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Window to Washington

An inside-the-beltway look at the legislative and regulatory process.
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By Jessica Zigmond and Rich Daly

Blog: Medicare issue prompts Obama to alter course

By Rich Daly

Fifty shades of Medicare.

The addition of Paul Ryan to the Republican presidential ticket has led President Barack Obama to expand his Medicare focus on the stump. But his Medicare comments include an unexpected twist.

Conventional wisdom in Washington was that the selection of Ryan, chairman of the Budget Committee and author of two budget blueprints that would add an insurance subsidy component to Medicare, would open the Republican ticket to charges of trying to undermine Medicare. The healthcare program for seniors is traditionally a third-rail issue in Washington that politicians from both parties have studiously avoided. And now, Mitt Romney appeared to be following Ryan right onto the tracks.

When Ryan’s selection was announced Aug. 11, Obama’s stump speeches quickly incorporated attacks on the Ryan plan for Medicare. But in recent days, they added something else new—a defensiveness over the impacts of the president’s healthcare law on Medicare.

“Congressman Ryan wants to turn Medicare into a voucher system,” Obama said at an Aug. 18 campaign speech in Rochester, N.H. “I, on the other hand, have strengthened Medicare.”

Obama’s comments on Medicare before Ryan’s selection were limited to a recitation of new benefits that the Patient Protection and Affordable Care Act added for Medicare beneficiaries. Since then, he has added lines defending the law’s $716 billion in reductions to the program’s growth over the coming decade that also were included in the law.

“So here’s the bottom line, New Hampshire—my plan saves money in Medicare by cracking down on fraud and waste, and making sure insurance companies aren’t getting unfair subsidies,” he told the same crowd.

The new defense of the president’s Medicare policy comes in response to Republicans’ charges that the president’s healthcare law would use those cuts to fund a new entitlement, while Ryan’s cuts would be used to extend the program’s solvency.

But the president may have added the defense of the healthcare law’s Medicare cuts because his campaign is seeing something else—polls. For instance, a Florida poll released last week by bipartisan Purple Strategies found voters in that critical swing state were evenly split 44%-45% over whether Romney or Obama were “more likely to protect Medicare.”

Polls like that have Republicans arguing that the health law’s changes to Medicare have effectively neutralized Ryan’s proposed Medicare changes as a campaign issue.

Meanwhile, the president’s new defensiveness indicates he’s taking seriously the potential political impact of the latest attack on his signature domestic policy achievement.

Who do you believe? Let me know at rdaly@modernhealthcare.com.

You can follow Rich Daly on Twitter @MHRDaly.

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