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A service for political professionals · Friday, May 29, 2020 · 518,159,370 Articles · 3+ Million Readers

Just Ahead: An Epic Fight to Save Social Security, Medicare and Medicaid

By Joe Rothstein — January 29, 2018

In the classic novel, “Moby Dick,” Ahab, the captain of a whaling ship, is obsessed with finding and killing a white whale that in a prior voyage bit off part of one of his legs. Ahab ultimately finds the whale, but instead of killing it, the whale destroys Ahab’s ship.

Paul Ryan is no one you would mistake for a whaling boat captain. But he, like Ahab, has a self-destructive obsession. He wants to kill off Medicare, Medicaid and Social Security as federal government managed programs.

After George W. Bush was reelected in 2004 with a Republican Congress, Ryan steered the White House and fellow Republicans into a futile chase to convert a portion of Social Security into a private investment program. Public resistance to that effort was a major contributor to GOP loss of the House majority in 2006.

Ryan resumed the hunt for his quarry as soon as Republicans regained the majority in Congress. And as Speaker, he now has control of the ship. To no one’s surprise, in December, Ryan announced that with the increased projected budget deficit the tax cuts would create, “entitlement” programs would need to slashed to fill the gap.

There’s been some political backing and filling to quiet the alarms triggered by Ryan’s statement, but don’t believe for an instant that he won’t come after his white whale once this year’s Congress is under full sail.

Yes, I realize that President Trump has said on many occasions that he’s not in favor of cutting Social Security, Medicare or Medicaid. But you can bank those statements with all the others that have become cheap currency in Trump’s White House. Does Trump want money for his wall? Are radical changes to our immigration laws important to him? Does he need Congressional Republicans to deliver these votes? He’s an easy mark for a legislative technician like Ryan.

And yes, I also realize that Mitch McConnell has said that cuts to the public’s most popular programs are not on his agenda. But listen to others in his GOP Senate leadership.

Finance Chairman Orrin Hatch: “Entitlements help people who won’t help themselves, won’t lift a finger, and expect the federal government to do everything.” Judiciary Chairman Chuck Grassley defending why the rich deserve tax breaks and “those that are just spending every darn penny they have, whether it’s on booze or women or movies,” have no business complaining about showering benefits on the rich. Senator Marco Rubio: “The driver of our debt is the structure of Social Security and Medicare for future beneficiaries.”

Captain Ryan has a lot of loyal mates on his voyage to kill off programs essential to most Americans. How essential? Nearly 75 million people rely on Medicaid to stay healthy and independent. Federal law guarantees Medicaid coverage to pregnant women, children, elderly and disabled people under certain income levels. Another 45 million Americans, elderly and disabled, are Medicare beneficiaries. It’s worth noting here that about half of all retirees die with less than $10,000 of savings. Cutbacks in Medicare or Social Security would be catastrophic for them.

There’s no question that with an aging population, adjustments need to be made to both Social Security and Medicare to keep the programs solvent for decades to come. In a rational political world, elected leaders could easily design a plan to increase revenue and marginally change benefits to stabilize the system. In fact, Obamacare alone, with minor tweaks, extended Medicare’s solvency by ten years. In 1986, a Democratic-controlled Congress worked with President Reagan to create a much longer shelf life for Social Security.

But if you are philosophically opposed to government management of health and retirement programs, as so many Republicans in Congress are, coming to the table to work out a long-term extension of what we have is heresy. No matter that the programs are working efficiently, cost-effectively and benefit most Americans.

The Ryan plan for Medicaid is to cap spending and turn the money over to states, which can then use that money however they decide. The history of block grants to states tells us that some states would use the Medicaid money wisely and well, and many states wouldn’t. Reduced overall money earmarked for Medicaid would make it even harder for states to maintain current levels of aid to those who need it. A preview of what lies ahead can be seen in Kentucky, whose governor, with the blessing of the Trump administration, expects to save save $300 million by trimming 95,000 from the state's Medicaid rolls.

For Medicare, the Republican fix would be for the federal government to get out of the retirement health management loop and send retirees vouchers to pay for health insurance. In other words, throw those eligible for Medicare onto the tender mercies of private insurance companies. Think of everyone aged 65 and older you know, navigating those shark-dense waters.

As for Social Security, we’ve been there. Ryan would redirect Social Security from a conservatively-managed, no-risk government protected investment pool to private investment brokers. If Ryan’s plan had succeeded in 2006 it would have been just time for the stock market crash of 2008. Unlucky Social Security recipients would have taken a hit to their monthly pension checks along with whatever equity they lost in their homes.

All of this is worth reviewing now because Paul Ryan, Budget Director Mick Mulvaney and others have served notice that if their tax cuts don’t result in the added revenue they expect, spending programs will be slashed to make up the difference. That’s this year, 2018, when they have control of both houses of Congress and their clueless president won’t be an obstacle.

In other words, Paul Ryan has never been closer to the prey he has chased for the nearly 20 years that he has been in Congress.

The Russian investigation is important. Immigration is important. Infrastructure repair is important. Jobs are important. Climate change is important. But we can’t take our eye off what may be the most important and immediate threat of all---destruction of health and retirement programs that represent lifelines to hundreds of millions of Americans.

Before the year ends, Captain Ryan will be coming to get us in what may be the most important political fight of 2018.

(Joe Rothstein is a regular columnist for and author of the acclaimed political thriller “The Latina President and the Conspiracy to Destroy Her.” Mr. Rothstein can be contacted at

Joe Rothstein is editor of U.S. Politics Today. His career in politics spans 35 years, as a strategist and media producer in more than 200 campaigns for political office and for many political causes. He was a pioneer in professional political consulting and one of the founding members of the American Association of Political Consultants. During his career Mr. Rothstein has served as editor of the Pulitzer Prize-winning Anchorage Daily News and adjunct professor at George Washington University's Graduate School of Political Management. He has a master's degree in journalism from UCLA.