After his last attempt at a budget went down in flames last year, House Budget Committee Chairman Paul Ryan (R-WI) unveiled the House GOP’s new budget this morning, painting it as a sensible plan to reform the nation’s tax code and reduce the debt while maintaining entitlement programs like Social Security, Medicare, and Medicaid. Yet again, however, Ryan and the GOP have the social safety net and Medicare in their sights, and yet again, they’re attempting to pass the cost of massive tax breaks for corporations and the rich off to middle and lower-income Americans.
Here are the five worst things about Ryan’s budget:
1. SENIORS WOULD PAY MORE FOR HEALTH CARE: Beginning 2023, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or traditional fee-for-service Medicare. But the budget does not take sufficient precautions to prevent insurers from cherry-picking the the healthiest beneficiaries from traditional Medicare and leaving sicker applicants to the government. As a result, traditional Medicare costs could skyrocket, forcing even more seniors out of the government program. The budget also adopts a per capita cost cap of GDP growth plus 0.5 percent, without specifying how it would enforce it. This makes it likely that the cap would limit the government contribution provided to beneficiaries and since the proposed growth rate is much slower than the projected growth in health care costs, CBO estimates that new beneficiaries could pay up to $1,200 more by 2030 and more than $5,900 more by 2050. Finally, the budget would also raise Medicare’s age of eligibility to 67. Some seniors who would no longer be eligible for Medicare would pick up employer coverage—but they would pay more in premiums and cost sharing. And since the budget would scale back or eliminate other coverage options, hundreds of thousands of seniors would become uninsured.
2. ELDERLY AND DISABLED WOULD LOSE MEDICAID COVERAGE: The budget would eliminate the exiting matching-grant financing structure of Medicaid and would instead give each state a pre-determined block grant that does not keep up with actual health care spending. This would shift some of the burden of Medicaid’s growing costs to the states, forcing them to — in the words of the CBO — make cutbacks that “involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost sharing by beneficiaries—all of which would reduce access to care.” The block grants would reduce federal Medicaid spending by $810 billion over 10 years, decreasing federal Medicaid spending by more than 35 percent over the decade. As a result, states could reduce enrollment by more than 14 million people, or almost 20 percent—even if they are were able to slow the growth in health care costs substantially.
3. THIRTY MILLION AMERICANS WOULD LOSE HEALTH COVERAGE: The budget repeals the Affordable Care Act’s requirement to purchase health insurance coverage, the establishment of health insurance exchanges and the provision of subsidies for lower-income Americans, the expansion of the Medicaid program, tax credits for small businesses that provide insurance coverage. As a result, more than 30 million Americans would lose coverage and the budget would eliminate the new law’s consumer protections, which have already benefited tens of millions of Americans.
4. CORPORATIONS AND THE RICH WOULD GET A $3 TRILLION TAX CUT: By repealing the Alternative Minimum Tax and the investment taxes in the Affordable Care Act and lowering the top income tax rate to 25 percent, the Ryan budget provides the wealthiest Americans with $2 trillion in tax breaks. By lowering the top corporate tax rate and allowing corporations to return profits made overseas to the United States at no cost, he gives corporations more than $1 trillion in tax breaks. Ryan insists his plan will be revenue neutral — he just won’t say how. The CBO’s scoring of the plan, meanwhile, is based on Ryan’s own assertions that the plan would maintain or increase revenue.
5. DEFENSE BUDGET WOULD GET A BOOST, WHILE THE SAFETY NET IS CUT: The Ryan budget protects defense spending from automatic cuts agreed to in last year’s debt deal, then boosts defense spending to $554 billion in 2013 — $8 billion more than agreed upon in the deal. At the same time, it asks six Congressional committees to find $261 billion in cuts. That includes $33.2 billion from the Agriculture Committee, meaning food stamps and other social safety net programs are likely to face cuts, all while the Pentagon remains untouched.
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