The Republican budget ends Medicare as we know it

May 4, 2011

Lois Capps


The federal budget deficit is a big problem, one that must be addressed to shore up our long term economic future.The issue is not whether we reduce the deficit, but how we do it.

The latest flavor of the month in this debate is the so-called “Ryan Budget” which House Republicans passed, in a partisan vote, last week.

The Republican budget has a lot of problems. For example, despite the $4.3 trillion in cuts it calls for, two-thirds of which are for programs helping low and moderate income citizens, the plan would barely reduce the deficit in the next ten years. That’s probably because the plan also calls for $4.2 trillion in tax cuts, which would go disproportionately to the wealthiest among us. In fact, most of the deficit reduction the plan claims actually comes from an accounting gimmick involving war funding.

But the most controversial proposal is probably the plan to end Medicare as we know it by turning it into a voucher program. This would be a huge mistake.

The first problem? Seniors wouldn’t be guaranteed health care under this plan. Instead, starting in 2022, seniors would be given a voucher for a fixed amount of money to partly pay for a private insurance plan.  But there is no guarantee of coverage.  And there is no guarantee the voucher would ensure a senior has the kind of coverage she has come to expect from Medicare. None.

The second problem? According to the nonpartisan Congressional Budget Office (CBO), this voucher would cover less than half of the cost of the benefits individuals receive in today’s Medicare. In fact, CBO estimates that average out-of-pocket costs for seniors would double –  from $6,000 to $12,000 – while the government’s share would actually drop. Moreover, seniors’ share of costs would increase even more over time because the voucher’s value would not rise as fast as health insurance premiums.

In fact, limiting the voucher’s value is how the Republican plan reduces costs to the federal government – it simply shifts the health care costs to Medicare beneficiaries, people who often live on modest, fixed incomes. It does nothing address rising health care costs and actually repeals efforts currently underway to do just that.

Another problem? The Republican budget repeals health care reform and its protections to ensure a senior can’t be denied coverage due to a pre-existing condition, the ban on co-pays for preventive services, and the closing of the dreaded “donut hole.”

The CBO is clear about what would happen under the Republican budget voucher plan: some seniors will forgo insurance all together, while others won’t get coverage because plans are too expensive or they don’t cover particular services.  Ironically, these problems – access and cost – are the reasons that Medicare was started in the first place!

Before Medicare, seniors were America’s most likely group to be uninsured—barely 14% of them had health insurance coverage.  Before Medicare, almost one-third of all seniors were in poverty—and countless others would have been, if not for large sacrifices borne by their families. Without Medicare’s guarantee of coverage, many seniors needed to make a horrible choice—go to the doctor or put food on the table.

Medicare put an end to that by providing guaranteed access to quality, affordable care for all seniors.  It is responsible for keeping millions of our parents and grandparents out of poverty, giving them a little peace of mind after a lifetime of work. And it has freed up their adult children to invest in the future of their own children, instead of having to worry about whether or not their parents will get the health care they need.

Medicare is a remarkable success story, one that has helped all Americans. Yes, we know it has its problems and they must be addressed. But the overall goal of the program is just as important today as it was when the program began:  guaranteeing seniors access to affordable, quality health care.

The Republican plan to privatize Medicare ends that guarantee. Seniors will pay more for health insurance – much more – than they do today, if they can get coverage at all. Some will get substandard coverage and some won’t be able to afford a policy at all.

Forty years ago, we promised as a nation that health care for seniors would be guaranteed.  The Republican voucher proposal breaks that promise. It’s the wrong way to fix our deficit problem.


Medicare was enacted to give seniors a fighting chance at having a life after retiring from the work force. Many seniors had no insurance because they either could not afford it or they simply could not find any to buy. The insurance companies do not want to insure those who are going to need the most care, ever. Medicare has had problems over the years, most noticeably was/is the spectacular fraud that has been visited upon the system, almost exclusively by businesses, large and small. The so-called fix the Republicans enacted in Medicare Part D actually made the problem worse, and it was simply a pay back to the big healthcare industries that donated quite heavily to Republicans as well as some Democrats. If “fixing” Medicare is a priority, let’s do away with Part D FIRST.

