Huffpost Politics
The Blog

Featuring fresh takes and real-time analysis from HuffPost's signature lineup of contributors

Ethan Rome Headshot

Republicans Want to Replace Medicare With Rationcare

Posted: Updated:

The Republican "Path to Prosperity" proposed by House Budget Chairman Paul Ryan of Wisconsin eliminates Medicare as we know it. The nation's most efficient health insurance program would be turned over to the private insurance industry and seniors issued "ration cards" instead of Medicare cards. Seniors would pay more and get less care, while health insurance companies would make more billions in profits. This isn't reform - it's rationing. It's Republican Rationcare.

The Republicans would dismantle Medicare, trading seniors' guaranteed health care benefits for so-called vouchers that send hundreds of billions of dollars directly to private insurance companies. Beneficiaries would be forced to pay two to three times more than they would if the law remained unchanged. For someone turning 65 in 2022, the first year of the program, the voucher would be worth $8,000, which is less than the average cost per Medicare beneficiary today. The vouchers are deliberately underfunded and the result is that seniors would pay a staggering 68 percent of the cost of their medical care in 2030, compared to 25 percent if the law were unchanged, according to the Congressional Budget Office.

So on Day One of this Republican pipe dream, folks start out thousands of dollars behind. Then the voucher would lag behind the growth in actual medical costs because it would rise in step with the Consumer Price Index and as people's age and medical expenses rise. Using the CBO assumption of 2.5 percent annual inflation, the voucher would only grow to $9,750 by 2030. As a result, a person age 65 would be saddled with $20,700 in out-of-pocket medical costs. And that doesn't even count health care expenditures that aren't covered by Medicare. Welcome to the Republican vision of middle-class retirement. Americans can fill their golden years by juggling the challenges of rationed access to doctors and hospitals and the inability to put food on the table and pills in the medicine cabinet.

Adding insult to injury, the GOP is also hatching an appalling scheme to devastate America's seniors and families with $1.4 trillion in Medicaid cuts. This Republican plan would desert millions of children, people with disabilities and chronic diseases, and seniors who need help paying for long-term care. It would decimate the working poor and leave hospitals without enough money to provide lifesaving care.

So who benefits from the Republicans' Medicare scheme? Not you. The proposal would shift billions in health care costs onto seniors while making insurers even more profitable, making their overpaid CEOs, corporate lobbyists and Republican campaign contributors even richer. The health insurance industry will manage an estimated $863 billion in premiums this year. Under the Ryan plan, they'll get hundreds of billions of dollars more. To Republicans, this proposal makes all the sense in the world. After all, the GOP is a wholly owned subsidiary of billionaires like the Koch Brothers and global corporations that do business in America.

Insurance companies are well-suited to the task of rationing care for seniors. They have vast experience jacking up premium rates and denying care to the rest of the population. For the insurance industry it would be a seamless transition.

According to the private-market zealots at the Koch Brothers-funded Cato Institute, this will all be fine. Much of Medicare's spending is optional care that seniors would forgo if they paid a greater portion of the costs. Seniors "might even decide not to do the critical care" if it was too costly, Michael Tanner, Cato's health policy point man, told Politico Pro. If some of those costs were picked up by the individual, they might decide they wanted to save their resources for their survivors, Tanner said.

The pretense is over. The Republican plan is rationing. It's heartless. It won't be Medicare anymore. You can call it Medicareless or Republican Rationcare, but by any name, it would no longer be the guaranteed health care program that has served our nation so well since 1965.