Changes to Medicare, Social Security Less Likely Without Paul Ryan
Speaker of the House has been a strong advocate for change to Social Security, Medicare and Medicaid
WASHINGTON—When House Speaker Paul Ryan leaves Congress, the Republican party will lose its most influential advocate for changes to Social Security, Medicare and Medicaid.
As Budget committee chairman, a vice presidential running mate to Mitt Romney in 2012, Ways and Means chairman and finally House speaker, Mr. Ryan had pressed for curbs on federal spending on the three programs. These retirement and health care programs are popular with voters, but their costs are rising faster than the funds to pay for them.
Mr. Ryan will leave Congress in January with no substantial progress on any of them, few lawmakers interested in picking up the torch, and a clear signal that prospects are dim for any big overhaul in the foreseeable future.
“Slim and None, and Slim is packing his bags to leave town,” said Tom Miller, a resident fellow at the American Enterprise Institute, the conservative think tank where Mr. Ryan unveiled the “Better Way” plan in 2016 that served as the party’s policy blueprint on federal programs.
Mr. Ryan faced long odds on the programs, as past efforts to tackle entitlements came up short.
In 2005, Republican President George W. Bush proposed allowing younger workers to divert a share of their Social Security payroll taxes for personal investment accounts. But Mr. Bush failed to win over reluctant Republicans. Later, Democratic President Barack Obama floated a change in the way benefits are calculated, dubbed chained CPI, but that was dropped as well amid political opposition.
Mr. Ryan’s prospects rose when Republicans gained control of the House, Senate and White House for the first time in a decade in the 2016 elections.
But the party faltered badly on its first push: repeal of the 2010 health law dubbed Obamacare, and with it, a rollback of spending on Medicaid, the state-federal health program for the poor. The repeal push set off a groundswell of support for both Medicaid and the Obama health law. The repeal bid barely made it through the House on a second try before finally failing in the Senate.
Complicating matters further, President Donald Trump had previously said he wanted no big changes to retirement or health benefits, spurning calls to extend retirement ages or reduce benefit payments for wealthier Americans in Social Security. Any chance Mr. Ryan had of changing his mind and getting a bill to his desk evaporated.
Underscoring the lack of desire on Capitol Hill, when Mr. Ryan said in December that he wanted to turn his attention to entitlements as a way of tackling federal deficit, Senate Majority Leader Mitch McConnell said that was unlikely.
The result is that in Mr. Ryan’s final months in office his supporters are talking up the passage of last year’s tax overhaul as the central piece of his legacy, as Congress pursues relatively minor changes to food stamps and the Trump administration seeks to add work requirements for Medicaid beneficiaries in a handful of states.
“Paul Ryan was really the only leader willing to push his party to do entitlement reform, and who knew the specifics, including that there were hard choices involved,” said Maya MacGuineas, president of the Committee for a Responsible Federal Budget, which supports debt reduction.
Part of the challenge for the GOP is that its base has aged, which has made Republicans wary of embracing Mr. Ryan’s calls for benefit overhauls. Meanwhile, some Democrats have called for more generous benefits for retirees and to also swear off any cuts, positions that have grown popular on the left.
Social Security faces depletion by 2034, which would trigger a 21% across-the-board benefit cut if Congress doesn’t act. More than 51 million Americans collected retirement benefits through the program last year, and nearly 10 million received payments from a separate disability-insurance program.
The costs of Medicare and Social Security are set to rise due to the aging of the U.S. population, making it difficult for the government to outrun the solvency problems even by sharply boosting economic growth. Medicare and Social Security accounted for 41% of federal spending last year, up from 36% in 2011.
Social Security, designed as a pay-as-you-go program, has been paying out more in benefit dollars than it collects in taxes since 2010. Its annual balances have remained positive due to interest payments it earns on trust-fund assets. By early next decade, however, it will pay out more than it collects, even after accounting for interest payments. After that, it would have to redeem government bonds that constitute its trust fund to pay benefits.
The trust fund for Medicare that supports hospital spending for older Americans is currently projected to be depleted in 2029.
Democrats indicated Wednesday they had no plans to stop attacking Mr. Ryan’s party for his ideas, citing the failed health law repeal bid and proposals to cut Medicare spending that they see as a winning issue in the 2018 midterms.
“It does mean no more Paul Ryan budgets. but otherwise, the Republicans have a war on health care, and they’re going to wage it…and we’re going to continue to fight it,” said Ethan Rome, co-director of Health Care for America Now.
Back in 2011, Mr. Ryan as chairman of the Budget Committee backed away from a major overhaul of Medicare that would end the traditional fee-for-service Medicare program for future retirees and replace it with subsidies starting at $8,000 that seniors would use to purchase private health plans.
Instead, with Democratic Sen. Ron Wyden of Oregon, Mr. Ryan proposed giving future seniors the choice of purchasing private insurance coverage or staying in the traditional federal plan, in a system known as “premium support.”
When he carried that idea into the 2012 elections, one attack ad depicted him pushing an old woman in a wheelchair off a cliff. Undeterred, Mr. Ryan included the idea in the “Better Way” plan.
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