The next fight over Medicare and Medicaid..

The more we learn, the more I realize that I wasn’t harsh enough about the deficit reduction proposal put forward by Rep. Paul Ryan last week.

In short, it’s a right-wing wish list, dressed up as deficit reduction when it would actually make the problem much worse.

There’s nothing new, courageous, or correct in proposing to give tax breaks to those in the top tax brackets and corporations, to repeal the Affordable Care Act and replace it with nothing to control costs, and to simply shift the risk and burden of increasing health care costs onto states and families, by replacing Medicare with a voucher program, and Medicaid with a block grant program.

Paul Krugman calls it “ludicrous and cruel,” and cites its fraudulent assumptions and outcomes:

People like me don’t say that the Ryan plan is too radical; we say that it’s a fraud. The spending cuts are largely fake, either because they’re just magic asterisks or because they wouldn’t survive politically; the revenue estimates are fake, because they combine huge tax cuts with vague assurances that extra revenue will be found by closing loopholes. There’s no there there — except for big tax cuts for the rich and pain for the poor.

Fairly conservative “New Democrat” analysts like William Galston, a deficit hawk, say that it’s a step backward, not forward, for the conversation that is needed about the deficit. As Jonathan Cohn has reported, “Even relatively conservative Democrats see the plan as a non-starter, with none other than Senate Finance Chairman Max Baucus vowing “not on my watch.””

The Center for Budget and Policy Priorities has more about how it doesn’t actually reduce the deficit, and how it targets low-income families.

As for alternatives, Ezra Klein reminds us that there is an alternative that makes progress in controlling health costs–the Affordable Care Act. Matt Yglesias makes a similar point. Several fellow Representatives who are progressive have a “People’s Budget” that is more responsible both in terms of balancing cuts (which are shared more broadly, including defense) with revenues (allowing the Bush tax cuts for the wealthy to expire, among other items).

Current law would allow the cost controls in the Affordable Care Act to take effect (reducing costs), and allow the Bush tax cuts to expire (raising revenue). Just allowing current law to work itself out would go a long way to reduce the deficit–some further adjustments can get you the rest of the way there.

President Obama is set to give a sppech on Wednesday outlining some principles around long-term deficit reduction, including on Medicaid and Medicare. We’ll see the contours of this next, big fight over health care in this nation.

Health Access California promotes quality, affordable health care for all Californians.
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