Without using the word endorse, House Speaker Paul Ryan announced in a newspaper op-ed Thursday that he will be voting for presumptive Republican presidential nominee Donald Trump in November. He said he feels confident that a President Trump would carry out the Republican policy agenda.
Last month, I raised the question of whether Trump would follow the politically risky healthcare policy path Ryan has blazed on Medicare, Medicaid and other big issues.
The House speaker apparently has concluded that he would.
Ryan has spearheaded a series of partisan House budget outlines that would significantly restructure Medicare and Medicaid and sharply reduce federal spending on those two programs. The Wisconsin Republican wants to convert Medicare into a defined-contribution, voucher-style program and change Medicaid into a capped state block grant program. Some experts say the plan would impose significantly higher costs on seniors.
But from the start of his presidential campaign last year, Trump repeatedly has promised he would not touch Medicare, Medicaid or Social Security, and has blasted Ryan for proposing to cut entitlements. “He's so anti-Medicare, Medicaid, Social Security,” Trump said of Ryan last fall.
Then, just before Trump held a big peace pow-wow with Ryan last month, his chief policy adviser, Sam Clover, signaled that Trump is open to the Ryan agenda on cutting and restructuring the nation's popular social insurance programs. “After the (Trump) administration has been in place, then we will start to take a look at all of the programs, including entitlement programs like Social Security and Medicare,” said Clovis, an economist who previously has backed Ryan-style restructuring of these programs.
Clovis said that while a President Trump would not seek any immediate changes in the social insurance programs, “we have to start taking a look not just at Medicare and Social Security but every program we have out there, because the budgetary discipline that we've shown over the last 84 years has been horrible.” The Trump adviser suggested that Trump might consider entitlement cuts after a few years of seeing the results of his tax reform plan and other fiscal policies.
That may have been part of the reason Ryan issued his lukewarm statement of support Thursday. “The House policy agenda has been the main focus of our dialogue,” Ryan wrote. “We've talked about the common ground this agenda can represent. We've discussed how the House can be a driver of policy ideas. We've talked about how important these reforms are to saving our country…. Through these conversations, I feel confident he would help us turn the ideas in this agenda into laws to help improve people's lives.”
Prior to Clovis' statement, there was general agreement among political experts that Trump probably wouldn't say anything during the campaign about entitlement reform, which likely Democratic nominee Hillary Clinton would use as powerful ammunition against him with older voters.
“Trump needs a very large portion of the over-60 vote, and he's not going to go near any change in Social Security or Medicare,” Robert Blendon, a professor of health policy and political analysis at the Harvard School of Public Health, said last month. “He has said one of the reasons Mitt Romney lost in 2012 is because he took up Ryan's proposal. He'll say flat out that the Ryan plan isn't where he's going.”
Nevertheless, it's expected that a House policy task force convened by Ryan to develop a healthcare policy proposal before the GOP convention in July will include Medicare and Medicaid restructuring as well as full repeal of the Affordable Care Act.
“For me, it's a question of how to move ahead on the ideas that I—and my House colleagues—have invested so much in through the years,” Ryan wrote in his Thursday op-ed piece. “It's not just a choice of two people, but of two visions for America. And House Republicans are helping shape that Republican vision by offering a bold policy agenda, by offering a better way ahead. Donald Trump can help us make it a reality.”
Democratic strategists are likely reheating their Medi-scare ad campaigns from previous elections, warning older voters about the possibility of Trump going after their beloved Medicare and Social Security benefits. Ryan's words will add weight to those warnings. “If I were a Democrat running for Congress, I would try to make the election about the Ryan plan,” Blendon said.
