Surprise! HHS pilot program to send 2 million poor seniors from Medicare into … “voucher” programs

posted at 11:01 am on September 8, 2012 by Ed Morrissey

I know that every campaign promise Barack Obama makes has an expiration date … but this is ridiculous.  The confetti is barely off the floor at the Time Warner Cable Arena in Charlotte, North Carolina after Obama’s acceptance speech, and already we find out that he’s flip-flopped.  Remember this part of the speech, in which he attacks the Paul Ryan plan to apply free-market reform and cost controls to Medicare?

And I will — I will never turn Medicare into a voucher.

No American should ever have to spend their golden years at the mercy of insurance companies. They should retire with the care and the dignity they have earned. Yes, we will reform and strengthen Medicare for the long haul, but we’ll do it by reducing the cost of health care, not by asking seniors to pay thousands of dollars more. And we will keep the promise of Social Security by taking the responsible steps to strengthen it, not by turning it over to Wall Street.

Expiration date — the very next day, courtesy of some fine reporting by National Journal’s Margot-Sanger-Katz [see update]:

In his convention speech in Charlotte, President Obama vowed to block the Republican Medicare reform plan because “no American should ever have to spend their golden years at the mercy of insurance companies.”

But back in Washington, his Health and Human Services Department is launching a pilot program that would shift up to 2 million of the poorest and most-vulnerable seniors out of the federal Medicare program and into private health insurance plans overseen by the states.

The administration has accepted applications from 18 states to participate in the program, which would give states money to purchase managed-care plans for people who are either disabled or poor enough to qualify for both Medicare and Medicaid. HHS approved the first state plan, one for Massachusetts, last month.

Bear in mind that Ryan’s plan made the vouchers optional; seniors could choose the traditional government-run Medicare plan or opt for a private insurance plan from a federal exchange of approved insurers.  Ryan also allows all seniors to choose, and didn’t force the poorest seniors to take the voucher option.  Not only will Obama push just the poorest seniors into this plan, in some states they’d have to know to opt back in to traditional Medicare:

California is already counting on more than $500 million in budget savings from its own program this year. Most states are proposing to automatically enroll people. Those who don’t want to participate would need to opt out. The Massachusetts plan includes that feature.

Talk about leaving seniors — the poorest seniors! — “at the mercy of insurance companies.”   And why has HHS decided to roll out this pilot program?  As Paul Ryan has argued all along, the competition will drive down costs, especially given the headaches associated with government bureaucracy for dual-qualified seniors:

Potential cost savings are a big incentive for states. Patients who qualify for both federal health programs are a costly population and include many who need nursing-home care or other expensive services. About 40 percent of Medicaid’s costs go toward patients who are also eligible for Medicare. Advocates of the pilot program also say it could lead to better coordination of care for patients who often struggle to navigate the two different programs.

Don’t get me wrong — this sounds like a good program to test.  In fact, it sounds a lot like the Medicare Advantage program that Obama gutted to pay for his Medicaid expansion in ObamaCare.  It’s similar to the approach Ryan wants to use to drive down costs, except that Ryan didn’t propose to use the poor as guinea pigs to test it out.  And he certainly didn’t propose his plan quietly while hypocritically railing against private insurance and Wall Street just as the program got ready to start.

Update: A couple of commenters object to my description of this as a “voucher” program — but that’s how Democrats describe Ryan’s plan, and that doesn’t have “vouchers,” either.  It’s a premium-support plan in a federal exchange of insurance plans approved by Medicare for coverage.  That’s what Medicare Advantage did too, and Obama raided it to pay for the Medicaid expansion in ObamaCare.  This plan doesn’t even have the federal exchange that Ryan envisioned, but fifty different exchanges doling out federal dollars.  Like I wrote, the plan and the experiment is worth trying, but it’s precisely the kind of push into private insurance that Obama swore the day earlier he’d never do … and he’s doing it with the poorest seniors with only an opt-out in some states rather than the opt-in that Ryan’s plan provided.  I’ll put quote marks on “voucher” in the headline, but this mechanism only differs from Ryan’s in that the exchanges get managed by the states rather than Medicare.

If Obama supporters don’t like the term “vouchers” or want to gripe about its accuracy, look first to the beam in thine own eye.

Update II, 9/10/12: Usually, I try to mention the name of the publication when I link, and especially when the reporter does really good work.  Margot Sanger-Katz did a great job in catching this, and I completely forgot to mention her name and National Journal’s.  I’ve fixed it, albeit a couple of days late.


