Sen. Barrasso: The Affordable Care Act Takes $500 Billion From Medicare And Seniors

January 25, 2011 11:53 am ET

Senator John Barrasso (R-WY) told Neil Cavuto that the Affordable Care Act takes $500 billion from Medicare and seniors to create a new entitlement program. Not only is Barrasso misleading viewers about the changes to Medicare — the $500 billion actually comes from savings from phasing out Medicare Advantage — he asserts that Republicans will protect Medicare despite his party's long record of supporting cuts to the program.

CLAIM: Sen. Barrasso Misleads Viewers By Saying ACA Takes $500 Billion From Medicare And Seniors

NEIL CAVUTO, HOST: We got a comment from Harry Reid's spokesman, the Senate Majority Leader, ripping what he considers to be the Republican Congress' road map to end Social Security and Medicare and I quote, "In an unsettling development for American seniors ending Social Security and Medicare is now the official position of the Republican Party." This coming from Harry Reid, "Republicans tap Congressman Ryan, who's going to be heading the budget committee by the way, with a plan to end Social Security and Medicare, to deliver the response to the President's State of the Union and his plan has been endorsed by the House Majority Leader and the top Republicans in the House and Senate budget committee." Reaction right now, we just threw this broadsided to Senator John Barrasso, the Republican from Wyoming, and I don't like to do that, but your quick reaction to that.

SEN. JOHN BARRASSO (R-WY): Well, of course, that is not true. Republicans absolutely are going to protect Social Security and Medicare in a way better than the Democrats. Don't forget, Neil, this health care law that Harry Reid loves, that the President is going to try to take credit for tomorrow, they took 500 billion dollars from our seniors on Medicare. Not to save Medicare. Not to help Medicare and our seniors but to start a whole new government entitlement spending program for someone else. Even the President's debt commission, Alan Simpson, Erskines Bowels said that's wrong. One of their recommendations is that any savings in Medicare should be used to help sustain Medicare not to start a whole new entitlement program. So, to me it is the Democrats who are hurting our seniors and specifically hurting Medicare.

FACT: The Supposed Cuts In The Affordable Care Act Are Actually Savings From Phasing Out Medicare Advantage

FactCheck.org: Cost Saving Provisions "Not A Slashing Of The Current Medicare Budget Or Benefits." According to FactCheck.org: "Whatever you want to call them, it's a $500 billion reduction in the growth of future spending over 10 years, not a slashing of the current Medicare budget or benefits. It's true that those who get their coverage through Medicare Advantage's private plans (about 22 percent of Medicare enrollees) would see fewer add-on benefits; the bill aims to reduce the heftier payments made by the government to Medicare Advantage plans, compared with regular fee-for-service Medicare. The Democrats' bill also boosts certain benefits: It makes preventive care free and closes the 'doughnut hole,' a current gap in prescription drug coverage for seniors." [FactCheck.org, 3/19/10]

Changes To Medicare Advantage Come With Extra Benefits For All Medicare Enrollees. FactCheck.org reported: "The CBO has estimated that the move would change the value of the extra benefits Medicare Advantage participants get, but they would not receive fewer benefits than the rest of seniors who aren't on the Advantage plans. The bill does add some extras for Medicare beneficiaries, eliminating copays and deductibles for preventive services, for example." [FactCheck.org, 12/2/09; emphasis added]

Health Care Reform "Will Keep Paying Medical Bills For Seniors." According to PolitiFact.com: "The government-run Medicare program will keep paying medical bills for seniors, but it will begin implementing cost controls on health care providers, mostly through penalties and incentives. The legislation would reduce payments for hospital-acquired infections or preventable hospital admissions. For Medicare Advantage, the federal government intends to reduce extra payments, taking away subsidies to private insurance companies. Insurers will likely cut benefits in order to not lose profits. The bill does not address the 'doctor's fix,' an expected proposal that Congress usually passes to prevent doctors' Medicare payments from severe cuts." [PolitiFact.com, 3/18/10; emphasis in original]

