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Friday, January 18, 2019

By Matt Fuller, CQ-Roll Call (TNS)

WASHINGTON — If the phrase “sustainable growth rate” sounds like it might be useful in putting you to sleep, you might have missed it.

Speaker John A. Boehner (R-OH) is quietly putting the finishing touches on a legacy item, a legislative accomplishment Hollywood is obsessed with and high school civics teachers insist is the third rail of politics: “entitlement reform.”

It’s no accident most Americans haven’t heard much about a potential deal eliminating SGR and making changes to Medicare. A long-term bill is still in question, and final details are still being hammered out. But every day there isn’t an uprising on SGR is a day closer to a deal.

It looks increasingly likely lawmakers will agree to ditch the yearly fixes to the payment formula for Medicare doctors and pay for it — at least some of it — by making changes to private Medigap plans and by forcing wealthier seniors to pay more.

“In budget after budget, Republicans have offered real, structural reforms to strengthen the Medicare program for seniors,” Boehner said in a statement to CQ Roll Call on Wednesday. “This is an important opportunity to start getting some of those reforms enacted into law for the benefit of generations to come.”

Close Boehner-ally and fellow Ohio Republican Pat Tiberi told CQ Roll Call Boehner has always wanted to accomplish “big things.”

“This framework would certainly fall into that category,” Tiberi said. “Speaker Boehner has made entitlement reform a priority over the years because he knows it would have the largest impact on solving our long-term fiscal problems. If the framework of this deal is enacted, Speaker Boehner would and should consider it a major win for taxpayers.”

Yes, Boehner has long argued for an entitlement overhaul. He’s been talking about it since he came to Congress in 1991. And it was a major part of his campaign to be majority leader in 2006. And yet there really hasn’t been much movement on the issue since the ’90s, when Congress passed a welfare overhaul in 1996 and the Balanced Budget Act of 1997. That’s how difficult the issue is.

Of course, the “fixes” being discussed now aren’t the most ambitious changes ever. But they are “changes” adjacent to the word “Medicare.” Sources close to the negotiations say most of the real savings would come from lowering income thresholds for aspects of Medicare that are already means-tested, such as prescriptions and doctor visits, or by increasing the percentage that these wealthier seniors have to pay for their premiums. Currently, means-testing on Medicare kicks in at $85,000 per year for individuals and $170,000 for couples.

Democrats in recent years have insisted any real changes to entitlements be coupled with tax hikes, but they’ve dropped that demand with SGR. And that could be a breakthrough for future negotiations.

Such negotiations aren’t likely to happen while Boehner is speaker. And, of course, this deal could fall apart. But GOP leadership is pushing the yet-to-be-released bill as a win for conservatives, particularly when the long-term savings are considered. Leadership acknowledges the deal would add to the deficit over the next ten years. But proponents say skeptics should look further out and measure the proposal’s long-term savings against the fact that Congress typically doesn’t pay for SGR anyway.

Democrats have stayed mostly silent on the negotiations. Boehner and Ways and Means Chairman Paul D. Ryan (R-WI) told the GOP Conference Tuesday they’d been working with Minority Leader Nancy Pelosi (D-CA) to jam the Senate into taking the House-passed bill.

That bipartisan angle may be part of the problem for conservatives, who would prefer Boehner try to pass legislation with all Republican votes before consulting Democrats.

“He was sitting down with Nancy first,” Representative Tim Huelskamp (R-KA), said of Boehner Tuesday, “and then he’s going to come back to conference and say, ‘Hey, we got the votes. I’m going to ram it through, and together, we’re going to jam the Senate.’

“No, it’s to jam the House Republican conservatives.”

Huelskamp predicted a majority of the GOP conference wouldn’t vote for the long-term deal. “But if he’s got Pelosi and her crowd, and he’s got 30 of the Tuesday group, he’s got her done,” he said.

Expect a lot more than 30 Republicans to vote for a deal. The doctor’s lobby has been all over Congress on this issue, hitting up Republicans and Democrats. And even some of the most conservative voices in the House see merit to a long-term deal.

“This is one that I’m going to take the leap of faith,” conservative Arizona Republican Paul Gosar told CQ Roll Call. “We got to do something.”

If Gosar is in, plenty more conservatives — not to mention rank and file — could join him.

“Democrats aren’t stupid,” Heritage Action Communications Director Dan Holler told CQ Roll Call in an email. “If they’re in on the deal, it is because it serves their long-term interests. Heck, a Democrat leadership aide is touting this as a ‘very big accomplishment’ for the minority!”

Holler went on to say that if Republicans wanted to vote for $130 billion in new deficit spending, that was their decision. “But they shouldn’t pretend they’ll be sneaking something by Nancy Pelosi, Harry Reid (D-NV), and Barack Obama,” he said.

Indeed, Democrats could be waiting until the bill is passed before sending out a round of self-congratulatory news releases. Most of these changes were included in President Barack Obama’s own budget. And even the changes that could affect less wealthy seniors, such as alterations to the supplemental coverage of Medigap, are pretty modest. Negotiators are discussing having seniors pay a deductible of less than $250 before their coverage kicks in. But the more significant changes — at least from a pay-for perspective — are the means-testing provisions.