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I know that every campaign promise Barack Obama makes has an expiration date

Ain’t it the truth.
And expect all that 11th hour propaganda promises about being a great supporter of Israel’s survival and of it’s capital Jerusalem to evaporate if Obama is elected:

Hamas-linked CAIR’s Nihad Awad on al-Jazeera from DNC: “The Democratic Party’s political platform with regard to the Middle East is developing”

http://bit.ly/Qo0rll

Obama’s words are worthless especially during campaigning, and I suspect all of his anti-Israel supporters on the DNC floor that voice voted against the addition of the Israel supporting amendments trust that Obama will double-cross.

Chessplayer on September 9, 2012 at 9:34 AM

MOOCH MOOCH MOOCH. Must get more, always more. SS, my precious, we musn’t let them take you froms me my precious.

astonerii on September 8, 2012 at 4:50 PM

By your post I take it you don’t pay into the SS system, or go not have the intelligence to realize you could probably do better with all the money the government has taken from you and used it anyway they wish. Do you even understand the amount of money received from SS is based on the amount each individual paid into the system? In other words my uninformed dunce more you pay more you get. If you are so irritate with others getting the money you pay into SSI, then attack the politicians who who raided the SSI fund to pay for all their overspending from the general fund. They set the laws, my greedy MOOCH

Wade on September 9, 2012 at 10:34 AM

In due course the purse strings will be tightened. Eventually the scope and reach of federal health care will necessitate it. How else to get millions of illegals into the program and voting Democrat. Panels, committees,,czars, the whole bureaucratic jungle.

arand on September 9, 2012 at 10:39 AM

When the veil of rhetorical re-election propaganda is lifted, BHO is not a leader, except for that of his own cult of personality.  

MT on September 9, 2012 at 11:09 AM

“…into private health insurance plans.”

Excuse me? “Private” insurance plans?

hahahahahahahaha Good one, Mr. Socialist-in-Chief.

creeper on September 9, 2012 at 11:31 AM

Woo Hoo!!!! More business for my employer, the biggest baddest health insurer of them all.

gengwall on September 9, 2012 at 11:54 AM

By your post I take it you don’t pay into the SS system, or go not have the intelligence to realize you could probably do better with all the money the government has taken from you and used it anyway they wish. Do you even understand the amount of money received from SS is based on the amount each individual paid into the system? In other words my uninformed dunce more you pay more you get. If you are so irritate with others getting the money you pay into SSI, then attack the politicians who who raided the SSI fund to pay for all their overspending from the general fund. They set the laws, my greedy MOOCH

Wade on September 9, 2012 at 10:34 AM

I do not pay INTO social security. I pay a tax which is then used to pay for current perfectly capable of still working permanently put on vacation people. I will never get my money back. When I do get social security, hopefully never as it will have either destroyed the nation or people finally woke up, it will be the government pointing a gun at someone else’s head and making them give up their money to give to me. There is no FUND, a fund is a pipe dream STOOPID SELFISH GREEDY MOOCHERS USE TO DELUDE THEMSELVES INTO IMAGINING THEY PAID FOR WHAT THEY ARE GETTING SO THEY FEEL BETTER ABOUT TAKING OTHER PEOPLES MONEY. The fund was a gimmick, like a coupon for a future purchase to con ignorant fools to keep paying into the system more than was needed to actually meet the day’s expenses allowing the government to spend more and claim they were spending less.

Nothing says DUPE more than someone thinking that Social Security has a fund. Its a bunch of IOUs the government owes itself. But, hey, Mitt the safety net is working Romney and Paul I can put off for generations the day of reckoning Ryan are counting on your DUPEness to get elected. Go team preservative!

astonerii on September 9, 2012 at 2:22 PM

Also one more note on SS, you know those nice letters you get every year that tell you how much you can expect to be paid if you become disabled or retire at age 62 or full age. Those are just telling you what current very much changeable law says will be taken from other people at the point of a gun in order to provide that money to you. Of course, the law can change, if more people see it as free money, they can vote more money into their pockets. If more people come to realize what a bad deal it is for themselves and the nation as a whole, perhaps you will end up with a big fat 0.

astonerii on September 9, 2012 at 7:36 PM

bluefox on September 8, 2012 at 9:00 PM

I have not been treated POLITELY in these forums since Newt won a primary. I have no obligation at all to be nice to these people, particularly after THEY attack me personally first, in order to prevent their feelings being hurt. Are we Democrats? Oops, I forgot, we actually are. The obamification of the Republican party is almost complete.

Do not debate on facts, feelings are more important. If you cannot win, do not debate, shut it down completely.

I could care less if they are giving vouchers or are just simply paying for the bills. In the end if there is a program out there giving away other people’s money, it will be abused, it will be inefficient, and it will not remain within budget. It will be an incentive for people to make bad choices.