As for the Ryan Budget; please, this is a serious discussion about attempting to balance the budget? Not hardly; if anyone wants to read a real prescription for addressing the deficit, then read The People’s Budget, a very serious attempt to balance the budget according to the CBO (Congressional Budget Office, a nonpartisan division of Congress that works with FACTS). As egregious as the tax cuts for the wealthy are in the Ryan Budget, the fact that there is absolutely no cuts to Defense spending is certainly to me even more outrageous. Please put your skepticism aside for a few minutes and look at what the Progressive Caucus put together and then tell me again how supposedly serious the Ryan Budget is. The fact that so many have bought into the conservative agenda that more tax cuts will always do the trick is mind numbing to say the least.


I just can’t believe how you people think (excluding (,,or their lack of thinking.

This Voucher thing is disgusting, absolutely disgusting. Most seniors,,not a few but most cannot afford private pay insurance. I can’t afford my insurance and I don’t have half of the pre existing conditions that most seniors have. My husband has high blood pressure, his insurance is so high that he has to have his own insurance plan with much less coverage. Just with their age alone seniors insurance will be out of reach. The Ryan bill is creating true death panels,,they’re called insurance companies. The Ryan Bill supporters attitude is ‘screw those seniors, those losers have been living off the ‘nanny state’ long enough, let them fend for themselves’. I just can’t think of anything colder than the people that support the Ryan Bill. The voucher amounts being discussed wouldn’t even cover my insurance premiums and medical bills. The ironic thing about this is, is that I know a few republican seniors (and one very vocal one) that are on Medicare,,don’t they get that they are going to be screwed?

Seniors won’t be able to afford insurance premiums and they certainly won’t be able to afford health care,,,what a sad world we live in when so many people don’t have a problem with throwing our seniors to the wolves ie private insurance companies.

” Before Medicare, seniors were America’s most likely group to be uninsured—barely 14% of them had health insurance coverage” Pathetic absolutely pathetic. I’m ashamed of how the right in this country treat people, its a disgrace. No other industrialized country throws their seniors under the bus like this, they take care of their parents and grandparents.

I know it won’t happen in this area, way too conservative but the rest of the country needs get rid of these neocons. We need the majority in Washington or this country. Look what they did with Bush, now they want to keep up they’re path of destruction.

@easymoney, how did you pay for your cancer treatment bills and your insurance premiums? You must either be pretty wealthy,,,although many wealthy people have lost all due to things such as cancer or you have a job with very good benefits. I’m curious though, how did you do it? Did your rates go up?



Usually the reason things are expensive is because the government is involved. More student loans? HIGHER tuition! More health care regulations, fees and laws? Higher costs. More social safety nets? More money for politicians to play with.

Here is a clue, free of charge: Bush and Obama are interchangeable. Try and wrap your mind around that. Ever notice that it’s been about 100 years since Big Government started to really interfere with our lives, and the whole time, we’ve had a 2-party system (both with useful idiots carrying their water) and as a country we’re STILL going down the same path, regardless of which one is in power? Doesn’t that ever cross your mind?

Knee-jerk reactions to one side or the other, complete with the cute little name-calling that works in your limited social circle of political junkies is really quite useless for the greater good. I don’t care if you hate neocons or liberal commies – whatever your side, it needs to stop. It’s now become serious, and adults need to intervene. This childish game of being one side’s useful idiot really is getting old.


,,,,,,,,,,,,guilty as charged,,,,it’s habit and I do it because that’s how I would be speaking in person. I would be taking a longer pauses when you see ‘,,,,’. Grammatically correct no, good spelling no and BTW in person I’m also not grammatically correct.

IMO most of what you said about the two party system is correct but there is nothing in the Ryan Bill that corrects any of those issues. The bill doesn’t cut down on expenses or cut down the cost of medical care. The only thing it does do is hurt the elderly. Medical expenses will still be off the charts even with the Ryan Bill. Private insurance is not govt. run it is ‘private’, perhaps if we got the govt. more involved then it wouldn’t be so expensive. Govt. doesn’t cause the insurance companies to over charge. The CEO of Blue Cross is making a fortune and I’m sure that his corp is lobbying the right wingers in congress to get this bill passed because they (the congressmen in the insurance co. pockets and the insurance companies) are the only ones that will benefit from this.

