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Ryan Revises History on Medicare Reform

Rep. Paul Ryan revises history when he says his Medicare plan is "in keeping with the Bill Clinton bipartisan committee" proposal in 1999. Contrary to the impression left by Ryan, the commission's final report failed largely along partisan lines. Clinton opposed it, and all four of his appointees voted against it. 

It's true, though, that both proposals recommended providing a government subsidy for seniors to buy insurance — that's one of the issues that caused the plan to fail to win final approval.

Not Clinton's Committee

On "Meet the Press," Ryan called his Medicare plan "sensible" and compared it to the work of a "Bill Clinton bipartisan commission" — referring to a 1999 final draft report issued by the National Bipartisan Commission on the Future of Medicare.

Ryan, May 22: And the way in which we propose reforming for the next generation, it's in keeping with the Bill Clinton bipartisan commission that — to reform Medicare, it's an idea that's been around for a long time called premium support: guaranteed coverage options for Medicare where the government subsidizes the poor and the sick a whole lot more than the wealthy, and people get to choose.

He's right that both plans recommended "premium support payments" — or government subsidies — to help seniors buy insurance. Under Ryan's plan, future beneficiaries (those currently younger than 55) would use the subsidies to buy private insurance. Under the 1999 plan, seniors would have been able to apply the subsidies toward the traditional government-run Medicare program or buy private insurance. So, to that extent, his plan indeed is in keeping with the 1999 proposal.

But any attempt to cast the 1999 report as bipartisan or suggest it was Clinton's commission is misleading.

The commission was created by Congress as part of the Balanced Budget Act of 1997. The New York Times reported that Clinton appointed just four of the 17 commission members, and all four of them voted against the report. Clinton himself opposed the final draft report. He issued a statement on the day of the vote that criticized the plan for, among other things, potentially increasing premiums for seniors who remain in the traditional government-run Medicare plan. Why? Clinton and other Democrats feared the subsidies would not keep pace with inflation. 

Rep. John Dingell, a Michigan Democrat and commission member, voted against the report and criticized it in words that echo today's partisan criticism of Ryan's plan: "The proposal before us would convert Medicare from a universal guarantee to a Government voucher for private insurance."

The commission failed to get the 11 votes it needed to approve the final report. All eight Republican appointees and only two centrist Democrats, chairman John Breaux of Louisiana and Sen. Bob Kerrey of Nebraska, voted for it. The report failed by a 10-7 vote.   

'Mediscare': A True Bipartisan Plan

Ryan is correct, though, when he blames both parties for engaging in what he called "Mediscare" — which we documented as recently as May 19 in the special House election in New York's 26th congressional district. 

Ryan, May 22: Look, of course people are scared of entitlement reform because every time you put entitlement reform out there, the other party uses it as a political weapon against you. Look, both parties have done this to each other.

He proved his point when he engaged in, well, a bit of Mediscare himself.

Ryan repeated a false claim that the Independent Payment Advisory Board created by the new federal health care law will "ration" Medicare to cut costs.

Ryan, May 22: The alternative to this, David, is a rationing scheme, are the 15 bureaucrats the president's going to appoint next year on his panel to ration Medicare spending.  We don't think we should give the government the power to ration spending to seniors.

As we have written before, the health care law specifically states that the advisory board “shall not include any recommendation to ration health care.” And the voting board members are doctors, economists and other outside experts, not Washington bureaucrats.