The Ryan Unicorn Plan Would Destroy Medicaid, Too

A lot of attention has been given to the Ryan Unicorn Plan's privatization of Medicare.  But the plan also includes turning Medicaid into a block grant program, and that would end up cutting trillions just from Medicaid over the years, all but destroying the program.  Jon Cohn calls it what it is:  Couponcare.

The Affordable Care Act will guarantee access to a level of benefits and, for the poor and most of the middle class, it will limit what individuals can spend on premiums and out of pocket expenses. The Dutch system already does the same thing for the people who live in the Netherlands, only it does so (much) more generously.

Compare this to the Republican proposal for Medicare, which critics have rightfully started calling "Couponcare." The government's contribution towards insurance would rise far more slowly than the cost of health care. It would not guarantee a fixed set of benefits or protection from individual expenses. Only the very poor would get extra financial assistance and, according to a Kaiser Family Foundation briefing paper, even that assistance would likely be inadequate for many (possibly most) of the people receiving it.

This distinction is entirely intentional. It’s why the Republican budget, on paper, seems to save so much taxpayer money in the long run. But the effects on individuals would be devastating, as the Congressional Budget Office noted in its assessment. By 2030, the average senior would be individually responsible for about two-thirds of his or her medical costs. Even with heroic assumptions about the ability of consumers to reduce prices through active shopping, it’s impossible to imagine that scheme not leaving many seniors with punishing health care costs.

Saying the Republican Medicare proposal is a variation on the Affordable Care Act or Dutch national health insurance is a bit like saying that a bicycle is a variation on the 747. Sure, you can get across the country on either one. But opt for the former and you will struggle mightily. You might even die on the way.

And that Kaiser Family Foundation report is grim:

Projected federal spending on Medicaid for the 10-year period 2012 to 2021 would fall by $1.4 trillion, a 34 percent decline. By 2021, states would receive $243 billion less annually in federal Medicaid money than they would under current law, a 44 percent reduction.

The effect on enrollment in state Medicaid programs could vary widely. By 2021, between 31 million and 44 million fewer people nationally would have Medicaid coverage under the House Budget Plan relative to expected enrollment under current law, the analysis finds, examining three possible scenarios using different assumptions about how states might respond to lower federal funding. Most of those people, given their low incomes and few options for other coverage, would end up uninsured.

That's right:  under the Ryan Unicorn Plan, the cost savings would come directly from kicking tens of millions of people off of Medicaid and hoping they can magically afford their own private insurance.  And nearly every single House Republican voted for this.

Any wonder then that Democrats have come roaring back in the generic congressional ballot race?

According to a CNN/Opinion Research Corporation survey released Tuesday, the Democrats have a four-point margin over the Republicans in the battle for control of Congress. The poll indicates that 50 percent registered voters say if the election for Congress was held today, they would vote for the Democrat in their district, with 46 percent saying they would cast a ballot for the Republican in their district. The Democrats' four-point margin is within the poll's sampling error.


The GOP won 63 seats in last year's midterm elections, taking back control of the House for the first time in four years. CNN's last poll conducted before the midterms indicated the Republicans had a six-point advantage over the Democrats.

That's a ten-point swing in less than eight months.  The Republicans have already blown their "mandate" and the Ryan Unicorn Plan is a big, big reason why.  Americans were certainly turned off by "Obamacare" and voted for the Republicans.  Then they saw what the Republican alternative is, tens of millions of people losing their Medicaid insurance, seniors having to pay tens of thousands to make up the difference in GOP's privatized Medicare scheme, and all to pay for even more tax cuts for the top 1%.

Gosh, Americans don't like that.  And the more they find out, the more they don't like.