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Boehner Counteroffer: Raise Medicare Age to 67

Badgered by yon lean and hungry Eric Cantor and the tea party caucus, Speaker John Boehner makes a counteroffer to the White House, and as Wonkblog's Sarah Kliff explains, there are a lot of reasons why his proposal to raise the Medicare age is a bad one (even if Jacob Lew, rumored to be the next secretary of the Treasury, is said not to have a problem with it):

House Speaker John Boehner has made his counter-offer on deficit reduction and, as my colleague Lori Montgomery reports, it floats the idea of raising the Medicare eligibility age from 65 to 67.

This isn’t a new idea: It’s come up in a lot of deficit reduction proposals of years past, as economists and legislators stare down a Medicare program eating up a growing chunk of the federal budget.

The idea has, however, gained a bit more traction since the Affordable Care Act passed. If the Medicare age were raised, the thinking has gone, the 3.3 million 65- and 66-year-olds would still be guaranteed access to health coverage through the tax subsidies. The lowest-income seniors — those earning less than 133 percent of the federal poverty line – would qualify for Medicaid.

That’s the upside. Health care economists see a number of downsides, too. For one thing, Medicare tends to be a pretty efficient program. Its costs have grown slower than private health insurance plans. The Center for Budget Priorities and Policy estimates that, while the federal government would save $5.7 billion, the rest of the health care system would end up spending $11.4 billion more to provide those same benefits.

Seniors themselves would end up spending $3.7 billion more as the benefits on the exchange would be less robust than those currently covered through Medicare. Employers would end up footing part of the bill, too, continuing to sponsor an additional two years of coverage.

That $2.5 billion in orange on the chart above comes from increasing the premiums that a lot of other people pay for their health insurance coverage. The Kaiser Family Foundation estimates that moving these seniors into the health insurance exchanges would increase premiums there by 3 percent, as the larger insurance pool absorbs a patient population that tends to be older and sicker than its younger counterparts.

Medicare premiums likely would go up too. These seniors would be the more expensive enrollees on the exchange. But when it comes to Medicare, they’re the least expensive patients, the younger population with fewer health care needs than, say, the 90-year-old cohort.

There’s also concern that these seniors might not even have an option should the eligibility age get raised as some states do not plan to expand their Medicaid programs. That could leave any senior who earns less than 133 percent of the federal poverty line — about $15,000 for an individual — without any coverage option at all.

Not to mention that many, many specialists refuse to take Medicaid patients -- a real hardship for the elderly.



Suddenly, Grover Norquist Wants Transparency In Politics!

Boy oh boy. This episode of Press The Meat is one for the record books. If you didn't know that Grover was a co-founder of the K Street Project and the host of his infamous Wednesday morning meetings, you might think he was really concerned about the integrity of the political process!

DAVID GREGORY: Grover, I want to start with you as we get first reaction to Secretary Geithner. the line in the sand is clear, and that is that the administration, the president, says that Republicans will indeed blink, that they will ultimately have to acquiesce, tax rates have to go up.

NORQUIST: Well, your interview with him was very, very helpful to me because in the past, there have been some Republicans who thought that maybe the administration, like Clinton, was going to be reasonable, that they might put real reforms like welfare reform like Clinton did on the table. what we just heard was no reforms. He even took the $1 trillion in spending cuts they agreed to, to the debt ceiling, took that off. So we’ll spend $1 trillion more there [...] this is a massive collection of spending increases and tax increases. Every Republican who had impure thoughts of maybe I could raise taxes a little because the other guy would be reasonable has to go back to the drawing board. They have just been told there are no real reforms in this budget at all.

GREGORY: But what about the –

NORQUIST: $1.6 trillion in tax increases, and some of the savings are actually tax increases.

GREGORY: How about the direct point? The Treasury Secretary telling me, look, Republicans are not going to stand in the way of tax rates going up. True or false?

NORQUIST: Republicans want to continue the Bush tax cuts and the extenders and the AMT patch and so on. And what we did two years ago, what Clinton signed two years ago, with a Democratic House and a Democratic Senate did two years ago, is exactly what we should do now to start with. It’s the president who is threatening to raise taxes on the middle class if he doesn’t stamp his feet and get his way. He needs to get into a room with cameras there and negotiate. That was all show and no economics. Have it in front of C-SPAN cameras. If the Republicans are reasonable, we’ll see that. If not, we’ll see that. Have cameras there.

Actually, Grover, it wasn't Clinton - it was President Obama who signed that. But it appears you're feeling a little insecure and shaken up lately. I wonder why?

And if you want to negotiations to take place on C-SPAN, fine. Just as soon as your Wednesday morning meetings are televised, too. Only fair, right?



The State of Play

One of the thing I learned while in the Clinton White House is that most Washington rumors, I’d say generally around two out of three, are false. In a deadline/crisis period that number goes to about 95 percent false. And by rumors, I am including most news reports, which trade in rumor, gossip, and leaks designed to help the agenda of the leaker. So most of what is coming out of D.C. right now on the default crisis is garbage. What deal is up and what deal is fading changes so fast that it may even be true at the moment it is reported, but could be completely reversed 15 minutes later.

So every time your blood pressure spikes in the coming days, just take a Valium like a normal person (as the sister-in-law character from “Desperately Seeking Susan” would say), and go do something other than watching cable TV.

Having said all that, though, there are some things that seem a lot more certain. The economy, already stalled, will have more roadblocks piled in its way. Middle-class and poor people will get more cuts in government programs that really do matter to their lives and their incomes. Nothing will be done to actually make the investments in infrastructure and housing and manufacturing we so desperately need. It is a sad state of affairs.

Many people, me included, have all kinds of theories — short-term and long-term — as to how we have gotten into this terrible place, but that is not my subject today. I want to talk about what happens if the worst of the rumors becomes mainly what happens. I still am hoping against hope that the final deal the President agrees to will not be as bad as the current rumors have it. Maybe the details will be a lot better than what they sound like today. Maybe the rumor mill just has it wrong, and that the deal that happens doesn’t have cuts in Social Security or Medicare that hurt the middle class. Maybe the McConnell-Reid compromise, which right now is the best of the deals out there, will come back into favor. But if this deal does as much damage to the middle class and poor as is currently rumored, if any tax increases are fudged so that might not even happen at all, then I think progressives have to declare all-out war on the deal and try to rally Democratic members of the House and Senate to vote against it and defeat it.

I want to be clear: I don’t believe that means declaring war on the President. The idea of Bachmann or Romney or one of these other Ryan-budget loving extremists as President, with these Republicans in charge of Congress, is a mortal threat to everything any progressive person, or for that matter any of the 80 percent of Americans who care about the middle class, cares about. Social Security and Medicare and Medicaid and Pell Grants would likely be gone, not just cut, by the time they were through. We still have to help get Obama re-elected, no matter how much we oppose him on specific issues. But just because you support his re-election doesn’t mean you have to support a terrible budget deal. If it is as bad as it looks like it might be, we have to leave no stone unturned in tracking down every Democratic vote to beat this bill. As bad as a default will be, and it would be very bad for the economy, decimating the middle class for generations would be worse. I also think if a bad deal goes down, the President and Congressional leaders would very quickly pass a version of the McConnell compromise, which would not be nearly as damaging as a bad deal.

We live in dark times, and they will get darker if the President is not re-elected. But that doesn’t mean the rest of the Democratic Party has to support him when he is wrong on policy.