I never said that I hate anyone but I’m getting to the point of being disgusted with cold hearted people that could care less about the health of our seniors, it truly sickens this political junkie and BTW the ‘neocons’ in this forum call me and other libs names daily, so get off your high horse, if my skin is tough enough to be called commie socialist or “useful idiot” I believe that most of you are tough enough to called a neocon,,,,,,(there I go again),,,hold the phone, where did I call anyone a name in that post in the first place?


“@easymoney, how did you pay for your cancer treatment bills and your insurance premiums? You must either be pretty wealthy,,,although many wealthy people have lost all due to things such as cancer or you have a job with very good benefits. I’m curious though, how did you do it? Did your rates go up?”

No I am not wealthy, the monicker is an oxymoron…

I have private PPO insurance which I pay for out of pocket every month, as I am a small business owner. No one chips in but me, no one paid for any of my proceedures but me and my paid insurance provider and I have a high deductable to keep the spiraling premium costs down and have to pay that deductable BEFORE any insurance kicks in…

When I asked my insurance provider why they bumped my costs 30% one year and then tried to do so again this year, they claim it is because they are preparing for obamacare mandates coming in 2014. The state insurance commissioner has already spanked them once for this and I am hopeful they get spanked again.

Insurance is like gambling, they are betting I will pay them and yet never make a claim, I am betting that after I pay out the thousands easch year for the priveledge of being covered they actually pay out when needed.

I am not rich, I am a person who takes care of my family and is responsible for my own situation. I am also hopeful that if and when I become of age and need medicare or medical it will be fixed and working so it will still be available but used only as a suppliment.


@easy, we have a few things in common in regards to being self employed, I am in the same boat and I also pay for a private PPO plan. But we pay so much in medical bills including insurance that monthly med costs are like a house payment as a matter of fact medical costs are our second largest monthly payment. We can’t get ahead and spend money to stimulate the economy because of our medical bills.

My Blue Cross just went up again as you insurance did and my benefits went down. I didn’t bother calling as I knew that they would blame health care reform. I know that this is a bogus claim though as they have steadily raised rates and decreased benefits over last ten years like crazy. It has been one of my pet peeves for years. They have now found an excuse to blame it on. They are raising our rates out of greed. Health care reform hasn’t effected them at all.

I agree about it being like gambling. They are very tricky though and they hold all the cards. Insurance companies try to weed women out at certain age by charging crazy premiums because women have more costly health issues then men as they age, I can’t imagine what they would charge a 75 year women. Well a 75 year old women wouldn’t be able to afford insurance unless she very wealthy. Another trick of the insurance companies is that they don’t put medical procedures towards our deductibles so many of us never meet our total deductible. I had almost 20,000$ worth of needed medical care last year and NONE of it went towards my deductible.


Then you especially, should understand that the system is broken and needs an overhaul. Insurance is high because we pay for all those who don’t pay at all or make multiple trips to the ER for a headache or splinter. It is the same thing with the frivolous 911 calls, someone has to pick up the tab.

One of my very first procedures I had “back in the day”, was before I had my current insurance carrier and when I went to Sierra Vista to check in for the pre op, they made me pay a big cash deposit, “because I was employed and had a good paying job”. And I know that if a person is indigent or homeless, and claims to have any ailment fire, ambulance and the hospital are bound to take them in and treat them regardless of ability to pay.

I would not mind extending social benefits to those less fortunate than myself, but I also know that a serious overhaul is needed across the board. Insurance, emergency rooms and public welfare benefits all have their place, but the amount of abuse and fraud needs to stop. As well as legislation that would allow us to shop across state lines for the best service at the best price. Here in CA there is not much choice if you are self employed or do not work for a corporation or the government. Blue Cross is indeed the biggest and in some cases the only choice we have…

So even though we may be from opposite poles politically, we do share the same unfortunate problems when it comes to paying the high costs past on to us…


….” Insurance is high because we pay for all those who don’t pay at all or make multiple trips to the ER for a headache or splinter. It is the same thing with the frivolous 911″…..

