Rep. Paul Ryan, a Republican authority on spending and taxes, made a dramatic break Thursday with the deficit and debt reduction plan released the day before by President Obama’s commission.
“I think it goes backwards,” Ryan, a Wisconsin Republican and the next chairman of the House Budget Committee, said at a breakfast with reporters sponsored by the Christian Science Monitor.
“I think it makes health care dramatically worse. And look, I’m trying to be guarded in my comments because I really respect what [commission co-chairs] Erskine [Bowles] and Alan [Simpson] have done. They should be commended. But they didn’t deal with health care.”
Ryan’s comments are the most unconditional rebuke of a plan that has been regarded even by conservatives on the commission as fairly conservative because of its recommendations on cutting spending in some parts of the budget, and on reform of Social Security and the tax system so that rates can be dramatically lowered.
Ryan, whose acumen with budget data has elevated him over the past year to become a leading figure in the GOP, acknowledged positive progress on these other issues, but said they were overshadowed by an acceleration of the health-care system put in place under Obama’s new law passed in March.
“It takes a few steps forward on social security and taxes and discretionary [spending], but it takes many steps backwards in health care. And that’s the big thing,” he said.
So far, nine of the commission’s 18 members have said they plan to vote for the plan released Wednesday, in a vote to be held Friday.
But even though Sen. Tom Coburn, the Oklahoma Republican who is as conservative as Ryan and who has worked with him on an alternative health care plan, is going to vote for the plan, Ryan said he will not vote for it.
“It not only didn’t address the elephant in the room – health care – it made it fatter,” he said.
The main feature of the debt commission plan that does this, he said, is changing tax laws to give a tax break for employer-provided health insurance, without doing anything to change the broader system put in place under Obama’s overhaul.
“If you repeal the tax exclusion for individuals while maintaining the infrastructure of Obamacare — this actually enhances it in a few ways — then all you’re doing is accelerating the expansion of Obamacare,” he said. “You’re going to accelerate the dumping of people from employer-sponsored health insurance into these exchanges. The exchanges will grow and magnify far faster than [Congressional Budget Office] or anybody else anticipated.”
“We’re going to expand and blow up a new entitlement,” he said. “It makes the health care cost curve go up not down.”
Ryan created a comprehensive plan a few years ago, called “The Road Map,” that would dramatically alter the way health care is paid for, specifically in programs like Medicare and Medicaid. His plan would give a payment to individuals and allow them to shop for the best price for services.
Critics say these vouchers, a term Ryan does not necessarily prefer, would be outpaced by the soaring costs of health care. Ryan believes that a system that empowers consumers to hold providers accountable for pricing is the best way to drive down costs, rather than a government-enforced system of price controls or private sector intervention.
He said that the nation’s unfunded liabilities have risen from $62.9 trillion in 2009 to $88.6 trillion, according to the Government Accountability Office.
“Five-point-three trillion of that is Social Security,” Ryan said. “The rest are health-care programs, federal health-care entitlements. You cannot fix this problem without taking on health care.”
The Bowles/Simpson plan, Ryan said, “exacerbates the health-care problem.”
“It doesn’t even take a step in the right direction. It takes many steps in the wrong direction from my perspective. It accelerates and entrenches the Obama care system, which to me is a huge step in the wrong direction.”
But a spokesman for Coburn said that the Republican senator “agrees the plan doesn’t do nearly enough on health care” but will support the commission proposal because “we’re assuming [Obama’s health care law will be] repealed.”
“Ryan’s critique seems to assume Obamacare stays in place,” said Coburn spokesman John Hart. “If Obamacare is repealed, the debt commission plan goes from a small step forward to a big step forward on health care.”
“In fact, the debt commission takes a step toward repealing Obamacare. The plan repeals the CLASS Act, a provision in Obamacare, and replaces it with spending cuts,” he said.
Ryan signaled that he wants to include many features of his “Road Map” in the budget he will propose next year as chair of the Budget Committee, but said he does not know how many of his Republican colleagues, who have shied away from his plan in the past for fear of becoming vulnerable to political attacks, will want to vote for such a budget.
“I know what I want to do but I don’t know what I can do,” he said.
Nonetheless, his comments raised the prospect that early next year the House could end up passing a budget proposal that would be a direct contradiction and rebuke — and a comprehensive alternative — to Obama’s health-care law.
“We will be choosing what kind of future we want to have for the rest of this century in the very near future in this country, probably in 2012,” Ryan said. “So I believe we owe it to the country to give them an alternative choice than the path we’re on right now. And I really sincerely believe, and I’ll back it up all afternoon long if you want me to, we’re on a path to being a social democracy, a cradle to the grave European-type welfare state.”