Older adults, and anyone who cares about them, should pay close attention to this year’s electoral campaign. Mitt Romney and Paul Ryan have advocated proposals that fundamentally threaten the primary programs for older adults: Social Security, Medicare, and Medicaid.
First, take their position on Social Security. For years, Paul Ryan promoted the partial privatization of Social Security for individuals under age 55. The 2012 House budget bill, which Paul Ryan wrote and introduced, includes a provision that would enable Congress to fast-track major changes in the program. The Republican platform states that Social Security “is long overdue for major change” and promises to set “it on a sound fiscal basis that will give workers control over, and a sound return on, their investments” (p. 23).
This sounds suspiciously like a scheme for privatization, and it overlooks the fact that Social Security is not an investment plan but a social insurance plan that provides support not only for older adults but also individuals with disabilities and young people whose parents die prematurely.
Turning to Medicare, Ryan’s plan to turn that program into a premium support, or voucher, system is well known. Beginning in 2023, Medicare beneficiaries would receive a voucher to buy their own health care coverage. The problem is that the value of the voucher would likely increase more slowly than the growth of health care inflation, shifting costs to beneficiaries. The plan would encourage younger and healthier beneficiaries to switch to the private plans, concentrating older and less healthy beneficiaries in traditional Medicare, which would cause costs there to skyrocket.
Complicating this is Romney and Ryan’s promise to repeal Obamacare. Obamacare has extended the life of the Medicare Part A Trust Fund from 2016 to 2024, begun closing the notorious prescription drug doughnut hole, and provided older adults free preventive services. Repealing Obamacare would reopen the doughnut hole, cause the preventive services to disappear, and move the date of exhaustion of the Trust Fund back to 2016. This would impact not just people under age 55, but current beneficiaries as well.
Finally, consider their position on Medicaid. The Romney/Ryan plan would be disastrous. Although we often think of Medicaid as a program for children, the bulk of its spending is on long-term care services for people with disabilities and older adults. Romney and Ryan would turn Medicaid into a block grant and reduce its funding by a third between now and 2022, pushing the burden of care onto already strapped state budgets. This hardly seems a prudent policy as the baby boomers begin moving into retirement.
Combined, the policy changes that Romney/Ryan have in mind for Social Security, Medicare, and Medicaid would be devastating for older adults. This is bad news for the roughly 20 percent of New Hampshire residents receiving Social Security benefits and 16 percent receiving Medicare.
Stephen Gorin (Executive Director of the New Hampshire Chapter of the National Association of Social Workers.)