Thursday, March 17, 2011

More Hypocrisy on Entitlements from CBPP

The Center for Budget and Policy Priorities is out this morning with yet another in a series of reports criticizing Republican entitlement reform proposals – in this case, the Rivlin/Ryan plan.  Chief among its criticisms is the report’s assertions about Rivlin-Ryan’s proposal to convert Medicare to a defined-contribution model for individuals currently under age 55, and to convert Medicaid into a block grant for states – both of which would grow at the rate of economic (i.e., GDP) growth plus one percent.  While the CBPP report criticizes the GDP plus one percentage point cap on entitlement growth, Section 3403 (page 413) of the health care law creates the EXACT SAME growth level for Medicare – GDP plus one percent.

The report makes many attacks on proposals to cap the growth in Medicare and Medicaid spending at GDP plus one percent:

  • On Medicare, the report alleges that the Rivlin-Ryan plan’s proposed growth rate “is slower than private health care costs have been rising in recent decades;”
  • On Medicaid, the proposed block grant would grow at a rate “up to 1.5 or 2 percentage points less each year than projected cost growth, with the difference compounding over time;”
  • Due to the slower growth rate, Medicaid funding disparities faced by states would be so great that plans to close the projected gap through more efficient care “would almost certainly prove unrealistic;”
  • State Medicaid programs could “cut services substantially, with the result that many of the nation’s poorest and most vulnerable people could become underinsured…the risks would likely be greatest for poor people with severe disabilities.”

If CBPP believes all these things will happen under the Rivlin-Ryan plan, why don’t they believe these dire scenarios will occur under the Democrat health care law – which establishes the EXACT SAME cap on the growth in Medicare spending?

The non-seqiturs within the CBPP report are significant.  On page three, it the Rivlin-Ryan plan’s proposal for private companies to deliver Medicare benefits on the grounds that “the Medicare cost-containment provisions in PPACA do not apply to private health insurance.”  Yet four pages later, it notes that “policy-makers will not be able to slow Medicare and Medicaid cost growth substantially without slowing the rate of growth of health care costs system-wide, unless they are willing to create a two-tier health care system.”  So what CBPP is really saying is that – because its Medicare cost-containment provisions do not apply to private health insurance – PPACA will create a two-tier health system.

To be sure, there are serious issues that need to be discussed regarding any proposal to transform American entitlements.  But some may believe that any organization that spends so much time criticizing a Republican proposal to place spending caps on entitlements – while failing to criticize a Democrat-enacted law that imposed the EXACT SAME type of spending cap – is fundamentally not serious about engaging in such a discussion.