The insurance companies don’t pay for the uninsured. They do make huge profits.

The Health Reform Plan addresses most of the things that you mentioned. For example, if I remember correctly the repubs managed to put in that bill a clause that keeps anyone that’s not a citizen from getting any benefits that are presented in the health care bill. I also believe that part of the new health care plan made it so we can cross state lines to attain insurance. Most of the benefits from the health care plan haven’t gone into effect yet and I’ve forgotten a good deal of it but I do believe that it addresses many concerns that you mentioned.

Seeing that like me you are self employed there is a good chance that you will need Medicare one day. Are you willing to give it up? Is your business so lucrative that you’ll be able to pay very high premiums when you retire? Although our family business supports our family and employees a few other people that support thier families we won’t be able to have health insurance when we get older if the Ryan Bill goes into effect as a matter of fact we probably won’t be able to get much in the way of health care at all.


I have watched as things have changed over my years and not always for the better. I have seen a huge increase in those on the dole and in the numbers of illegal aliens. I have seen companies like Blue Cross make huge profits by raising prices and cutting what they decide to cover. I have seen our legislators fight over wording and nuance, I have seen our legislators adding pork to every bill and allow the economy get to where it is today, I have seen them fighting over partisanship without coming up with a budget let alone a balanced one.

I for one have always worked for myself, never taken welfare, food stamps, public assistance or even unemployment. I look out for me and mine, paying all my bills on time, being responsible.

Yet I too know one day if things continue to unravel like they have, I will probably need a secondary insurance program like Medicare. I wonder if it will be worth it and will it actually help or hinder…


Who do you think is paying for all of those newly enrolled children with pre-existing conditions ( thanks to Obamacare) without having built up reserve premium to offset costs? Those insurance companies.


Insurance companies try to weed women out? Really….does anyone but you know this? No, because it simply isn’t true. Just because YOU feel this way doesn’t make it gospel. Blue Shield has a premium band for a family of 4 that is $993 a month. Anthem, for the same plan, has a premium for that same family for $358. The deductible for both is $10k.

You want your cake and eat it too…good luck with that. Can you get gas prices lower too, please???


“Insurance companies try to weed women out? Really….does anyone but you know this? No, because it simply isn’t true.”

danika danika danika, this is always like shooting fish in a barrel, it’s just too easy. I am absolutely correct and there are numerous studies that back up what I said.

There are many studies that indicate that what I’m saying is a fact. The first person that told me that insurance companies want to weed out (my term) women was my doc.. But here’s some info from a study printed in JAMA that was done by Kaiser:

“The health insurance market does not work for older women. Women are less likely to be eligible for employer-based health benefits than men – in fact, less than half of women have the option of obtaining employer-based coverage on their own.2 But the individual insurance market is not a reliable alternative. One-third of older adults seeking coverage in the individual market are denied coverage.3 Discrimination based on age, gender, and health status also means that older women who purchase health insurance directly from an insurance company pay premiums that are roughly four times greater than those who have employer-based coverage.”

There’s another study (not tech savvy enough to CCP two articles) that indicates that women pay an average of 40% more in premiums. Danika, you should Google these things that you know nothing about prior to commenting on them. It only takes a minute and you can learn so much in that minute.

there was a very good study and I can’t remember who did it but if you Google ‘women, I’m not a pre-existing condition’ you’ll find an easy study to read. This study helped form part of the Health Care Reform Act.

What was the point of your insurance quotes? There’s a lot more to an insurance policy then the deductible. I price shop for insurance every year and usually Blue Shield isn’t that far off from Blue Cross AKA Anthem. I presently have Anthem BC because it was less expensive comparably but not by that much.


I have always said thank God I’m not a woman, you have a very hard row to hoe…

Good luck ladies.


easy, why can’t everyone debate like you. I like a good debate and you play fair and square and seem pretty bright,,,,,,,,,even if you are always wrong :) (JK)


No offence taken, even if you don’t know what you are talking about…


No sense getting worked up over a debate amongst ourselves, better to get worked up about our legislators…


Wow, all the commentators seem to be dupes of the corporations and ultra rich. You are the targets of the Repo cuts while the ‘big boys’ get breaks and can easily afford to pay for any services they need. There are many in our land who need a little help-some of them are our parents. Without national help we will have to let them die or bankrupt our younger family to pay for their care.