With years before many of those changes ever take hold, Democrats could be paying for the so-called “doc fix” for free if they’re able to undo the modifications — or just delay them until Congress becomes accustomed to the idea of not doing it.

Sort of like what happened with SGR in the first place.

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8 responses to “Quiet Win For Boehner? Bending The Entitlement Curve”

  1. Daniel Jones says:

    I cannot believe anyone would be surprised at Boehner seeking to move quietly and portray this to House ‘pubs as sneaking it by Pelosi and Co., after six years of House and Senate Republicans torpedoing *their own bills* to avoid being seen as working with the Obama Administration.
    ~~
    Simply put–he *has* to sneak Republican efforts by until they are ratified and enacted into law, or these Yahoos will literally prevent their own successes!

    • Dominick Vila says:

      The fact that Boehner and Pelosi have been working together on this issue is likely to make the TP heads explode! This is a legitimate concern that deserves attention. The key is to do it in a way that does not jeopardize the retirement benefits that millions of Americans depend on to survive.
      A few weeks ago I joked about cyanide pills becoming a viable option for those who refuse to pay for what their elders need, like we did when we supported ours. It may not be long before such options are part of the solutions by those whose idea of achieving a balanced budget depends strictly on taking away what our most vulnerable citizens need to survive.

  2. charleo1 says:

    As long as 9 of every 10 dollars produced in the economy flows through the hands of the top 1%, the easier it becomes to find more bi-partisan support in Congress for cutting taxes at the top, than paying for programs that help the masses. So over time, it’s a gradual adding to the benefits of the rich, causing a rise in deficits, leading to calls for, “fiscal responsibility.” Which puts social programs once again back on the chop block. Where they are whittled down, ostensively to offset deficits that stubbornly continue to climb. Now, the remedy next proposed by the Right to quell the rising public debt, demonstrates the insidiousness, and singleminded tenacity of these Darwinian cretans to eventually eliminate the social safety net forever. And it is not cuts to Medicare, Medicaid. Why heavens no! They are in love with Medicare! They are trying to save it! What they say is just the ticket, just what America needs. Heck, just what all Americans have been screaming for. The thing for which there is more, bi-Partisan support in Congress by far than anything else. Another fine round of tax breaks for the rich!

  3. Dominick Vila says:

    The Devil is in the details. If the compromise reached between Boehner and Pelosi involves asking wealthy seniors to pay more for the MEDICARE services they get, I doubt too many seniors will object, but if it involves curtailment of benefits or higher costs for all seniors, the Grand Ayatollahs of this deal are going to pay a heavy price in 2016. Honestly, I expect this to be a political stunt turned into a huge accomplishment. Both parties are well aware of the fact that messing with Social Security and MEDICARE means the end of their political careers. What happened to the old fashion concept of paying for what we get and need?
    There is no question that as our demographics continue to stretch our ability to provide adequate services to seniors and students, something is going to have to give sooner or later. The ratio of beneficiary Vs contributor is reaching the point of being unsustainable, and it is likely to worsen as time goes by. Our birth rate of 1.8 per couple, and our stand on immigration, suggest negative population growth for decades to come, which means that the current situation is likely to worsen in the not too distant future.

  4. Eleanore Whitaker says:

    Shocker for the GOP power drunks…It takes 60 votes in the Senate for the Congress to pass ANY legislation. So Boehner is really as lame a duck as Speaker as the GOP wants to believe this powerhouse President is. It generally takes more than 41 Democrats to block a vote when the Minority Leader in the Senate so desires.

    Even if the GOP has the majority control of the Senate agenda, it still needs the approval of the Senate Minority leader to pass legislation to bring it to a vote.

    For example, the Keystone pipeline legislation failed because it needed the 41 Dem votes for a total of 67 to pass. It failed.

    The GOP would love to change Senate rules to the nuclear option where only the majority and not the 41 Dem votes would be required. However, no matter what the House or Senate proposes, the president still has veto “power.”

    To impeach a president takes 67 votes. This is one example of why House GOP couldn’t use the budget process to stop Obama’s executive actions on immigration and why McConnell egged Cotton on to write that letter to Iran to subvert Obama’s executive right to take action on foreign policy as Commander-in-Chief of the military.

    President Obama tried to work with the GOP in January 2009 by adding several Republicans to the cabinet. He was soundly rebuffed by Boehner and McConnell, who demanded the Republican cabinet candidates withdraw to embarrass the president.

    Now, Obama has NOTHING to lose. He can and will do what he believes is best with or without Republican cooperation. They haven’t cooperated in 6 1/2 years. He knows they won’t for the rest of his term. He has accomplished most of what he set out to do in 2009. More than any GOP president EVER has.

  5. tdm3624 says:

    “He was sitting down with Nancy first,” – Rep Tim Huelskamp, more concerned with party loyalty than governing.

  6. booker25 says:

    Republicans continue to do the bidding of people like the Koch Bros who won’t be happy until they crush the middle class out of existence.

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