In it, but not of it. TPM DC
Not only did Republicans vote aspirationally to cut Medicare -- in both the near and short term, and by huge amounts -- in their dead-on-arrival budget this year, they've arguably made cutting Medicare a hallmark of what it means to be a Republican.
Here's a brief, incomplete recap of how that's played out in recent years.
The House GOP budget -- which an overwhelming majority of Republicans in both chambers voted for -- would cut Medicare in the near-term by repealing the new health care law. That would re-open the prescription drug donut hole, and rescind new guaranteed wellness benefits for seniors. It would also maintain the health care law's $500 billion Medicare cuts -- principally over-payments to private insurers participating in Medicare advantage.
It would impose much, much larger cuts in the long term. Setting aside the privatization scheme, the government saves money under the plan principally by capping Medicare spending (the value of the subsidies to private insurers) and pegging that cap to inflation -- way below the rate of growth of medical costs. That's a cut no matter how you slice it.
They've been at this very plan for some time.
In 2009, 137 or their 178-member minority, including Boehner, voted for the Republican alternative budget, authored by -- whom else -- Rep. Paul Ryan (R-WI). That budget will sound familiar. It "[p]reserves the current Medicare program for individuals 55 and older. For those under 55, the resolution gradually converts the current Medicare program into one in which Medicare beneficiaries receive a premium support payment -- equivalent to 100 percent of the cost of the Medicare benefit -- to purchase health coverage from a menu of Medicare-approved plans, similar to options available to members of Congress."
The plan also reduced the prescription drug benefit for seniors with household incomes over $170,000
Despite the similarities to the current GOP budget, dozens of Republicans defected from this plan, including many members -- like Dean Heller (R-NV) and Pete King (R-NY) to name two -- who just walked the plank on the 2011 version.
In 2007, a similar story played out when 159 of their 202-member minority, including Boehner, voted for Ryan's alternative. That version of his plan would have capped Medicare spending and cut it relative to the growth of health care costs, and would have imposed further means testing of the program. It didn't lay out the precise privatization scheme included in the 2009 and 2011 Republican budgets, but it envisioned "a reform strategy that will advance the transformation of Medicare into a vital and flexible program that can meet its mission without imposing unmanageable burdens on the Nation's medical community, and its economy."
Republicans have been at this about as long as there's been Medicare. But from time to time they make it obvious. In the 1990s, then-House Speaker Newt Gingrich proposed a milder version of the current Medicare phase out policy. His version would have preserved traditional Medicare as an option alongside a privatized program, and incentivized seniors to drop out of the government plan. Here's how he famously described it in a speech to Blue Cross in 1996. "[W]e don't get rid of it in round one because we don't think that's politically smart and we don't think that's the right way to go through a transition. But we believe it's going to wither on the vine because we think people are going to voluntarily leave it."
These votes were mostly about positioning. To the extent that they could succeed, they would have loved to, but the main ideas were to stake out bargaining stance, and draw a distinction between the GOP and the Democrats. But that's precisely the point: if they had their way -- if Congress was a parliament and Boehner was Prime Minister-- this is what they would do.