When someone is being a hypocrite in my favor, I just simply tend to not stand in their way. Particularly when they have no loyalty to me nor I them to being with.

astonerii on September 8, 2012 at 10:58 PM

You and I discussed Romney during the debates and before, if you recall. I appreciated your information on his record and was in agreement with you. Your comments were correct in many ways. Romney was never my choice, but now he’s my only choice. Palin had she run was my first choice, then Perry and finally Gingrich. I still think that Gingrich was the only one capable of beating Obama.

I also understand you’ve been criticized about political issues on the threads and I’ve stayed out of it.

My issue with you is not your political views, only your rudeness to a couple of commenters on this thread. You made it personal and I don’t think that was necessary.I happen to agree with you politically. Both parties are to blame and the corruption is overwhelming. Our only solution is to do what Sarah Palin is doing and that is vote in as many Candidates with the integrity and backbone to make a difference.

We can pick up the political issues on another thread. I did take note of your other comment about what you do for family & friends.
Your compassion and ability to help is to be commended. All I’m asking is to be considerate of commenters that perhaps don’t get involved in the political issues, but health issues. Keep in mind we all hate what this government, Presidents and Congresses have done. But we can’t give up! We are late to the party so to speak in trying to make changes, but better late than never.

bluefox on September 9, 2012 at 8:58 PM

bluefox on September 9, 2012 at 8:58 PM

Eh, too much time on my hands for the last two and next two weeks. Maybe that is it. Wife is in Philippines for a month. I do not deserve to be commended for doing what is within my responsibility to do. I was just trying to show what being responsible is to people who do not seem to understand it.

Compared to my grandmother, I am nothing. She never earned a penny more than $10,000 a year, had me, my sister, a couple cousins and an aunt living with her. Worked to age 74 or 75 and died I think at age 76. She always helped the family, had 9 daughters and sons and countless grandchildren and great grandchildren, could be counted on for support, worked a job, planted a garden, and not just some small one, but two fields of multiple acres each (about a quarter city block in Iowa each). Canned food for hard times. I wish I had her spending discipline today. She was a democrat. Voted for Bill Clinton twice, Jimmy Carter even. She did vote for Reagan though, he was the more handsome of the two she said.

Why the story? I cannot even find Republicans today that are as conservative as she was in the 1970′s and 1980′s as a Democrat. The party left me behind. Far far behind. many more people deserve commending for going above and beyond. I am just living up to my moral values. I had a teacher, people who learn without a teacher are the real commendable ones.

astonerii on September 9, 2012 at 11:05 PM

astonerii on September 9, 2012 at 11:05 PM

Just finished watching the Broncos/Steelers game. Manning & Team were awesome!! They won 31 to 19(IIRC)

Your grandmother was raised in a time when Family, Faith & Responsibility was the normal way. A democrat during her day is a lot different than now. Children learn so much from families such as your grandmother.

Reagan was more handsome:-)

Regarding the HA threads, keep in mind there have been two open registrations and a lot of Obots/Trolls along with “concerned” commenters got in. And we all have noticed the attacks from them.

While I had the Denver/Pittsburg game on, I was reminiscing of a better time: http://hotair.com/archives/2012/01/22/open-thread-sunday-morning-talking-heads-9/comment-page-1/#comments

Those comments and others are what I remember about you:-)

bluefox on September 10, 2012 at 12:35 AM

astonerii on September 9, 2012 at 2:22 PM

Agreed that the SS “trust fund” is a hoax, but you cannot point your fire at the “ignorant fools” who “keep paying more than is needed.” We are taxed for Social Security and have no choice but to pay the tax. You want to heave epithets? Heave them at the politicians on both sides of the aisle who have perpetrated this scam, not at the people trapped in a system not of their own making.

UnrepentantCurmudgeon on September 10, 2012 at 11:06 AM

Agreed that the SS “trust fund” is a hoax, but you cannot point your fire at the “ignorant fools” who “keep paying more than is needed.” We are taxed for Social Security and have no choice but to pay the tax. You want to heave epithets? Heave them at the politicians on both sides of the aisle who have perpetrated this scam, not at the people trapped in a system not of their own making.

UnrepentantCurmudgeon on September 10, 2012 at 11:06 AM

Politicians do one thing. The will of the people. If they ar enot doing the will of the people, then they lose elections. The voters are cuplable in all of this. It is their/our responsibility to give politicians the right incentives to do the right thing. Unfortunately we have failed. Future generations did not fail, WE DID. We are to blame for this, WE should pay the price.

You have a vote. Have had a vote for a long time. You are an adult, and you have the freedom of speech. You have had this right since you became the age of majority. You have allowed a wrong to continue in your government. When it looked like you were going to make out like a bandit on the SS gravy train, all was well. Steady as she goes. My daughter, and four more children god willing, has never had a vote, has never had the chance to speak up, has no responsibility what so ever for the spending, yet you are willing to demand that she pay you back? Are you freaking serious!?!

astonerii on September 10, 2012 at 11:25 AM

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