Real sweet of all of you to throw the less fortunate under the bus while giving a free ride to the fat cats, how lame is that? Want to get tough and balance the budget? Make sure ALL members of our society share in the pain. But that isn’t proposed here, only beating up the young, the old, and the poor. Miserable response to a serious situation that calls for sense, not a hatchet.

And Lois only had so much room. I don’t know what she is thinking or doing but to supply a commentary here on this huge issue will necessarily be limited. It was probably designed to get us thinking about the dangerous ramifications of the seemingly heartless repo proposals. Big cuts to the defenseless and MORE tax breaks for the rich-all backwards.


She could have told us about anything, such as:

When she first ran against Tom Bordanaro, she signed a term-limits pledge and blasted Tom for not doing the same (rightly so, BTW). Still, she has repeatedly broken this promise.

What major legislation has she authored, not co-signed but authored? Any ideas of her own? It’s easy to criticize, harder still to lead.

What positions or leadership does she hold after all of her years in Congress? (even though she signed the term-limit pledge mentioned above, she’s had a LOT of years to do something)

Has she *ever* voted against Pelosi or the party-line on any major bill or legislation? Ever?

Does she have *ANY* thoughts of her own that have not been scripted by the democratic party?

Instead, she chose to attack “the opposition party” – hoping we’d all be good Central Coast lefties and dust-off the “corporations = evil” mantra that hotdog constantly supplies us with. Sorry, many of us want a little more.

As much as I appreciate her taking time out of her “busy” schedule to post a useless op-ed piece, I wish I could have a few of my votes back. I feel cheated sometimes.


“Has she *ever* voted against Pelosi or the party-line on any major bill or legislation? Ever?

Does she have *ANY* thoughts of her own that have not been scripted by the democratic party?”

You’re kidding right? If you don’t have the patience or time to watch C-Span then just track the posts in this forum. Please tell me of one just one time where a con has spoke against the party line. Lois explains her positions on issues. The right doesn’t even do that, they just follow blindly. I’ve watched M. Backmann asked why she feels some way on certain issues and flat out won’t answer at least Lois will, that’s why Palin won’t even talk to anyone other than the hacks on Faux. Libs do the same thing but they do think outside the box once in awhile. I have seen Libs go on the other side on some issues. I myself can be conservative on some issue from time to time, I’ve yet to see a con use thier own brain to form an original opinion.. I take that back, K. McCarthy just did that with the Nuke thing but it’s very rare.


Hurry up and pass that Ryan Budget, I want to party in the streets!

The great socialism experiment has failed, time to start unwinding the nanny state crap and get back to being real Americans. The fruits of my labor are being forcibly taken by the government and I am sick of it. If someone feels strongly enough to advocate spending more of my money on some program, they should first give away all of their money to that program.



Whaa, whaa, whaaa, lois you have had ample time to something. Anything…

Cut the whining and help get the budget balanced and cut the spending.


You people had ample time with Bush and look what you did. We need to not follow you guys off the cliff, we need to do the right thing and fix the messes that you people have gotten us into.


You seem very ungrateful as you wallow in your victim mentality. Perhaps if you tried to appreciate and be grateful for all the blessings in your life, you wouldn’t always sound and act so miserable.


I am very grateful for all of life’s blessings. I am just sick and tired of the socialists in our government continually trying to steal an ever larger portion of my blessing through higher taxes. “Victim mentality”??? Wanting to keep the fruits of my own labor makes me a victim??? Really?

“Miserable”? Maybe we should base the misery index on how much is taken from the producers to give away to the non-producers. I contend that a non-producer’s entitlement mentality is the actual focal point of misery.

The rise of the Taxed Enough Already party is evidence that a large portion of the American people have been pushed to their breaking point. Many who have sat idly by and watched it happen are now taking to the streets. What we have seen so far will be mild compared to a possible future where the socialists continue to attempt to buy votes from non-producers.

