Medicare misses the 2017 agenda — Democrats hardest hit? Paul Ryan sat down with CBS’ Scott Pelley for an in-depth interview that aired last night on 60 Minutes to reveal the legislative agenda under total Republican control of Washington DC. Despite scare tactics from Nancy Pelosi and other Democratic leaders that mainly served to protect their own positions, Ryan tells Pelley that Medicare reform isn’t a high priority for Donald Trump. Instead, they have decided to focus on issues Trump prioritized in the campaign. At the top of the list — repealing ObamaCare:
ObamaCare repeal? Check, although later in the interview Ryan didn’t offer too many particulars on how that would unfold, saying they were still working on the issue. Regulatory reform? Check. Tax reform? Check. Immigration enforcement? Big check. Ryan doesn’t mention the Supreme Court nomination, but that’s not an issue for the Speaker of the House anyway.
On Medicare reform, one of Ryan’s biggest concerns, the need is getting greater than ever, he explains. But it certainly sounds as though Ryan’s not planning on pushing that — especially given Trump’s explicit dismissal of it during the campaign. Ryan hasn’t even raised the issue with Trump in their meetings, he tells Pelley:
Scott Pelley: What changes do you plan for Medicare?
Paul Ryan: Here’s the problem. Medicare goes bankrupt in about 10 years. The trust fund runs out of money. So we have to make sure that we shore this program up. And the reforms that we’ve been talking about don’t change the benefit for anybody who is in or near retirement. My mom’s now enjoying Medicare. She’s already retired. She earned it. But for those of us, you know, the X-Generation on down, it won’t be there for us on its current path. So we have to bring reform to this program for the younger generation, so that it’s there for us when we retire, and so that we can keep cash flowing to current generations’ commitments. And the more we kick the can down the road, the more we delay, the worse it gets.
Scott Pelley: But you are going to kick the can down the road for the next year or two. This is not your top priority.
Paul Ryan: It’s not our t– I haven’t even discussed this with Donald Trump yet. But it is an issue that we have to tackle.
It could still come up, of course, but the agenda that Ryan laid out looks very ambitious even for a two-year agenda. As I wrote a couple of weeks ago for The Fiscal Times, Trump’s decided disinterest in spending his political capital on Ryan’s top issue means exactly what Pelley suggests — a two-year kick of the can, for better or worse:
In fact, national debt and budget deficits appear to have dropped off the GOP’s radar screen, at least for the moment. Trump has promised a trillion-dollar stimulus to update national infrastructure, a key part of his “Make America Great Again” campaign pledge, and Democrats want to jump on board that part of his bandwagon. Trump’s plan differs from outgoing President Barack Obama’s 2009 stimulus bill in key ways, but so far it doesn’t come with explicit spending cuts elsewhere to fund it.
Former Senator Alan Simpson, a Republican deficit hawk who has crusaded for budget and entitlement reform, sees both as lost causes and fiscal conservatives as locked out of the process, at least for now. “I don’t think our phones will be ringing off the hook,” Simpson told the Post’s James Hohmann. “Deficit or debt, fiscal or monetary, the real issue is the budget guys aren’t dealing with two-thirds of the budget – the entitlements.”
The Trump administration will spend its first months working on its campaign promises and other goals. If Trump does anything significant with Medicare, it’s likely to be addressing the “waste, fraud, and abuse” that he and other politicians from both parties insist are the real problems in the entitlement system.
Perhaps by the midterms in 2018, Trump will have learned that those issues only nibble at the edges of the coming debt nightmare of Medicare, and will be willing to act more boldly. By that time, Republicans have a fair chance of achieving a nearly filibuster-proof majority in the Senate that could push Democrats into a sense of fiscal reality as debt continues to spiral out of control.
Ryan seems to have made the rational choice to get what he can from Trump while the GOP’s political capital is at its highest. He can save the Medicare fight for 2019, when he’ll have more Republicans on his end of Pennsylvania Avenue to fight with him.