Josh Barro on Romney-Ryan vs. Ryan

Josh Barro of Bloomberg View takes conservatives to task for their efforts to reconcile the Romney-Ryan stance on Medicare spending over the next decade with the Ryan FY 2013 budget:

Cutting more than $700 billion out of Medicare over 10 years is hard. Ryan’s position is that he will make those cuts, but they won’t be through an IPAB or an IPAB-like mechanism. And they won’t be through premium support. And they won’t hurt seniors. But we don’t get to know how they will work. It is no surprise that defenses of this position fail.

The other defense, offered by both [James] Capretta and [Avik] Roy, is that even though Ryan favors big Medicare cuts over 10 years, Romney doesn’t, and Romney is at the top of the ticket. There are two problems with this. The first is that, in March, Romney said he was “very supportive of the Ryan budget plan,” which includes the Medicare cuts.

Let’s say Romney has changed his position — it’s happened before — and now he wants to restore all the Medicare cuts from PPACA through 2022. That would mean Medicare spending would grow from $560 billion in 2011 to $1.17 trillion in 2022. Allowing Medicare spending to double in eleven years is a position that conservatives should attack, not defend.

Josh underscores the scale of the Medicare savings PPACA is committed to achieving, and it is extraordinary. My sense is that the Romney-Ryan campaign is prepared to bite the bullet and embrace a trillion-dollar Medicare budget as a down payment on longer-term reform, but Josh raises really important questions: even if we shrink the growth of Medicare, we will be doing so from this much higher base.

Reihan Salam — Reihan Salam is executive editor of National Review and a National Review Institute policy fellow.

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