Ryan is Going After Medicare, and Trump is Letting Him Do It

After signing the Medicare amendment, President Johnson said, “American seniors will never suffer for lack of medical care again, unless of course a presidential candidate’s husband took money and used it to help people with AIDS in Africa and also the candidate herself used a private server. Then Americans will have no choice but to elect the candidate who bragged about grabbing women by the pussy, thus empowering the heirs of my political opponents to destroy Medicare.” By White House Photograph Office, President Johnson (1963 – 1969). [Public domain], via Wikimedia Commons

As mentioned in yesterday’s links roundup, Speaker of the House Paul Ryan wants to destroy Medicare. Unified Republican control of the presidency and Congress now makes his dream possible. The big question is whether Donald Trump will go along with it or not. As is the case with many issues, Trump has tried to have it all possible ways on Medicare. He has recognized its importance and effectiveness in the past, even going so far as to warn that Republicans seeking to weaken or destroy Medicare or Social Security invite electoral ruin. However, Trump and his surrogates maintained flexibility throughout the campaign, promising to look into all these things after taking office should he be elected.

That we never knew Trump’s intentions concerning major life-or-death programs like Medicare is a scathing indictment of the smallness of our elections. But now, Trump needs to govern. He can no longer genuinely (or cynically pretend to) have no idea what he thinks about important programs and policies. It comes as no surprise then, to me at least, that Trump’s president-elect website now adopts Ryan’s language on Medicare. There, he proposes to “modernize Medicare,” which is code for Ryan’s plan to destroy Medicare and replace it with a voucher system that allows seniors to buy private plans. Whatever that is, it’s not Medicare, and we cannot allow Ryan and Trump to claim they’re preserving it by killing it. In fact – and this really galls – what Ryan proposes and Trump appears to support is basically Obamacare for seniors. All of the challenges Obamacare faces increase dramatically when it comes to seniors. I wish I still had any gob to be smacked.

Josh Marshall and his staff  at Talking Points Memo are going to be essential reading on this. Here’s a quick summary of how many Republicans in the House are already on record supporting Ryan’s plan. That is, they voted for it; look here to see if your representative did or not.

Trump could veto legislation that destroys Medicare. Democrats and others who favor saving Medicare need to figure out if they can pressure him on this or not. But since Trump seems to be on board with killing Medicare, it would be much safer to defeat Ryan in Congress. While Republicans have majorities in the House and Senate, there are enough vulnerable members of both that Democrats might be able to forge a coalition with the strength to save Medicare.

Restoring Medicare will be extremely difficult should Ryan succeed in getting rid of it over the next two or four years. But it’s not over yet. This fight is just beginning. It’s one that Democrats can win and if we don’t, we need to make sure Republicans pay for it in future elections.

The best way to start is to call your House representative and your senators. Tell them you know that Paul Ryan has already given interviews in which he insists we have to change Medicare. Describe the plan that Ryan and most Republicans in the House voted on last year – subsidies for private insurance plans – and ask for your representative’s and senators’ positions on that plan. If they don’t have a position, ask them when you can expect to call back and hear one. Let them know you believe Medicare is a vital program for seniors and that you want it to be there for you when you retire (if you’re not on it already). Insist that replacing Medicare with vouchers for private insurance is not Medicare. Be polite but firm; don’t settle for mealy-mouthed horseshit. Republicans in particular will have incentives to avoid staking a clear position. Some will try to get away with not having a clear position at all before a vote. We cannot let that happen. In fact, similar citizen engagement back in 2005 helped Democrats save Social Security from President George W. Bush’s efforts to change it to a private investment account system.