Politics & Policy

Congressional Malpractice

Medicare, in the emergency room.

A story published in Monday’s New York Times painted a bleak picture regarding the financial future of our nation’s Medicare and Medicaid programs. “Economists and health policy experts say the federal health programs are unsustainable in their current form, because they are growing much faster than the economy or the revenues used to finance them,” the story noted. “The Medicare program is especially endangered; its hospital insurance trust fund is expected to run out of money in 11 years.”

Such dire predictions are not unfounded. Last week, the federal Centers for Medicare and Medicaid Services (CMS) released a report showing that — if left unchecked — government health-care spending will grow to over $2 trillion by 2017, and Medicare alone will constitute nearly one quarter of all health-care spending in the United States. A 2007 Social Security and Medicare Trustees report put this into perspective, noting, “Medicare’s financial difficulties come sooner — and are much more severe — than those confronting Social Security. While both programs face demographic challenges, the impact is greater for Medicare because health care costs increase at older ages.”

Both the CMS and New York Times reports are just the most recent reminders of something we’ve known for some time now: There is an urgent need to reform Medicare and preserve the program’s benefits for future generations of American seniors. The next move is up to Congress, and this week, we will begin debating a new federal budget that could allow us to take the first critical steps toward real reform. Will we take the initiative to make the necessary yet difficult choices to save Medicare, or will we become the political equivalent of the ostrich, sticking our head in the sand and waiting for the next generation of lawmakers — and taxpayers — to accept this responsibility?

In 2003, the Medicare Modernization Act included a little-known provision — known as the “trigger” — that requires legislation to bring down future Medicare costs if the program draws more than 45 percent of its funding from general revenues (instead of the Medicare trust fund) for two years in a row. The provision is basically a tripwire, a mechanism to force Congress to stop putting off Medicare reform. When the “trigger” is pulled, it starts an expedited process for developing and passing a bill to bring the share of general revenue back down.

Not surprisingly, the “trigger” has kicked in, and a week ago, I introduced a proposal that gives both parties in Congress a fresh opportunity to begin making the decisions necessary to ensure Medicare remains viable for generations to come. Is this bill the be-all, end-all answer to the problems facing Medicare? No, but it is a foundation on which we can build even more substantial reform. The American people know that Medicare must be reformed or future benefits will be threatened, and by addressing the skyrocketing costs of medical liability insurance and ensuring Medicare remains focused on the neediest seniors first, this proposal begins the process of making the tough decisions we all know we’ll need to make in order to save the program.

Unfortunately, congressional Democrats in charge of Congress have been largely absent from our efforts to preserve Medicare on behalf of seniors and taxpayers alike. Democrats, it turns out, could teach the ostrich a thing or two about hiding from a problem. A year ago, the majority forced through Congress a budget that was completely silent on Medicare reform and — frankly — anything that approached real reform for other entitlement programs like Social Security and Medicaid. Republicans offered an alternative plan that addressed the impending crisis, but Democrats ignored our plan and Congress punted.

Fast forward to this year.

After last week’s announcement that the “trigger” had kicked in and amid the mounting reports of Medicare’s perilous state, House Majority Leader Steny Hoyer took a pass once again, saying, “I believe this issue will be one of the most important that the next Congress and the administration must address.” In other words, we know there’s a major problem — but let’s not worry about actually acting on it until next year at the earliest. That’s simply irresponsible.

What’s also irresponsible is that last year, when Majority Leader Hoyer and other House Democratic leaders last attempted to deal with Medicare (as part of their broader plan to expand the State Children’s Health Insurance Program to cover more adults and illegal immigrants), they backed a bill that would have taken a meat cleaver to the most successful and innovative part of the Medicare program, private sector-based Medicare Advantage, as part of a scheme to lure upper-middle class families into government-run health care. That would have been a catastrophic approach, and fortunately Republicans worked to stop the scheme from ever becoming law. But to simply ignore the problem altogether — as the majority apparently intends to do again this year — is not much better.

By passing a bipartisan economic-growth package earlier this year, Congress has proven that when Democrats are willing to work with Republicans, we can get things done for the American people. A priority like Medicare reform — or any type of entitlement reform — which is admittedly politically volatile, requires bipartisan cooperation. I stand ready to work with any Democrat who is willing to work seriously to confront this issue.

The highest responsibility of every elected official is to leave the nation better off for the next generation. Failing to deal with the demographic tsunami facing our entitlement programs would be a clear breach of that trust. It would put an unsustainable burden on our children and grandchildren, and it would be a failure of epic proportions.

  — John Boehner (R., Ohio) is Republican leader of the U.S. House of Representatives.

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