CBO: Cost Changes To Medicare Made From Savings. According to the Congressional Budget Office: "Changes to the Medicare program and changes to Medicaid and CHIP other than those associated directly with expanded insurance coverage: Savings from those provisions are estimated to total $93 billion in 2019, and CBO projects that, in combination, they will increase by 10 percent to 15 percent per year in the next decade." [CBO.gov, 10/7/09]

New England Journal Of Medicine: The Affordable Care Act Phases Out "Substantial Overpayments" To Medicare Advantage Plans. From the New England Journal of Medicine:

A phased elimination of the substantial overpayments to Medicare Advantage plans, which now enroll nearly 25% of Medicare beneficiaries, will produce an estimated $132 billion in savings over 10 years.

[...]

The ACA also produces nearly $200 billion in savings by assuming that providers can improve their productivity as firms in other industries have done. On the basis of this presumed improvement, the law reduces Medicare's annual "market basket" updates for most types of providers - a provision that has generated controversy. [New England Journal of Medicine7/8/10]

Cuts Would Only Affect Medicare Advantage Plans. As reported by Kaiser Health News:

The new health law will cut $136 billion in spending on the Advantage program by 2019, which currently pays private plans to administer Medicare benefits and pays them about 14 percent more than the per-patient cost of the traditional Medicare program. Plans use that subsidy to lure members with lower premium costs or extra benefits not normally paid for by Medicare, such as vision care or better prescription drug coverage. Some Democrats and analysts have argued the higher rates are wasteful. 

Even experts who support the change concede that the impact of the cuts could be evident. Robert Berenson, a scholar at the Urban Institute and former Medicare official, said some Advantage plan members will notice skimpier benefits, "but the Republicans have really exaggerated that this will wipe out the Advantage plans." 

Marsha Gold, a health policy analyst for the private research group Mathematica, said, "Over time, there will be less rich benefits or higher premiums, but it's going to be gradual," noting that the largest cuts do not begin until 2015. 

[Kaiser Health News, 4/6/10]

Medicare Advantage Costs Taxpayers 14% More Than Traditional Medicare. As reported by PolitiFact.com:

Let's back-up for a minute and explain Medicare Advantage: There are two basic ways most people get Medicare coverage. They enroll in traditional Medicare and a prescription drug plan through the government and maybe buy a supplemental policy to cover most out-of-pocket costs. Or they enroll in Medicare Advantage programs (they include drug plans), which are run by private insurers. Medicare Advantage programs typically have more generous benefits such as dental and vision coverage. Some plans even pay the patient's monthly Medicare premium, which can amount to about $100.

The Medicare Advantage program was intended to bring more efficiency from the private sector to the Medicare program, but it hasn't worked as planned. A June 2009 analysis from the Medicare Payment Advisory Commission said that the Advantage programs costs taxpayers on average of 14 percent more than the traditional Medicare plan. President Barack Obama has said repeatedly that the Medicare Advantage plan wastes public money that could be put to better use.

[PolitiFact.com, 9/20/10]

CLAIM: Sen. Barrasso Also Claimed Republicans Will Protect Social Security And Medicare Better Than Democrats

BARRASSO: Well, of course, that is not true. Republicans absolutely are going to protect Social Security and Medicare in a way better than the Democrats...

FACT: For Years Republicans In Both Chambers Of Congress Have Repeatedly Voted To Cut Medicare

House Republicans have voted to cut $1.02 trillion from Medicare since 1991 and Senate Republicans have voted to cut $1.31 trillion from Medicare since 1995.

