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GOP should avoid Medicare third rail

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Rodney Whitlock writes in Health Affairs:

“Republicans have expressed interest in repealing and replacing the Affordable Care Act (ACA), restructuring Medicare to a premium support model, and reforming Medicaid through either block grants or per capita caps. Taking on all three programs is an extremely heavy lift — both politically and legislatively. If it is improbable to do all three, Republicans should openly acknowledge that they are taking Medicare restructuring off the table. This is not meant to belittle the importance of Medicare as a fiscal issue. The reality is that this election was in no way a mandate for major Medicare restructuring, and the President-elect came out rather strongly against the concept during the campaign.

“With premium support-style Medicare reform off the table, the political calculus changes dramatically for the Democrats. The Democrats have been revving up the Medicare privatization rhetoric that has been politically beneficial since 1995. Without Medicare as a rallying point, Democrats would be forced to defend the Affordable Care Act (ACA) which is relatively unpopular and in need of reconsideration. Refusing to engage might not be in their political interest. And while the Medicaid program is critical to the people it serves, it has not been shown to be the salient political issue that drives voters the way Medicare has.”

Of course Medicare has long since become a political third rail because elderly people vote at very high rates compared to younger and/or poorer folks.

To read Mr. Whitlock’s full piece, please hit this link.

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