Which $700 Billion?

Today’s Romney-Ryan-Republican demagoguery is that President Obama cut $700 billion from Medicare. Yesterday when he officially announced that he was adding Paul Ryan to the ticket, Mittens said,

“Unlike the current president, who has cut Medicare funding by $700 billion, we will preserve and protect Medicare and Social Security.”

And Mr. Caterpillar went further

“This president stole — he didn’t cut Medicare — he stole $700 billion from Medicare to fund Obamacare,” said Republican National Committee Chairman Reince Priebus, on NBC’s “Meet The Press.” “If any person in this entire debate has blood on their hands in regard to Medicare, it’s Barack Obama. He’s the one that’s destroying Medicare.”

The old lie was that Obama had cut $500 billion from Medicare, and I wondered where they got the new number. I saw it attributed to a new revised analysis of the Affordable Care Act by the Congressional Budget Office, done after the recent Supreme Court decision on the ACA. I found the analysis, dated July 2012, but it didn’t seem to say much about Medicare.

But then I found “Letter to the Honorable John Boehner providing an estimate for H.R. 6079, the Repeal of Obamacare Act,” dated July 24, 2012. Boehner had requested a revision on the budget impact of repealing the ACA.

So the CBO wrote back and said, dude, repealing Obamacare will cost us big time. It would add $109 billion to the federal deficit during the period 2013 to 2022. And then it said,

The ACA also includes a number of other provisions related to health care that are estimated to reduce net federal outlays (primarily for Medicare). By repealing those provisions, H.R. 6079 would increase other direct spending in the next decade by an estimated $711 billion.

And that’s where they got the $700 billion. If repealing Obamacare would add $700 billion to Medicare spending, it must be that Obamacare is draining $700 billion out of Medicare spending. Except, it isn’t. No programs are being cut; the the $700 billion represent savings in cost made possible by Obamacare.

For example, when the individual mandate kicks in in 2014, about 30 million more Americans will get health insurance who don’t have it now. That means hospitals won’t be stuck with so many unpaid bills, which will save them much money. The Obama administration used that to negotiate a reduction in Medicare hospital reimbursement rate. That’s a chunk of the $700 billion. Ending the overpayments to Medicare Advantage is another chunk. There are several other such chunks that should make it possible to run Medicare with less money.

The savings are to keep Medicare solvent. No benefits are being cut. The ACA is not taking money away from Medicare and giving it to some other program. Now, it’s possible that when all the pieces are in motion it will not work as planned, but to say that the $700 billion is being cut out of Medicare to fund “Obamacare” is just dishonest.

Paul Ryan’s budget, on the other hand, cuts just as much out of Medicare to help fund tax cuts for the wealthy.

We’re going to be hearing all about the awful $700 billion over the next few days, if not weeks. I just thought we all ought to be clear about what’s being discussed.

Way to Go, Fetus People

I keep hearing about states like Mississippi and Arizona closing abortion clinics and restricting abortion, and I’ve been wondering why we haven’t heard much about back-alley abortions. And now I know why. Women who can’t get an abortion in the U.S. are going to Mexico, where a miscarriage-inducing drug is available over the counter.

The catch is that abortion is illegal in most of Mexico also, so even though the drug — mifepristone — is available over the counter, and everyone knows taking it can terminate a pregnancy, women who purchase it have to pretend its for their ulcers. And the pharmacy workers, who know good and well why all these women are buying mifepristone, cannot give them directions about the correct dosage. So the women either don’t take enough, and stay pregnant; or they take too much and have to be hospitalized for bleeding.

The Choice

Ralph Nader must be slowing down. He hasn’t yet issued an open letter declaring there’s not a dime’s worth of difference between the two tickets. Give him another 72 hours.

Of course, there really is a huge difference between the two tickets. Let’s hope voters notice before November.

Jonathan Chait writes that Paul Ryan’s placement on the ticket signals that “movement conservatism” now is in complete control of the Republican Party. It feels as if they’ve been in control for the past 30 years. However,

What makes Ryan so extraordinary is that he is not just a handsome slickster skilled at conveying sincerity with a winsome heartland affect. Pols like that come along every year. He is also (as Rich Yeselson put it) the chief party theoretician. Far more than even Ronald Reagan, he is deeply grounded is the ideological precepts of the conservative movement — a longtime Ayn Rand devotee who imbibed deeply from the lunatic supply-side tracts of Jude Wanniski and George Gilder. He has not merely formed an alliance with the movement, he is a product of it.

In this sense, Ryan’s nomination represents an important historical marker and the completion of a 50-year struggle. Starting in the early sixties, conservative activists set out to seize control of the Republican Party. At the time the party was firmly in the hands of Establishmentarians who had made their peace with the New Deal, but the activists regarded the entire development of the modern regulatory and welfare states as a horrific assault on freedom bound to lead to imminent societal collapse. In fits and starts, the conservatives slowly advanced – nominating Goldwater, retreating under Nixon, nominating Reagan, retreating as Reagan sought to govern, and on and on through Gingrich, Bush, and his successors.

Over time the movement and the party have grown synonymous, and Ryan’s nominations represents a moment when the conservative movement ceased to control the politicians from behind the scenes and openly assumed the mantle of power.

Romney, meanwhile, is still pretending to be his own man and says he will not run on Mr. Ryan’s infamous budget, but will produce his own budget. Don’t hold your breath waiting for details until you enjoy passing out. It’s plain that, if elected, Mittens will be hostage to the Ryan Republicans. And we’ll all be screwed.