Reaction to GOP budget proposal swift, includes concern, support and political intrigue

Apr 7 2011

After the budget proposal's release, reaction came from across the political and health industry spectrum. For instance, providers expressed concerns about reshaping Medicare and Medicaid. Possible GOP presidential hopefuls offered support, yet were viewed by some as "walking a tight rope."

The Hill: Ryan Budget Criticized For Potential Cuts To Nursing-Home Care
While House Budget Committee Chairman Paul Ryan (R-Wis.) is pitching his Medicaid overhaul as welfare reform, health care providers and liberal groups are warning that its greatest impact may be on seniors. Because Medicare does not cover long-term care such as lengthy nursing home stays, some 14 million seniors and people with disabilities instead rely on Medicaid. The nursing home and assisted living industry is raising that concern in a yet-to-be-released statement from former Gov. Mark Parkinson (D-Kan.), obtained by The Hill. "One million patients require long term care through Medicaid every day," Parkinson, the president and CEO of the American Health Care Association, said in the statement. "In 2010, Medicaid underfunded nursing facilities by $5.6 billion, or $17 per patient, per day. We owe it to these patients to find a workable solution while still meeting their critical care needs." (Pecquet, 4/5).

Modern Healthcare: AHA Sees Risks In GOP Budget Plan
The House Republicans' budget proposal to cut hundreds of billions in Medicare and Medicaid funding over the next 10 years would have negative consequences for both patients and health care providers, the leader of the American Hospital Association said Tuesday. "We think it's going to severely impact access for seniors and vulnerable citizens of the Medicaid program," Richard Umbdenstock, president and CEO of the AHA, told Modern Healthcare. On Tuesday, House Budget Committee Chairman Paul Ryan (R-Wis.) released his panel's fiscal 2012 budget, which aims to cut $6.2 trillion in government spending over the next decade compared with President Barack Obama's budget for next year; bring non-security discretionary spending to below 2008 levels; and reduce deficits by $4.4 trillion over 10 years (Zigmond, 4/5).

NPR's Shots Blog: GOP Unveils Plan To Remake Medicare And Medicaid
Just about every health interest group has chimed in, too. None whose constituents are in the business of providing care seem pleased. Take, for instance, the Federation of American Hospitals, which represents for-profit institutions. The group is particularly concerned about Medicaid cuts. "We understand that reforms are to be expected," Chip Kahn, CEO of the group said in a statement. ... "[W]e must not undermine the critical role that our nation expects of its community hospitals, clinicians and other health care providers" (Hensley, 4/5).

Politico: Alice Rivlin: I don't Back 'Ryan-Rivlin' Plan
Rep. Paul Ryan (R-Wis.) touted the help of former Clinton advisor Alice Rivlin — "a great, proud Democrat" — in promoting a key Medicare provision in his budget proposal Tuesday. The only problem? Rivlin said she told the Republican she doesn't support the final version of the measure he wrote into his budget — a provision Ryan referred to generally as the "Ryan-Rivlin" plan when rolling out his sweeping economic blueprint (Shiner, 4/5).

Bloomberg: Republicans Eyeing Run Against Obama Line Up Behind Ryan's Medicare Revamp
Republicans considering running for president were quick to embrace House Budget Chairman Paul Ryan's plan to shrink the U.S. budget deficit, a blueprint likely to frame the debate over federal spending heading into next year's elections and spur Democratic attacks. The proposal released yesterday by Ryan, a Wisconsin Republican, would cut more than $6 trillion over the next decade from Medicare, Medicaid, food stamps and scores of other programs. It calls for the biggest overhaul of federal benefits since President George W. Bush's failed 2005 attempt to reshape Social Security (Lerer and McCormick, 4/6).

National Journal: Hopefuls Have Delicate Task In Approaching Ryan Plan
Nowhere are the reforms more radical than on Medicare, and already the field of prospective Republican presidential candidates is walking a political tightrope in reaction to Ryan's sweeping proposal to convert Medicare into a voucher-based system for people younger than 55. Their dilemma is this: Opposition to the Ryan proposal, or even a show of only qualified support, exposes them to charges from the right wing that they are not sufficiently committed to spending-cuts and deficit-reduction, which is now the heart of Republican orthodoxy. However, if a candidate fully embraced Ryan's proposed entitlement change, he or she risks angering and alienating seniors, a critical part of the GOP's successful 2010 coalition that reclaimed control of the House. Either way, a clear position on the Medicare reform proposal in 2011 could sink them and the party's chances in 2012 (Roarty, 4/6).

CBS: Will 2010 Medicare Ads Come Back To Haunt GOP?
[I]t should be evident enough to Ryan and other Republicans that proposing changes to Medicare is politically risky — and now Democrats are launching their own attacks. Ryan's plan would dramatically transform the health care plan for seniors. Instead of providing those over 65 with government-run health care, seniors starting in 2022 would receive "premium support" (subsidies given directly to insurance providers) to get the health care of their choice from private insurers. The congressman contends his plan would save $389 billion in Medicare expenses over the next decade, compared with President Obama's budget. The plan would not effect those who are currently 55 and above. Many Republicans have praised Ryan's efforts today, but much of the praise has been reserved for Ryan's leadership, rather than the substance of the proposal itself. Some of those Republicans may have 2010 in mind, when the GOP hammered the Democratic health care plan, which included $500 billion in Medicare cuts (Condon, 4/5).

Stateline: Governors React To Medicaid Block Grant Proposal
Republican governors called the House Budget Committee's plan to trim $1 trillion from the federal Medicaid budget over the next 10 years, "far superior" to the Affordable Care Act and hailed it for ending the "out of control spending spree of recent years" (Vestal, 4/6).

Politico Pro: Cuomo: States Do Have Medicaid Flexibility
The speculation in Washington about why Cuomo didn't sign on to the letter — which was the brainchild of Govs. Martin O'Malley of Maryland, Christine Gregoire of Washington and Deval Patrick of Massachusetts — was that he was afraid his own proposal would be painted by critics as a block grant. In his letter to congressional leaders, Cuomo explains why his plan won't restrict eligibility and why states already have all the latitude they need to tackle Medicaid problems … Ryan's plan, Cuomo argues, would fail because it could not anticipate the unique problems that each state faces. "The costs associated with enrollment increases, aging populations, economic downturns, natural disasters, new diseases or epidemics are not uniform across states," Cuomo writes (Coughlin, 4/5).