Nice Admission

Paul Ryan (R-WI), on Republican efforts on health care:

FRANK: I just want to ask Paul one question. … When did you figure that out? Because apparently for the 12 years that the Republicans were in control — eight of which had a Republican president — that hadn’t occurred to you. So I’m glad you now understand that. Can you tell me at what moment the revelation occurred?

RYAN: First of all, I introduced on this subject about six years ago.

FRANK: You had control of the Congress. Why didn’t the Republican Congress fix it?

RYAN: I will have a moment of bipartisan agreement. We should have fixed this under our watch and I’m frustrated we didn’t.

The simple answer is that Republicans have no interest in policy. They have an interest in power and profit-taking. That's pretty much it.

Wanted: Left-Wing Demagogues

That after months of tea parties and protests against Big Gubmint takeovers and socialism, the Republican Party would come out as the defenders of Medicare has got to be one of the most hilarious things I've ever witnessed. If the rank and file agitators had half a brain they'd recognize how they've been played for suckers.



Nothing like limited-government conservatism.

This is of course a big sham.

Michael Steele tells me the Democrats want to dismantle Medicare. So my first question is simple: Why do Democrats hate Medicare?

The hypocrisy is shameless. I won't go through the history of Medicare, but for Republicans to say that you should trust us on Medicare is like Colonel Sanders guarding the chicken coop. I think most seniors know that, and these scare tactics will boomerang. I don't think people will buy it, since the guys peddling this stuff are the very people who have been trying to undermine and weaken Medicare for years and years. There was a budget alternative put forward by Paul Ryan this year that would have ended Medicare as we know it and given all seniors a voucher to get their health care on the private market. And they voted for it. So we know what they wanted to do with Medicare.

Actually, people don't know this story. Because Democrats haven't bothered to tell it.

Here's that alternative budget. The Ryan proposal would have converted the entire Medicare program into a voucher system, throwing seniors onto the individual market with a fixed amount of money to purchase their own plan. It didn't have insurance regulatory reform, to my knowledge, so all the voucher money in the world wouldn't have helped one senior get coverage from companies who would deny all of them based on a pre-existing condition.

Now, establishment Democrats may find this funny, but they haven't informed the public that, five months ago, 80% of the GOP caucus voted to eliminate Medicare and turn it into a private, voucher-based individual market without guaranteed coverage. They just expect seniors to know about some alternative budget vote.

How the hell would they know?

Was one ad created telling America what Republicans were willing to do to their health care? Was one flyer sent from the vaunted DNC voter file into targeted senior-heavy districts explaining this tale? Was any talking head discussing on television the goal of the GOP to eliminate Medicare, and their votes for it?

I mean, this was the kind of stuff Democratic strategists at least used to be good at. If you can't scare seniors to death over a vote to ELIMINATE MEDICARE, you cannot hope to win a health care fight. It's at least worth a try now, but it may be too late at this point; seniors are already nervous about cuts that would come in a new bill, and they no longer trust Democrats to do right by them. A well-timed push back in April could have shut down the resonance of the entire tea party movement. "Republicans want to eliminate your Medicare... Democrats want to strengthen it, for you and for future generations." Is that so hard?

Sometimes I think this isn't a political party but an elaborate episode of Candid Camera.

This Week In Health Care

Ezra Klein is moving to the Washington Post. That's great - Ezra is one of my favorite bloggers, and I particularly appreciate his ability to drill down on health care policy. So in his honor, here's a great big health care post!

I would describe the prevailing mood from health care policy experts on the Hill as ebullient. The Senate committee chairs with jurisdiction are planning to mark up a bill by June, while working in close concert so the bills aren't all that different, and a final vote is expected by early fall. This appears to be happening.

The question, of course, is "what is happening?" What form will this legislation take? Some liberals are alarmed by the subtle shifts in the debate, and for good reason.

As Congress returns to begin an intense debate over reshaping the nation's $2.2 trillion health-care system, prominent left-leaning organizations and liberal House members are issuing a warning to their Democratic allies: Don't cave on us.

The early skirmishing -- essentially amounting to friendly fire -- is perhaps the clearest indication yet of the uphill battle President Obama faces in delivering on his promise to make affordable, high-quality care available to every American.

Disputes over whether to create a new government-sponsored insurance program to compete with private companies shine a light on the intraparty fissures that may prove more problematic than any partisan brawl.

More than 70 House Democrats recently warned party leaders that they will not support a broad health reform bill that does not offer consumers a government-sponsored policy, and two unions withdrew from a high-profile health coalition because it would not endorse a public plan.

"It's way too early" to abandon what it considers a central plank in health reform, said Andy Stern, president of the Service Employees International Union. He said the organization pulled out of the bipartisan Health Reform Dialogue because it feared its friends in the coalition were sacrificing core principles too soon. "You don't make compromises with your allies."

