“Support Builds for Premium Support Plan for Medicare”

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Last spring, when the House Republicans took the risky and courageous step of lining up behind a serious structural reform of Medicare proposed by Paul Ryan—a reform that would replace the program’s fee-for-service monopoly with a premium-support system to enable some real competition among private insurers—many people thought they had committed political suicide. The Democrats pounced, announcing plans to put that proposed reform at the center of their own 2012 election campaign in an effort to scare seniors away from Republicans. Even many Republicans were wary, and it was far from clear if the party’s presidential candidates would back the idea.

As the Republican primary race has progressed, however, it has become clear that the House Republicans’ decision has had its desired effect: The dire need to reform Medicare and the case for doing so through a premium-support reform have become conservative orthodoxy, and all of the Republican candidates have adopted some version of the idea as their own.

Now, this article in Saturday’s New York Times suggests that far more than that may be afoot, and that even some Democrats are acknowledging that some version of a premium-support reform will be necessary and could well work. Referring to the hearings held by the Supercommittee before it concluded in failure last week, the Times’s Robert Pear notes:

Members of both parties told the panel that Medicare should offer a fixed amount of money to each beneficiary to buy coverage from competing private plans, whose costs and benefits would be tightly regulated by the government.

Republicans have long been enamored of that idea. In the last few weeks, two of the Republican candidates for president, Mitt Romney and Newt Gingrich, have endorsed variations of it.

The idea faces opposition from many Democrats, who say it would shift costs to beneficiaries and eliminate the guarantee of affordable health insurance for older Americans. But some Democrats say that — if carefully designed, with enough protections for beneficiaries — it might work.

The idea is sometimes known as premium support, because Medicare would subsidize premiums charged by private insurers that care for beneficiaries under contract with the government

At the very least, this news should complicate the Democrats’ efforts to build their 2012 campaigns around a demagogic attack on the Ryan plan, since clearly “some Democrats” seem to have realized that it doesn’t involve pushing elderly people in wheelchairs off of cliffs and in fact might even save Medicare and the federal budget from doom. At most, this news might even mean that the idea could have a chance of getting somewhere if a president who supports it is elected next November.

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