The Democrats' Medicare Problem

| Fri May. 13, 2011 3:00 AM PDT

Democrats have had a field day attacking Republicans for supporting Paul Ryan's drastic plan to voucherize Medicare. Now Republicans are starting to push back—and their counterattacks could highlight some of the Democrats' own vulnerabilities on the popular entitlement program for seniors. 

Republicans have already launched an ad against Rep. Jerry McNerney (D-Ca.), a Democrat representing a Northern California swing district, Politico reports. In the television ad, Republicans claim that "McNerney and President Obama's Medicare plan empowers bureaucrats to interfere with doctors, risking seniors' access to treatment. Now, Obama's budget plan lets Medicare go bankrupt: That'd mean big cuts to benefits. Tell McNerney to stop bankrupting Medicare."

The first sentence of the ad refers to a new Medicare payment advisory panel created by Obama's Affordable Care Act. The ACA empowers an independent, Senate-approved group of experts to reduce Medicare costs—so long as their actions don't ration care, increase premiums, or decrease coverage. In terms of keeping wasteful spending and costs down, it's one of the most important pieces of the federal reform—and one of the most widely misunderstood, reviled by the GOP as the new "death panel." House Democrats were wary of supporting the panel to begin with, and concerned about its ability to bypass legislators. (Congress can still vote to override the panel's decisions, but the panel doesn't need advance approval to act.) Now a small but growing number of Dems have signed on to a GOP effort to scrap the panel, known as the Independent Payment Advisory Board (IPAB).

So in response to the message that Republicans would end up placing seniors at the mercy of rapacious, private-hungry private insurers, the GOP will contend that faceless, unelected bureaucrats will be trimming Medicare instead. Democrats, of course, could argue that they're just trying to set fairer ground rules for the health-care market, which has victimized consumers through sky-high costs and unjust practices. But some Dems' willingness to sign on to the bill that would repeal IPAB shows that they may not be entirely confident in that argument.

To be sure, Obama has not only vowed to protect IPAB but also promised to strengthen its authority. Politically speaking, it could be an uphill battle for Democrats to explain their own reform plan for Medicare—and, as I predicted last month, Republicans will do everything they can to exploit that vulnerability. 

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