the House voted on final passage, 70 Republicans voted for it, and 68 voted against it. In the Senate, 13 Republicans voted in favor, and 17 against.
The ad also pictures former president George W. Bush as the first example of a Republican who "opposed Medicare." In fact, Bush pushed through and signed the largest expansion of Medicare since its inception – the prescription drug benefit.
A Good Idea?
We’ll leave it to our readers to judge which party has the better plan for Medicare. It’s worth noting, however, that something very similar to the GOP idea was endorsed by a majority of the National Bipartisan Commission on the Future of Medicare in 1999.
The proposal was authored by then-Sen. John Breaux of Louisiana, a Democrat, and supported by then-House member Bill Thomas of California, a Republican. Breaux and Thomas were co-chairmen of the commission. Just as with the GOP proposal, the Breaux plan envisioned giving Medicare recipients access to a variety of private, government-approved health plans with premiums heavily subsidized (at about 88 percent, initially) by the government. The proposal stated: "We believe modeling a system on the one Members of Congress use to obtain health care coverage for themselves and their families is appropriate," a sentiment later echoed by Rep. Ryan when explaining the GOP budget proposal.
Under the Breaux proposal, Medicare beneficiaries would have chosen from a menu of private managed care plans, but (unlike Ryan’s plan) also could have opted for the traditional, government-run, fee-for-service plan. Beneficiaries willing to pay extra could purchase an expanded benefit package. The plan ultimately was supported by 10 of the commission’s 17 members. Two Democrats supported it, Breaux and Sen. Robert Kerrey of Nebraska. All seven who opposed it were Democrats. But the 10-vote majority fell short of the 11-vote super-majority that was required to refer any recommendation to Congress and the president, so the proposal was not formally adopted.
Such ideas remain controversial and even Republicans aren’t unanimously in favor. Indeed, 38 House Republicans voted against the budget plan containing the Medicare policy statement. Republican Rep. J. Randy Forbes of Virginia, though he ultimately was among the 137 Republicans who supported the budget proposal, nevertheless said he had "strong reservations" about endorsing the Medicare proposal without more thorough study: "Before embarking on any change to Medicare to ensure that this program exists for my children’s generation and my grandchildren’s generation, I expect the House to engage in a thorough, earnest debate that we have not yet had."
Those seeking thorough, earnest debate won’t find it in the DNC’s 30-second TV ad, however. It mischaracterizes what Republicans actually voted for.
– by Brooks Jackson
Sources
Congressional Record: 2 Apr 2009; H4469-H4467.
U.S. Congress. "House Concurrent Resolution 85" 111th Congress, 1st Session.
"Building a Better Medicare for Today and Tomorrow," final Breaux-Thomas Medicare Reform Proposal, National Bipartisan Commission on the Future of Medicare. 16 Mar 1999.
"Record of the final vote.Meeting Agenda for Tuesday, March 16, to Consider the Final Breaux-Thomas Medicare Reform Proposal, National Bipartisan Commission on the Future of Medicare. 16 Mar 1999.
"After the Bipartisan Commission: What Next for Medicare?" Commonwealth Fund. Oct 1999.