Ultimately, I think the Administration supports a public plan, but they're willing to make it more of a public plan in name only (PPINO?), along the lines of Uwe Reinhardt's plan, which would operate like Medicare, but not paying the same bargain rates. That makes little sense to me and doesn't do much more than add a non-profit health care provider to the space. It won't necessarily force the private market to compete on price and quality, and given that a separate set of rules would do away with pre-existing condition and rate communities with a standard price, I don't see the benefit to a neutered public option. Reinhardt's plan isn't all bad, and it's actually better than other "level playing field" options I've heard. But I question its efficacy, and think that progressives still ought to push for a real public option.

The other big fight is over budget reconciliation, allowing Congress to pass the budget, with health care embedded therein, on a party-line vote instead of it being subject to filibuster.

Under the reconciliation process, the House and the Senate first agree on an overall budget blueprint and then pursue legislation — in this case, the health care overhaul — “reconciling” the blueprint with the needed policy changes. If enough Senate Democrats support the legislation, the White House would not need a single Republican vote.

The House adopted its version of the budget with the procedural shortcut. The Senate has been reluctant to authorize it, but may ultimately follow the House’s lead as the two chambers try to work out their differences.

A health care bill written mainly or entirely by Democrats would almost surely create a new public health insurance program, to compete with private insurers. It would require employers to provide insurance to employees or contribute to its cost. Employers who already offer insurance could be required to provide more or different benefits, and Congress could limit the tax breaks now available for such employer-provided insurance.

There's actually a budget vote today that would keep the option of reconciliation alive for health care, which Democrats in the Senate appear to be ready to allow, or at least not kill for now, since the leverage from threatening it can at least get Republicans to the bargaining table. This is an option, it must be said, that is a commonly used technique by both parties over the last three decades, and does not represent anything approaching a power grab. Nevertheless, obstructionist Republicans are vowing all-out war if Democrats go the route of reconciliation.

Although Senate Democrats are far from reaching a consensus on the reconciliation issue, party leaders confirmed Wednesday that they are reserving the right to use it to pass health care reform if Republicans fail to negotiate in good faith. Senate Republicans — saying they have every intention of being a full partner in the upcoming health care negotiations — said holding reconciliation in reserve could poison the discussions, and threatened retribution.

“If they go down that road, I think the fur is going to fly,” Senate Republican Conference Vice Chairman John Thune (S.D.) said. “I suspect that there is going to be an awful lot of resistance, and we will exercise our prerogatives so that the rules of the Senate are respected.” [...]

Sen. Lindsey Graham (R-S.C.), who was a member of the 2005 bipartisan “Gang of 14” that negotiated a deal on President George W. Bush’s stalled judicial nominees, said he would be willing to tap into the Senate’s parliamentary arsenal to block the majority from pursuing its agenda.

Similarly, National Republican Senatorial Committee John Cornyn (Texas) and Sen. Orrin Hatch (R-Utah) predicted that the GOP Conference would respond to Democrats’ use of reconciliation on health care with tough action.

What's comical about this is that Republicans are CURRENTLY using everything in their parliamentary arsenal to block the President and the Democratic Congress' agenda. Just today they blocked a vote on Kathleen Sebelius for Health and Human Services Secretary, despite the fact that she has enough votes on the floor to beat a filibuster (two Republicans voted her out of committee, plus 58 Democrats). And the head of the RNC has called on Obama to withdraw Sebelius from the position, all because she supports reproductive choice, as does the President, who was elected by the American people by a wide margin. I don't know how much more Republican obstructionists could possibly slow the chamber, given the circumstances.

Meanwhile, even their leadership is off message on this. Here's Paul Ryan on reconciliation.

“It's their right. They did win the election,” said Ryan, R-Wis. “That’s what I tell all my constituents who are worried about this. They won the election. They did run on these ideas. They did run on nationalizing health care. So, you're right about that. They have the votes with reconciliation. They nailed down the process so that they can make sure they have the votes and that they can get this thing through really fast. It is their right. It is what they can do.”

More proof that the GOP is stumbling around on this health care fight, without an alternative option and without a strategy other than "block that kick." They're giving the Administration and the Democratic Congress little choice but to blow right by them, and in that case, Democrats ought to get everything they can in the absence of Republican participation.

New And Improved, With Numbers!

Tired of all the mockery, Congressional Republicans today released a budget - OK, made a plan to release a budget.

House Minority Leader John Boehner (R-Ohio) and Senate Minority Leader Mitch McConnell joined their colleagues, entering from the side, and addressed the gathered reporters.

After ripping the Democratic budget as too expensive, Boehner said that "Republicans in the House will offer a better solution that'll be less on spending, less on taxes and a lot less on debt for our kids and grandkids."

But there was no budget. "Do you guys have a formal budget yet?" asked a reporter.

"Mr. Ryan will outline the Republican budget at 10:30 this morning. And yes we do have it," replied Boehner, referring to Rep. Paul Ryan (R-Wisc.).