House Votes

1991: Republicans Voted To Cut $52.4 Billion From Medicare

89 Republicans Voted To Cut Medicare $25.2 Billion Over Five Years. In 1991, 89 House Republicans proposed and voted for a substitute amendment to the Fiscal 1992 Budget Resolution that would have cut Medicare $25.2 billion over five years. The substitute amendment, introduced by Rep. Gradison (R-OH), was rejected. [CQ.com; H. Con. Res. 121, Vote # 70, 4/17/1991]

105 Republicans Voted To Cut Medicare $27.2 Billion Over Five Years.  In 1991, 105 Republicans voted in support of a substitute amendment introduced by Rep. Kasich (R-OH) to the Fiscal 1992 Budget Resolution that would have implemented cuts in Medicare. Specifically, the substitute amendment would have "cut entitlement programs by $6.4 billion in fiscal 1992 and $48.6 billion over five years, including cuts in Medicare, totaling $27.2 billion over five years." The motion was rejected. [CQ.com; H. Con. Res. 121, Vote #69, 4/17/1991]

1992: Republicans Tried To Slash $138.4 Billion From The Americans Most In Need

57 Republicans Voted To Cut Medicare And Medicaid $138.4 Billion Over Five Years.  In 1992, 57 House Republicans voted for a substitute amendment to the Fiscal 1993 Budget Resolution - Spending Freeze introduced by Rep. Dannemeyer (R-CA) that would have "cut Medicare and Medicaid entitlement programs by $138.4 billion over five years." The substitute amendment was rejected. [CQ.com; H. Con. Res. 287, Vote # 38, 3/4/92]

1993: Republicans Voted To Cut $34 Billion From Medicare

156 Republicans Voted To Cut $34 Billion From Medicare. In 1993, 156 House Republicans voted for an "amendment to cut federal spending by $90 billion over five years through various proposals, including $34 billion in Medicare cuts, $52 billion of discretionary spending cuts and $4 billion in other entitlement cuts and user fee increases." The motion failed. [CQ.com; HR 3400, Vote #609, 11/22/93]

1995: Republicans Votes Would Have Cost Medicare $292.6 Billion

227 Republicans Voted Twice To Cut Medicare By $270 Billion.  In October 1995, 227 Republicans voted for the misnamed Medicare Preservation Act of 1995, which cut $270 billion from Medicare over seven years.  The bill passed. In November 1995, 232 Republicans voted to adopt the conference report on the Budget Reconciliation Act of 1995, which reduced spending on Medicare by $270 billion over seven years.  The bill passed. [HR 2425, Vote #731, 10/19/95; HR 2481, Vote #812, 11/17/95]

  • 84 Republicans Voted To Cut An Additional $22.6 Billion From Medicare.  In 1995, 84 House Republicans voted for the Conservative Republican Substitute to the FY 1996 Budget Resolution.  The substitute bill would have cut Medicare by an additional $22.6 billion, on top of the $270 billion in cuts already contained in the budget.  The amendment failed.  [H.C.R. 67, Vote #343, 5/18/95]

1996: Republican Votes Took $158.1 Billion From America's Seniors

212 Republicans Voted To Cut Medicare By $158.1 Billion.  In 1996, 212 House Republicans voted to adopt the conference report on the Fiscal Year 1997 Budget Resolution, which contained $158.1 billion in Medicare cuts over six years.  The bill passed. [H.C.R. 178, Vote #236, 6/12/96]

1997: Republicans Passed A Budget That Cut $115 Billion From Medicare

219 Republicans Voted To Cut $115 Billion From Medicare.  In 1997, 219 House Republicans voted for passage of the Balanced Budget Act of 1997, which "cut total projected entitlement spending over five years by about $137 billion, including a $115 billion reduction in Medicare." The bill passed. [CQ.com; HR 2015, Vote #241, 6/25/97]

2002: Republicans Supported Drastic Medicare Cuts

206 Republicans Voted To Kill A Resolution That Sought To "Repeal Cuts In Payments To Hospitals That Serve Low-Income Patients...And Ensure Necessary Medicare And Medicaid Funding." In 2002, Rep. Sam Farr (D-CA) introduced a resolution that would "express the sense of the House that Congress should" work on legislation that would repeal cuts to health programs, including Medicare.  Rep. Kenny Hulshof (R-MO) motioned to table the resolution, effectively killing it with the agreement of 206 Republican votes.  The motion to table passed. [CQ.com; accessed 12/4/09; HR 854, Vote #440, 10/3/02]

