Photo credit: James Keivom/New York Daily News
It’s important to separate fact from fiction on the Medicare and Welfare reform portions of Clinton’s speech because those are the parts that have the most potential to damage to the Romney campaign. The Washington Post Wonk blog did of the heavy lifting on the Medicare falsehoods.
FALSE: “Both Governor Romney and Congressman Ryan attacked the president for allegedly robbing Medicare of $716 billion. That’s the same attack they leveled against the Congress in 2010, and they got a lot of votes on it. But it’s not true.”
The Affordable Care Act did indeed cut Medicare spending by $716 billion, as the Congressional Budget Office wrote in a July 24 report. It does that by reducing payments to Medicare hospitals and doctors, essentially ratcheting down the amount they receive when they see a patient. Here’s how those cuts break down, in graph form:
DOUBlE COUNTED: “Instead of raiding Medicare, he used the savings to close the doughnut hole in the Medicare drug program…and to add eight years to the life of the Medicare trust fund so it is solvent till 2024.”
Both of these facts are, independently, true. The health care law did indeed use some of the revenue it generated to pay for seniors who land in the “donut hole,” the gap after normal drug coverage ends and catastrophic coverage kicks in. And it did extend the solvency of the Medicare trust fund by eight more years, until 2024, per a report earlier this year.
But this represents some of the least-liked math in Washington, because it represents a sort of “double counting” of Medicare savings. The Medicare Trust Fund counts the health law’s $716 billion in savings as going back into its coffers. The Congressional Budget Office counts them as paying for provisions in the Affordable Care Act, like closing the donut hole. In reality, it would be very, very hard for a Medicare dollar saved to achieve both these purposes. In fact, it would be impossible.
This accounting isn’t unique to the Affordable Care Act. Budget wonks have regularly used this double counting for Medicare savings generated by Congress. But it is one of the points that the Affordable Care Act’s Medicare savings regularly gets attacked.
TRUE: “I didn’t know whether to laugh or cry because that $716 billion is exactly, to the dollar, the same amount of Medicare savings that [Ryan] has in his own budget.”
Rep. Paul Ryan’s most recent budget does indeed include the Affordable Care Act’s $716 billion in Medicare savings. Mitt Romney has, however, disavowed those cuts and promised to restore insurers’ and hospitals’ reimbursement rates as part of his plan to repeal the Affordable Care Act.
Ah – there’s an important caveat that gets missed in all the howls of hypocrisy. The WaPo factchecker dutifully notes that Obamacare doublecounts Medicare savings,but forgets to mention that Ryan’s plan does not.
President Obama leaves the $716 billion in Medicare reductions in place, and he spends the money again to create a vast new Obamacare entitlement program. Paul Ryan doesn’t double-count this money. His budget leaves the BBA Medicare payment cuts in place, but also creates a plan to make the program more efficient by injecting market forces through competition and consumer choice. Ryan’s premium-support model would require health plans to compete for the business of future seniors by offering better benefits at lower prices. Seniors would be guaranteed coverage because Medicare would fully cover the premium costs of the second-lowest-cost plan or the cost of traditional Medicare, whichever is lower. Those who are older or sicker, or have lower incomes, would get additional help.
FALSE: “So if [Romney is] elected, and if he does what he promised to do, Medicare will now go broke in 2016.”
Here, Bill Clinton is referring to the Medicare Trustees’ 2012 report, which estimated that the Medicare Trust Fund would be exhausted in 2016 without the Affordable Care Act’s changes.
There’s a huge difference, however, between exhausting the Medicare Trust Fund and the program going broke. The trust fund is essentially an accounting mechanism, a balance sheet for what the Medicare program takes in (via taxes and premiums) and what it spends out on benefits. If Medicare were running short on cash, there’s nothing to stop Congress from chipping in with extra dollars.
To that point, the Congressional Research Service once rounded up previous Medicare Trustees Reports. In 1970, the Medicare Trustees Report predicted that the fund would be insolvent just two years later, in 1972. Pretty much every year after that, the Trust Funds’ insolvency has never seemed that far off, as the following chart shows.
FALSE: “Lot of folks don’t know it, but nearly two-thirds of Medicaid is spent on nursing home care for Medicare seniors who are eligible for Medicaid.”
Lots of folks don’t know this fact…because it’s not true. Clinton here is referring to the 9.1 million seniors who are low-income or disabled, making them eligible for both entitlement programs. In health wonk terminology, they’re referred to as the “dual eligibles.”
Dual eligibles certainly cost more than other Medicaid enrollees, like children and pregnant women. But there’s no evidence to support that these patients eat up two-thirds of the Medicaid budget.
Clinton then swerved into the welfare reform, which he “had the brass” to take credit for after vetoing it, twice:
FALSE: They actually have charged and run ads saying that
President Obama wants to weaken the work requirements in the
welfare reform bill I signed that moved millions of people from
welfare to work. Wait. You need to know, here’s what happened.
Nobody ever tells you what really happened. (Yes, they do – see below,)
Here’s what happened. When some Republican governors asked if they could
have waivers to try new ways to put people on welfare back to
work, the Obama administration listened, because we all know
it’s hard for even people with good work histories to get jobs
today, so moving folks from welfare to work is a real challenge.
And the administration agreed to give waivers to those
governors and others only if they had a credible plan to
increase employment by 20 percent and they could keep the
waivers only if they did increase employment.