A silence followed, with reporters apparently unsure what to ask next.

I'm beginning to think the Republican Party is a giant episode of "Punk'd."

What amounts to the alternative budget, as described by Paul Ryan in the Wall Street Journal, consists mainly of those innovative and fresh ideas like cutting taxes on corporations and the wealthy, freezing spending in the middle of a recession, and drilling for oil.

* Deficits/Debt. The Republican budget achieves lower deficits than the Democratic plan in every year, and by 2019 yields half the deficit proposed by the president. By doing so, we control government debt: Under our plan, debt held by the public is $3.6 trillion less during the budget period.

* Spending. Our budget gives priority to national defense and veterans' health care. We freeze all other discretionary spending for five years, allowing it to grow modestly after that. We also place all spending under a statutory spending cap backed up by tough budget enforcement.

* Energy. Our budget lays a firm foundation to position the U.S. to meet three important strategic energy goals: reducing U.S. dependence on foreign oil, deploying more clean and renewable energy sources free of greenhouse gas, and supporting economic growth. We do these things by rejecting the president's cap-and-trade scheme, by opening exploration on our nation's oil and gas fields, and by investing the proceeds in a new clean energy trust fund, infrastructure and further deficit reduction.

* Tax Reform. Our budget does not raise taxes, and makes permanent the 2001 and 2003 tax laws. In fact, we cut taxes and reform the tax system. Individuals can choose to pay their federal taxes under the existing code, or move to a highly simplified system that fits on a post card, with few deductions and two rates. Specifically, couples pay 10% on their first $100,000 in income (singles on $50,000) and 25% above that. Capital gains and dividends are taxed at 15%, and the death tax is repealed. The proposal includes generous standard and personal exemptions such that a family of four earning $39,000 would not pay tax on that amount. In an effort to revive peoples' lost savings, and to create an incentive for risk-taking and investment, the budget repeals the capital gains tax through 2010 for all taxpayers.

On the business side, the budget permanently cuts the uncompetitive corporate income tax rate -- currently the second highest in the industrialized world -- to 25%. This puts American companies in a better position to lead in the global economy, promotes jobs here at home, and strengthens worker paychecks.

In case you missed it, Ryan wants to drill offshore in order to fund clean energy. My head hurts now.

They also helpfully scored the competing budgets over a 70-year time-frame, and while I think they're off a bit in 2072, you can plainly see that government under Robot Obama, who will be governing until he is 117, will explode in size.

Ryan also came up with a new health care plan while simultaneously cutting entitlements, a neat trick. (This shows that Republicans are deathly afraid of being left behind on health care reform, actually. It's quite interesting.)... aha, I see how they pull this off, they actually phase out Medicare over time. Brilliant!

Ryan calls on the Administration not to sow fear over their alternative budget at the same time that Judd Gregg takes to the Washington Post to sow fear about the President's budget. But it's not working. Americans don't mind investments in their future; in fact, they voted for them. And the Obama budget would actually reduce federal deficits by $900 billion dollars compared to current policies. The cuts are simply in programs and areas that conservatives don't like, such as ending privatization in various forms, stopping cost overruns in defense, incorporating tax fairness, and pulling back on subsidies for rich corporations.

Party of No Numbers

The GOP's "budget" was roundly mocked throughout Democratic circles and even in the suddenly-caring-about-policy traditional media for not having any numbers, the way that, you know, a budget does. Yesterday, John McCain sought to calm the waters by claiming that the Senate GOP would put together, in fact, an actual budget with hard numbers instead of just a pamphlet with a bunch of circles and positive affirmations.

DAVID GREGORY: Do you think that Republicans should provide a detailed budget alternative?

McCAIN: Yes.

GREGORY: With numbers?

McCAIN: Yes.

GREGORY: Will that happen in the Senate?

McCAIN: We're working on it, working very hard on it.

Rick Klein reports that Sen. McCain is mistaken.

According to a spokesman for Senate Minority Leader Mitch McConnell, R-Ky., the Senate GOP's plan remains the same: Republicans are planning to offer individual amendments to the Democratic budget but not a detailed, comprehensive budget of their own.

Sen. Judd Gregg, R-N.H., the top Republican on the Senate Budget Committee, has pointed out that if the GOP amendments are accepted en masse (which will not happen), the amended budget would be the Republican alternative. Senate GOP leaders have also pointed out that Senate Democrats didn’t offer a detailed alternative budget in 2005 and 2006, when Republicans last controlled the Senate.

In any event, a full budget alternative may be what McCain wants, but it's not going to be what happens.

This comes after GOP leaders immediately blasted their own superiors in the House after the negative reaction to the non-budget, and after Rep. Paul Ryan conceded that, with actual numbers, the non-budget would in all likelihood increase the deficit.

These guys really have no idea what they're talking about or even who their leader is, do they?