I think I need some health care. Socialists make me sick.



Its about time you take responsibility for your lot in life, choprzrul. Playing the victim and blaming all your woes on others won’t help you or anyone else. Maybe you should try living within your means and then you wouldn’t have such a problem paying your fair share of taxes.


So Lois, do you have a better plan? I never saw mention of the Capps Plan!


Yes, Lois along with the other Dems passed health care reform and now they are working on weeding out the waste. That’s the plan and that’s what they’re doing as long as they keep the right from screwing things up again.


While I do not support the “Ryan Plan” at all, since it is nothing but a band-aid on a severed limb!

I am so tired of political hacks coming in and throwing the “sacred cow” crap around: “the other guys are going to kill elderly/starve children/take away firefighters and cops/etc” – please. Can you for just a moment assume we are not brain-dead ideologues who simply regurgitate whatever indoctrination is forced upon us.

A DOCTOR’S LABOR IS NOT MY RIGHT. I have no RIGHT to healthcare, publicly-funded retirement, nor any other “security” from the government. Instead, get the hell out of my way and let me take care of myself and my family!

Yes, there are some where a safety net is needed, but a safety net by the government is a guaranteed system to be gamed by the cheats (both in power and who use it).

Please try to figure out the serious financial problem that is brewing as you speak (that of the real estate loan debacle). Stop pointing fingers and calling names, and DO SOMETHING USEFUL.


Lois Capps, I see you slamming the Republican plan but fail to provide an alternative in this article. You think we can afford as is Medicare? Hell NO! We are b.r.o.k.e. thanks to legislative decisions by like minded persons such as yourself. It’s gonna be painful; it’s gonna be unfair to some. We are broke. I don’t want to owe my soul to China…thank you very much.


With all due respect to the Honorable Congresswoman, Medicare is seriously flawed, and despite efforts to affect repairs, it remains flawed. It is largely responsible for the huge deficits we now enjoy, it is bankrupting medical professionals in private practice who are forced to accept the payments from the Medicare system, it is skewing private insurance costs skyward to make up the costs that Medicare will not pay, and the layers of bureaucracy that do not contribute toward actual health CARE reduce Medicare’s efficiency such that only about 15 cents of every dollar used by Medicare arrives in the caregivers hands, once overhead to manage the dizzying amount of paperwork is factored in.

In the current tax schema, I pay more in Medicare ‘TAX’ than I do to the IRS. A system where competition can drive down costs instead of payment caps or ‘single payer’ gambits is preferable.

Further, I don’t recall guaranteed health care being listed in the Bill of Rights, nor do I think it is the responsibility of the younger taxpayers to pay for the older generation’s hip replacements. For that matter, the term ‘Health Care’ in this discussion is inaccurate, because what is being discussed is HEALTH INSURANCE. I currently pay more than $12,000 per year for health insurance, and since seniors use more medical services, they should bear the costs. That is fair. I bear those costs. I’m over 50 and work to pay for my health care. Surgery for old folks like me is EXPENSIVE. Medicare was not designed as a permanent all-you-can-eat medical solution.

‘Flavor of the month’ may not be appealing, but neither is keeping the status quo.

I respectfully thank the honorable Congresswoman for posting her opinion. Thank You for your service to the district and the country.


Thank God it ends medicare as we know it since “medicare as we know it” is going bankrupt! While Rep. Ryan’s plan may not be perfect, it reduces the deficit more than President Obama’s outline or budget proposal. It is also true that there are tax cuts, and they do affect the wealthy, but those are also offset by getting rid of tax deductions. The “Ryan Plan” restructures the tax code and simplifies it. I got all that from reading over the last few weeks. It would be nice if our elected officials would do so as well instead of reading/writing off a script.

Also, as someone who has survived going to the doctor at least 3 times a year without medical insurance for 17 years, the health insurance reform passed in a partisan vote was unnecessarily complicated.


As a cancer survivor and a person has paid for private insurance all my life i get tired of hearing the whining, especially from politicos who have a benefit package far superior to what any one on Medicare or I have…

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