2003: Republicans Refused To Increase Medicare Payments To Doctors And Rural Hospitals

208 Republicans Voted Against A Measure That Would Take Medicare Competition Savings And Put It Toward Increasing Payments To Medicare Physicians.  In 2003, 208 House Republicans voted against a "motion to instruct House conferees to reject provisions of the House bill that require the traditional Medicare program to compete with private plans to provide Medicare benefits by 2010, and reject provisions of the Senate bill that establish an alternative payment system for preferred provider organizations in highly competitive regions. The savings from the rejection of these provisions would be used to increase payments to physicians for Medicare services." The motion was rejected.  [CQ.com; HR 1, Vote #615, 11/6/03]

215 Republicans Voted Against Increasing Medicare Payments To Rural Hospitals.  In 2003, 215 House Republicans voted against a "motion to recommit the joint resolution to the House Appropriations Committee with instructions that it be reported back with language that would continue payment rates for physician services under Medicare at fiscal 2002 levels and increase the base payment amount that hospitals in small urban and rural areas receive through Medicare to the same as that for larger urban hospitals." The motion failed.  [CQ.com; H J Res 18, Vote #18, 2/5/03]

2008: Republicans Cut $20 Billion From Medicare Doctors

59 Republicans Voted To Cut $20 Billion From Medicare Physician Reimbursement.  In 2008, 59 House Republicans voted to maintain a 10.6% scheduled cut in reimbursement rates for doctors serving patients who receive Medicare. The motion passed. [Kaiser Health News, 7/16/08; HR 6331, Vote #443, 6/24/08]

2009: Republicans Voted To Slash $210 Billion From Medicare Doctors

172 Republicans Voted To Cut $210 Billion From Medicare Physician Reimbursement. In 2009, 172 House Republicans voted against blocking "a 21 percent cut scheduled to take effect in January 2010, and increase the payment rate based on the Medicare economic index." The vote would have restored $210 billion in scheduled physician reimbursements. The measure failed. [Congressional Quarterly, accessed 12/4/09; New York Times, 11/19/09; HR 3961; Vote #909, 11/19/09]

Senate Votes

50 Republicans Voted To Cut Medicare By $6.4 Billion.  In 2005, 50 Senate Republicans voted in favor of the budget reconciliation bill that cut funding for Medicare by $6.4 billion by requiring that beneficiaries purchase medical equipment and cutting payments to home health care providers. The motion passed 50-50, with Vice President Cheney casting the deciding vote. [S. 1932, Vote #363, 12/21/05]

50 Republicans Voted To Cut $5.78 Billion From Medicare.  In 2005, 50 Senate Republicans voted in favor of passage of a Fiscal Year 2006 Budget Resolution that would cut $5.78 billion from Medicare. The legislation passed 52-47.  [S. 1932, Vote #303, 11/3/05]

51 Republicans Tabled An Amendment That Would Have Given The Sickest Seniors $12 Billion In Medicare Funding.  In 2003, 52 Senate Republicans voted to table an amendment that would have allocated $12 billion for additional treatment for Medicare beneficiaries with cancer, heart disease, Alzheimer's disease and disabilities. The motion to table passed 57-41. [S. 1, Vote #253, 6/26/03]

49 Republicans Voted To Put Needs Of Wealthy Americans Over The Needs Of American Seniors.  In 2003, 49 Senate Republicans voted against an amendment that would reduce the enormous tax cut given to the wealthiest American tax payers in order to give a fair reimbursement to rural health care providers under Medicare. The amendment failed.  [SCR 23, Vote #89, 3/25/03]

50 Republicans Voted Against Increasing Medicare And Medicaid Funding By $4.1 Billion.  In 2003, 50 Senate Republicans voted against a measure which would have increased funding for health care programs under Medicare and Medicaid by $4.1 billion. The motion was rejected 41-56. [HJR 2, Vote #21, 1/23/03]