Now, did — did I make myself clear? The requirement was
for more work, not less.
Mickey Kaus dealt with this at the Daily Caller, here.
Nevada was cited by the Obama Health and Human Services department when it quietly announced its plan to grant waivers on July 12 .** Here’s how the Times describes what Nevada wants to do:
[Nevada] asked to discuss flexibility in imposing those requirements. Perhaps, the state asked, those families hardest to employ could be exempted from the work requirements for six months while officials worked with them to stabilize their households. [E.A.]
“Exempted from the work requirements for six months.” That’s not just “weakening” work requirements–the safe, milder charge I chose to make a couple of days ago. It’s explicitly tossing them out the window for an extended period–“to allow time for their barriers to be addressed and their household circumstances stabilized”, in Nevada’s words.***
For those six months it’s also, unaccountably, exactly what Romney says will happen in his ad:
You wouldn’t have to work and wouldn’t have to train for a job. They just send you your welfare check.
Romney’s ads are overstated and oversimplified–some of them say Obama has ended the work requirement, not that he plans to end it.** But they get at a decidedly non-trivial point, which is that Obama’s department of Health and Human Services is undermining at least two aspects of the historic 1996 welfare reform law: a) That recipients should be required to “Work First,” at the best job they can get, rather than be paid to prepare for a better job that may or may not materialize down the line; and b) that we want to get welfare recipients into jobs quickly because that’s the best way to get them out of poverty–but we also want to require work to deter would-be recipients from making the bad choices that would put them onto welfare in the first place.
Newt Gingrich. As a lawmaker, prime mover of the Contract With America, and Speaker of the House, Gingrich pushed a reluctant Bill Clinton into signing the reform bill. Clinton did it kicking and screaming; he vetoed the bill twice before making an election-year calculation that he had to sign welfare reform or risk defeat in his 1996 re-election bid.***The bottom line is that the Democratic leadership, from Bill Clinton down, hated welfare reform. Gingrich and his fellow Republicans pushed hard for it and created the political atmosphere in which reform became a reality. That’s what happened, and Newt Gingrich, not Bill Clinton, led the charge.
In a legal opinion requested by Senator Orrin Hatch, Ranking Minority Member of the Senate Committee on Finance and Representative Dave Camp, Chairman of the House Committee on Ways and Means, the GAO General Counsel’s Office determined that the Department of Health and Human Services’ recent memo making changes to operation of the Temporary Assistance for Needy Families (TANF) program… must be submitted to both Houses of Congress before it can take effect.
While Democrats have been crying foul over Republicans’ attacks, the GAO has found that an attempt to institute this waiver process without Congressional review would be an illegal power grab. This will at least put a small bump in the road for the Obama Administration’s attempt to relax one of the key components of welfare reform.
CHARLOTTE, NC – Round two of the 2012 DNC is finally complete, following an interminable stemwinder from former President Bill Clinton. A few thoughts on the evening: Prior to the 10pm ET hour, the convention lineup was wholly unremarkable. Nancy Pelosi and Steny Hoyer both spoke for the second time this week. Why? These speeches lasted nearly six-and-a-half hours in total. Were retreads necessary? In any case, we heard from more abortion proponents, several union bosses, and a long list of unremarkable politicians. It was tedious in the extreme, especially the mindless Bain demagoguery.
What was most interesting was that her speech had obviously been reworked rapidly in the last week. It was a weird, copycat complement to Republicans. It’s like an unsure competitor looking to see what the champion is doing, and quickly trying to mimic it. “Oh, you talked a lot about the American Dream and that resonated with the public — watch me, I can do it, too.” She even cribbed lines and phrases from the Romneys. The trouble is that the pretend principles did not match who the Obamas actually are. It was the perfect ersatz speech from the wife of our Faker in Chief.
It seemed to me that the Dems have been polling the impact of Dinesh D’Souza’s important film, 2016: Obama’s America and feel they have to counter it. Although all the experts keep telling us we mustn’t say anything negative about Obama because the public won’t believe it and won’t like it, Obama does not share their confidence.
Michelle’s whopper of the night was a direct lie to counter the impact of 2016:
And as I got to know Barack, I realized that even though he’d grown up all the way across the country, he’d been brought up just like me. … But when Barack started telling me about his family – that’s when I knew I had found a kindred spirit, someone whose values and upbringing were so much like mine. You see, Barack and I were both raised by families who didn’t have much in the way of money or material possessions but who had given us something far more valuable – their unconditional love, their unflinching sacrifice and the chance to go places they had never imagined for themselves.
Michelle’s Lie One: “even though he’d grown up all the way across the country.”
Barack didn’t grow up all the way across the country. He grew up in Indonesia. One of most the powerful parts of 2016 is the visual impact of seeing what Indonesia looks like, to realize this is the place where Obama spent his most formative childhood years. It is not America.
This cracker snake oil salesman, as my pal John Coyne calls him, immediately began to lecture the Republicans about how immoral they are. Yes!!!! This man, who had a college intern give him oral sex in the Oval Office while he was on the phone with a Congressional Committee Chair, who inserted cigars into this woman’s private parts in the Oval Office, then smoked them, then lied about it all, who was impeached, is lecturing the GOP about morality.It is art.This man, credibly accused of something very like sexual assault, is cheered to the rafters by the women at the DNC. It is fantastic. This is not grist for the political analyst. It is grist for the psychoanalyst.