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Republicans still seek Medicare overhaul in budget talks

By Tom Cohen, CNN
  • Show us a better idea, top Republicans challenge Democrats
  • Democrats say the Republicans want to "end Medicare as we know it"
  • The GOP plan is blamed for the party's loss of a traditional Republican House district

Washington (CNN) -- Top Republicans tiptoed their way around the Medicare question Sunday, playing to their conservative base by backing a controversial overhaul proposal while acknowledging they will have to negotiate the issue with Democrats.

Senate Minority Leader Mitch McConnell, R-Kentucky, and House Majority Leader Eric Cantor, R-Virginia, both told Sunday talk shows that all issues are on the table in deficit reduction talks led by Vice President Joe Biden intended to reach a deal on raising the federal debt limit.

That would include the Medicare overhaul plan initiated by House Budget Committee Chairman Paul Ryan of Wisconsin, which is embraced by bedrock conservatives but appears too extreme for the general public. It was the main issue of a special election last week in which a Democrat won a traditionally Republican House district in New York.

"Medicare will be a part of it; the details will have to be negotiated," McConnell told NBC's "Meet the Press." He refused to get drawn into specifics, but insisted that Republicans were united in reforming the government-run health care program for senior citizens.

McConnell said he was "very comfortable" with Ryan's proposed overhaul that would end direct government payment for health care by 2022 in favor of government money to help people pay for private health coverage. However, McConnell noted, President Barack Obama is a Democrat and Republicans "have to work with him" to get a deal.

Cantor, appearing on the CBS program "Face the Nation," answered "absolutely" when asked if he continued to support the Ryan proposal despite a public backlash against it -- as evidenced by the New York special election -- because it will increase health care costs for senior citizens.

"It's undeniable it played some role in the election," Cantor said of the Medicare issue. He depicted the situation as one in which Republicans were taking a courageous stand by offering an unpopular solution while Democrats offered no credible alternative.

In the White House-led deficit talks, Republicans seek fiscal balance by shrinking the size of government through deep spending cuts and reforming entitlement programs such as Medicare, Medicaid and Social Security that consume the lion's share of government money.

Democrats want increased tax revenue as well as spending cuts to address the fiscal imbalance, and are reluctant to overhaul the entitlement programs that comprise the social safety net for senior citizens, the indigent and the disabled.

Both sides agree that some kind of change is necessary in Medicare, but differ sharply on scope and shape.

While Ryan's plan would preserve Medicare in its current form for those 55 and older, it would eliminate health care reforms enacted by the Obama administration. Democrats argue that the Obama reforms are the basis for reducing Medicare costs and increasing its efficiency, while Republicans say more substantive change is needed.

"Either we're going to save the program or you let it go bankrupt," Cantor said of Medicare. "We put forward a program to save it. Where is their plan? They don't have a plan."

He called Democratic criticism of Ryan's proposal "demagoguery" and scare tactics.

In response, Rep. Debbie Wasserman Schultz of Florida, the new head of the Democratic National Committee, noted on the CBS program that Republicans used similar political attacks about Obama's health care reforms in last year's congressional elections.

Now, she said, the GOP seeks to "end Medicare as we know it," while Democrats are seeking a balanced approach.

On NBC, Democratic Sen. Chuck Schumer of New York insisted that Republicans have to drop Ryan's Medicare overhaul in order for any deficit reduction deal to emerge.

"We have been proposing changes in Medicare for a while, but we believe in preserving the current system," Schumer said. "Medicare delivers a very good product. Most people are very happy with the health care they get. It's just an inefficient system, and there are ways that you can change the way Medicare delivers things without cutting the benefits to individuals and still save hundreds of billions of dollars."

If Republicans don't drop the Ryan plan, Schumer said, "it will legitimately be one of the major issues in" the 2012 election.

Despite all the political grandstanding, Cantor said on CBS that the Biden-led talks so far have been "all positive," and he acknowledged that "everything is on the table."

Less clear was whether the Republican stand against tax increases also means opposition to any increase in tax revenue, even from a reform of the tax code that lowers rates but brings in more money by eliminating loopholes and subsidies.

Anti-tax conservatives oppose any kind of tax-revenue increase, believing that undermines their efforts to shrink the size of government. However, some Republicans have started differentiating between higher tax rates, which they oppose, and the possibility of increased revenue through tax reform.

Republican Sen. Tom Coburn of Oklahoma, a leading fiscal conservative, told C-Span's "Newsmakers" program that he recognized increased tax revenues will likely end up being part of a comprehensive solution.

However, the main thrust of a workable plan must be slashing government spending and obligations through entitlement reforms that address the major source of the imbalance, Coburn said. Asked about the stated opposition to tax hikes by his GOP colleagues, Coburn said he believed many Republicans would accept increased tax revenue but only as part of a plan that "really solves the problem."