53 Republicans Voted In Favor Of Cutting Medicare Nearly $160 Billion Over Six Years.  In 1996, 53 Senate Republicans voted to cut Medicare by $158.1 billion over six years.  First - the Senate version of the Fiscal Year 1997 Budget Resolution that contained the cut and, Second - the same cut in the conference report.  Both passed 53-46. [H.C.R. 178, Vote #156, 5/23/1996; H.C.R. 178, Vote #159, 6/13/96]

  • Budget Cuts Included Reductions In Medicare, Medicare, Welfare, And Discretionary Spending.  Senate Republicans voted in favor of adopting of the conference report on the concurrent resolution to establish a six-year plan to balance the federal budget by 2002. Projected spending cuts over six years include $158.1 billion in Medicare, $72 billion from Medicaid, $53 billion from welfare and $297.9 billion from discretionary spending. The conference report passed 53-46. [HCR 178, Vote #159, 6/13/96]

Republicans Cut $270 Billion From Medicare.  In 1995 Senate Republicans voted in favor of a budget that would cut Medicare by $270 billion. The budget passed.  [H.R. 2491, Vote #584, 11/17/1995; H.R. 2491, Vote #556, 10/27/1995; H.C.R. 67, Vote #296, 6/29/95]

52 Republicans Voted Against Reducing Medicare Cuts By $181 Billion In Favor Of Tax Cuts For The Wealthy.  In 1995, 52 Senate Republicans voted against a motion reducing cuts to Medicare by $181 billion by reducing tax cuts for upper income taxpayers. The motion was rejected 46-53. [S. 1357, Vote #499, 10/26/95]

51 Republicans Voted To Maintain Tax Cuts Instead Of Reducing Medicare Cuts By $100 Billion.  In 1995, 51 Senate Republicans voted against an amendment to reduce by $100 billion the cuts to Medicare and Medicaid by reducing tax cuts. The amendment failed 46-52. [S.C.R. 13, Vote #173, 5/22/95]

52 Republicans Voted To Preserve Tax Cuts For The Wealthy Instead Of Reducing Medicare Cuts By $181 Billion.    In 1995, 52 Senate Republican voted against a motion reducing cuts to Medicare by $181 billion by reducing tax cuts for upper income taxpayers. The motion was rejected 46-53. [S 1357, Vote #499, 10/26/95]

50 Republicans Voted Against Increasing Medicare Payments To Hospitals By $4.5 Billion.  In 1995, 50 Senate Republicans voted against an amendment restoring $4.5 billion in payments under Medicare to hospitals that treat a disproportionate share of poor patients. The amendment failed 47-52. [S 1357, Vote #524, 10/27/95]

54 Republicans Voted In Favor Of Cutting $270 Billion From Medicare.  In 1995, 54 Senate Republicans voted to adopt the conference report on the fiscal 1996 budget resolution to put in place a seven-year plan to balance the budget by 2002 by cutting projected spending by $894 billion, including cuts of $270 billion from Medicare, $182 billion from Medicaid, $190 billion in non-defense spending, and $175 billion from various entitlement programs such as welfare. The conference report was agreed to 54-46. [HCR 67, Vote #296, 6/29/95]

54 Republicans Voted To Cut Medicare By $256 Billion.  In 1995, 54 Senate Republicans voted to adopt the resolution to adopt a seven-year budget plan that would balance the budget by 2002 by cutting projected spending by $961 billion of which $256 billion would come from Medicare, $175 billion from Medicaid, $190 billion from non-defense discretionary spending, and $209 billion from various entitlement programs. The concurrent resolution was agreed to 57-42. [SCR 13, Vote #232, 5/25/95]

51 Republicans Voted To Maintain Tax Cuts For The Wealthy Instead Of Reducing Medicare Cuts By $100 Billion.  In 1995, 51 Senate Republicans voted against an amendment to reduce by $100 billion the proposed cuts of $256 billion to Medicare and Medicaid by reducing tax cuts. The amendment failed 46-52. [SCR 13, Vote #173, 5/22/95]

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