Mitt Romney was dead wrong, and deliberately so, when he told viewers in the first presidential debate that people 60 or older "don't need to listen any further..." about how his proposed health care changes would impact Medicare. He said that simply because he wants current Medicare participants, and Americans workers who yet hope to obtain its security in the next few years, to think his plan wouldn't change Medicare for them.
But it would, in major and very destructive ways. A new analysis by Families USA, one of the nation's most respected, nonpartisan, healthcare advocacy groups, confirms the extent of the damage from Romney's cuts. Its summary:
"These proposals would increase Medicare premiums; force seniors to pay considerably more for their prescription medicines and prevent care services; and cause many physicians to stop seeing Medicare patients.
"They also would hasten the program's insolvency. The result is that seniors would lose the peace of mind they now enjoy, knowing that high-quality, affordable care is there for them," said Families USA executive director, Ron Pollack.
Families USA findings show that Romney's plan to shift funds out of current and future Medicare budgets and its trust fund would result in an almost immediate increase in Medicare premiums, along with a range of additional related domino cuts in the next 10 years. These increases would be triggered under the terms of the 1965 Medicare Act, which requires premiums to be balanced against current and projected tax revenue. If budget projections for immediate and future revenue are cut as Romney proposes, premiums would rise, and cuts in services would be mandated.
Romney frankly proposes to cut Medicare revenue by more than $700 billion by making it a limited voucher program in a few years designed only to help seniors buy private-market insurance. He promises, in addition, to jettison President Obama's plan to save a similar amount -- $716 billion -- by ending subsidies to, and overcharges by, private, for-profit health insurers and providers, and plowing that money back into benefits and an extension of the Medicare trust fund.
Romney's overall cuts would lead to the unraveling of the physician network for Medicare, and ignite an unending cost spiral due to the cutoff of younger, healthier patients whose premiums now help sustain the Medicare network. That problem would be compounded by private insurers' penchant for cherry-picking younger, healthier customers, and avoiding customers whose aging and health problems would pose bigger costs risks, leading to a growing voucher-gap.
Romney also promises to whack funding for in-home nursing care for seniors on Medicare, and to make deep cuts in actual nursing home care in Medicaid, which actually finances most of the nation's nursing home care. The Romney/Ryan proposal calls for cutting Medicaid by around a third, a huge and alarming amount.
As Romney cuts current and projected funding for Medicare, the costly dough-nut hole in prescription drug coverage -- now being reduced by Obama, and soon to be eliminated -- would widen again, along with the loss of new wellness care provided by Obama's Affordable Care Act. Under Romney, the return of the original dough-nut hole exclusions on prescription drug costs would widen next year to $3,800. That would instantly reverse the savings, under Obamacare, which helped nearly 4 million Medicare recipients save an average of $613 on prescription drugs, Families USA found.
And while Obamacare would extend the Medicare trust fund to 2024, Romney cuts would bring on a trust fund deficit beginning in 2016.
Given all the cuts and defunding promised by Romney, it is perfectly clear that Romney and Paul Ryan are targeting the demise of Medicare as we know it -- and not its voucher salvation, as they claim. If Americans understood the dire direction Romney would take Medicare, all but the super-rich would reject it. The question is, are they listening closely enough.