Wednesday, May 25, 2011

Five Medicare Lessons from NY-26 Election: POLITICO

By DAVID NATHER 5/25/11 4:44 PM EDT

Who would’ve thunk it? One party calls for changing the Medicare program to save money, the other party crushes them at the polls.

Democrat Kathy Hochul’s big win in the New York special election Tuesday proved that voters are not, in fact, rewarding Republicans for political bravery in backing Paul Ryan’s Medicare plan. But then, they didn’t reward Democrats in 2010 for passing a health care reform law with about $500 billion in Medicare savings, either.

And yet, neither side can just leave Medicare alone forever, if they want to make an actual dent in the deficit. So here are five lessons they can learn from the New York election for the next round:

Don’t propose things that change the game for everyone. Ryan’s plan would switch everyone into a new Medicare “premium support” program — subsidizing private insurance, rather than covering seniors directly — starting in 2022. Republicans insisted that anyone age 55 or older wouldn’t be affected, but everyone else would have to go into those plans.

And Democrats have been arguing that even current seniors would lose out under the plan, because new Medicare benefits under the health care reform law — such as beefed-up prescription drug coverage and annual wellness visits — would be repealed.

Under other versions of the Medicare premium support plan — like the bipartisan deficit proposal by former Sen. Pete Domenici and former Office of Management and Budget director Alice Rivlin — seniors can go into Medicare premium support if they want, but they can also stay in traditional Medicare if they want. Making it a choice, rather than a requirement, might make Medicare premium support a bit less scary to seniors. And there are other bipartisan ideas that leave Medicare the way it is but get money out of milder changes, like making seniors pay higher cost-sharing.

Stick to bipartisan deficit plans for political cover. The deficit commission headed by Alan Simpson and Erskine Bowles is the most well-known example, but there are others, like the Domenici-Rivlin plan. Any idea pulled from one of those plans — like higher cost-sharing for seniors — gives either Republicans or Democrats an instant political shield that can at least limit the damage. By choosing a mandatory Medicare premium support program, Ryan didn’t have that kind of cover.

Think about how it can be distorted. Political operatives from both sides are supposed to do this, but if they have, it hasn’t stopped their bosses from charging ahead. Fairly or unfairly, Democrats have been able to call the House Medicare proposal a “plan to end Medicare” because it would fundamentally change the structure of the program.

And fairly or unfairly, Republicans were able to attack Democrats last year for “cutting Medicare” because the health reform law gets about $500 billion in savings out of slowing payment increases to providers and Medicare Advantage plans. (Ryan’s plan keeps those savings, by the way.) Lesson: If your political opponent can make your plan sound that scary, think twice about it.

Pay attention to the polls. It’s not that House Republicans weren’t warned; GOP pollsters gave them plenty of warnings about the political dangers of the Ryan plan before they voted on it. Likewise, by the time Democrats took the final vote on health care reform in March 2010, they had had months of polls showing how unpopular the plan had become since the August 2009 town halls. They just decided the opposition would fade once the public learned more about the law — a prediction that, for the most part, hasn’t come true.

If you fire, the other side will probably fire back. Republicans won big with seniors in 2010 by attacking Democrats over the reform law’s Medicare cuts. How predictable was it that, this year, Democrats would attack Republicans if they put out a plan with Medicare cuts? About as predictable as politics can get.

And likewise, now that the Democrats have gotten so much mileage out of beating up on the Ryan plan — a process that will continue with the upcoming Senate vote on it — expect a sharper Republican attack against any Medicare savings plan the Democrats put out on their own. That includes Obama’s deficit reduction plan, which strengthens the Independent Payment Advisory Board, the reform law’s panel of experts who are supposed to propose more Medicare savings. Speaking on "Morning Joe" Wednesday, Ryan called it a “rationing board.” Other Republicans may be tempted to step up their attacks on “unelected bureaucrats” making medical decisions.

And that’s how the cycle will go, until one party or the other proposes a cease-fire on Medicare — which isn’t likely now until, say, 2013.

“Yes, we will be giving our political adversaries things to use against us in the next election, and shame on them if they do that,” Ryan said in April shortly before he unveiled the budget plan. But there’s plenty of shame to go around — and the biggest lesson of the N.Y. 26 race may be that shame doesn’t work as a political strategy.

My Thoughts..

The election in NY-26 last night was, contrary to GOP statements, something of a major event. To start, the district in question has traditionally been a solid Republican area and considered a "safe bet". Then suddenly, the Democratic challenger, Kathy Hochul (a political nobody apparently) and the third party candidate, Jack Davis changed the tone of the race dramatically.

The third party candidate, Jack Davis, is arguably a winner in the election even though he didn't actually win. His victory was over the Republican party for which he was a member for most of his life until he apparently had a falling out with the party over him wishing to question former VP Dick Cheney about free trade issues. He then tried several times to challenge the GOP for the NY-26 seat running as an independent and even as a Democrat occasionally. However this year he chose to run as a Tea Party candidate against the incumbent Jane Corwin. He's main political view during the election was neither party is taking the threat from China seriously and the US free trade practices need radical change. For his efforts, he succeeded in getting some 9% of the vote, most of which would probably have gone to the GOP candidate.

But the star of the show is definitely Democrat Kathy Hochul, though calling her a "star" is something of a stretch. Ms. Hochul was something of a political nobody before the election, with her experience including being a practicing attorney and legislative aide. Combine that with the fact she is not the typical Democrat in that she stated she supported major cuts to the federal government to deal with the deficit, being largely pro-life (though not to the same degree as her fellow candidates), and opposing new and existing free trade agreements. However she does support "ObamaCare" and does not support Congressman Paul Ryan's proposal of changing Medicare which she made her primary issue.

And that was the elephant in the room of this election. There was a good deal of mud-throwing over Mr. Ryan's proposal for reforming Medicare, with the Democratic candidate using the plan (which is generally disliked according to most national polls) to beat over the GOP's head. So much so that Charles Krauthammer stated on Fox's O'Reilly Factor the other night that it was likely the election would be decided because of the "MediScare" threat.

But as many commentators have pointed out, Special Elections are not the best gauge for making political predictions. While it does make it clear the Ryan Plan does worry some and Democrats are likely to take advantage of that worry and try to make it a major issue next year. Strikingly, former President Bill Clinton today commented that while he was happy the Democrats won the seat, he did not want Democrats to copy this strategy for next year's election because of the problem of trying to scare people about the issue (hence Krauthammer's reference to MediScare).

So yes, this special election showed that the Ryan Plan is becoming something of a problem for the GOP and if they want the plan to become reality they will need to launch a major counter attack to convince voters their plan is better than the alternative. However, focusing on this single issue will not bring Democrats back to power and could possibly backfire in the long term as voters become more irritated with talk of Medicare instead of talking about fixing the economy.

Personally, I have not made up my mind on the Paul Ryan Budget proposal. To deny it is a radical plan is pretty hard but radical change will be necessary to fix the looming budget crisis. I like Bill Clinton, don't necessarily love the plan but so far I have see no real alternatives from the Democrats and many aspects of Ryan's plan are appealing to me. Regardless, the plan deserves to be studied and debated openly and publicly and not demonized for short term political gains.

No comments:

Post a Comment