Paying for Obamacare

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A couple of nights ago Bob Somerby watched the folks on MSNBC discussing the Ryan/Romney charge that Democrats “funneled” $716 billion out of Medicare to pay for Obamacare. He was unhappy with the liberal response:

On Wednesday, Rachel Maddow asked Ezra Klein to clear up all the confusion….But uh-oh! Like his blog-mate Sarah Kliff, Klein largely repeated Romney’s Medicare charges—restated those charges in his own voice!

….Go ahead—ask yourself this: At any point, does Klein make a clear, concise statement about what Ryan said that was wrong? No such statement ever occurs in this wandering ballad. Instead, Klein throws a bewildering array of figures and claims into a very thick stew.

The problem here is simple: there is no silver bullet liberal response to Ryan’s Medicare charges. This is because, rhetorical excesses aside, his charges are basically correct.

Unlike most Republican programs of the Bush era, Obamacare is fully paid for — as Obama himself has boasted repeatedly. This was an act of political courage for which Democrats deserve credit, but it was only courageous because it has a downside. And the downside is that the money to pay for Obamacare had to come from somewhere. In the end, most of it came from two places: (1) an assortment of modest tax increases, and (2) an assortment of modest spending reductions on Medicare.

There’s really no way around this: Planned spending on Medicare was reduced, and the savings were applied to Obamacare. These savings came from cutting payments to hospitals and insurance companies, not from cutting benefits to seniors, but it’s still perfectly defensible for conservatives to argue that the spending reductions may eventually lead to service or quality cuts in Medicare. There are some strong arguments that this won’t happen, but they’re hardly bulletproof.

So do liberal responses to Ryan’s charges seem muddled? Of course they do. That’s because people like Ezra don’t like to flatly lie about this stuff, which is the only way to construct a clear and simple rebuttal. Instead, liberal wonks have to explain where the spending reductions came from and why they aren’t likely to have a substantial effect on Medicare beneficiaries. But no matter how you do that — and I agree that we should probably have crisper replies than we do — you’re implicitly acknowledging Ryan’s point that money which would have been spent on Medicare is now going to be spent instead on Obamacare.

The best response, I suppose, is to either evade the question entirely (the pol’s approach) or to keep things very, very short and simple. For example: “There were no cuts to Medicare benefits. President Obama is dedicated to making Medicare more efficient, and to do that he cut bloated payments to hospitals and big insurance companies. Why does Mitt Romney want to give that money back?” And then move on.

But the one thing you can’t do is pretend that money wasn’t taken from Medicare to help pay for Obamacare. It was.

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And the truth is, going into the final 4 days of the year we still needed to raise $TK to hit our $350,000 goal and start 2021 on track. It's nerve-wracking, wondering if the big spike we normally see at the end of December is going to be another thing that doesn't go as planned in 2020, or worse, if, now that Donald Trump is set to leave the White House (for longer than a taxpayer-funded golf trip to a property he owns), folks might be pulling back from fighting for the truth and a democracy and think the hard work is done.

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