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Why Can't Democrats Demagogue Medicare?

April 22, 2011

By Josh Barro

Brian Beutler has a piece at Talking Points Memo, pondering why liberal activists are (so far) failing to foment national outrage of the Paul Ryan budget’s cuts to Medicare and Medicaid. He notes that Republicans benefited massively from the popular outcry over PPACA (the health reform law) in 2009, with angry constituents effectively shutting down town hall meetings held by Democratic officeholders. Medicare is popular, so where is the outrage over phasing it out?

Beutler goes through several possible explanations. These include angry mobs being out of fashion ever since the attempted murder of Gabrielle Giffords, and liberal political resources being tied up in state-level fights over budgets and collective bargaining. I think he gives short-shrift to the fact that the rise of the Tea Party wasn’t just about PPACA, but Obama’s overall governing agenda, including financial and auto bailouts (yes, a holdover from the Bush Administration) and the stimulus package.

But I think Beutler has altogether missed the most important reason that Democrats can’t capitalize politically on Republican plans to cut Medicare—Democrats also want to cut Medicare. In 2009 and 2010, Republicans came out hard against the Medicare cuts in PPACA. While some of the critics were careful to complain about cutting Medicare “to pay for another program,” often the message was simply about Medicare cuts being bad. Republicans gained the advantage on Medicare by being the pro-Medicare party.

Democrats can’t do that now without abandoning their budget plans. There are some liberals in Congress who do want to ease up on Medicare restraint—Pete Stark, for example—but Obama and congressional Democratic leadership have been clear about the importance of slowing the growth of Medicare spending. Indeed, the most important spending-side component in the President’s recent budget speech was a call to lower the target growth rate for Medicare spending by 0.5 percentage points per year.

So, Democrats will say that Republicans want to cut your Medicare deeply. And Republicans will say that Democrats want to cut it deeply, too. Republicans will also tout their plans to repeal the Independent Payment Advisory Board, the Democrats’ “death panel.” Democrats can then point out that Republicans have no real plan to hit their cost saving targets without IPAB, but that’s a challenging message to craft—“Republican Medicare cuts are draconian and won’t actually happen.”

Basically, any fight over Medicare is likely to evolve into a he-said-she-said, with each party trying to make the other side’s Medicare cuts sound worse. But with neither party taking the “don’t cut Medicare” position, neither has a clear advantage to gain from a fight over the program.

There is a clearer difference on Medicaid—the Ryan budget involves tremendous restraint of Medicaid spending (unrealistic restraint, as I have said) while Democrats want to expand Medicaid eligibility. But Medicaid does not have the same kind of powerful political constituency behind it that Medicare does, and so the political risk to Republicans on that issue is lower.

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