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Obama: Medicare, Social Security changes only on my terms

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http://www.politico.com/story/2013/01/obama-medicare-social-security-changes-only-on-my-terms-86502.html?hp=l2

By DAVID NATHER | 1/21/13 12:58 PM EST

President Barack Obama drew a hard line once again Monday against entitlement cuts that could change the basic structure of programs like Medicare or Social Security — making it clear that any measures to reduce the cost of health care must be done on his terms.

(See also: Obama inaugural address (full text, video))
http://www.politico.com/story/2013/01/president-barack-obamas-2013-inaugural-address-full-text-86497.html

It wasn’t a new message, but by reinforcing it in his inaugural address, Obama doubled down on the boundaries he has drawn in his fight with Republicans over the next stages of deficit reduction. The president’s forceful defense of these social safety-net programs fit with a larger theme of his speech, defending the role of government in American society.

“We must make the hard choices to reduce the cost of health care and the size of our deficit. But we reject the belief that America must choose between caring for the generation that built this country and investing in the generation that will build its future,” Obama said.

(See also: Complete coverage of the Inauguration 2013)
http://www.politico.com/p/pages/inauguration-2013

Obama delivered those lines as Rep. Paul Ryan (R-Wis.), the author of the House Republican Medicare plan and Mitt Romney’s former running mate, sat in the crowd at the Capitol.

Obama’s message could make it harder to negotiate entitlement changes down the road as part of a deal to head off across-the-board spending cuts, or to keep the government open this spring after its temporary funding runs out. But it could also buy him some room to make cuts that don’t restructure the programs — as long as Obama can convince Democrats that they don’t shift costs to “the generation that built this country.”

“We do not believe that in this country, freedom is reserved for the lucky, or happiness for the few. We recognize that no matter how responsibly we live our lives, any one of us, at any time, may face a job loss, or a sudden illness, or a home swept away in a terrible storm,” Obama said.

And in an unmistakable dig at Romney’s 47 percent remarks, Obama declared that the main three entitlement programs “strengthen us” — and don’t make Americans a nation of freeloaders.

“The commitments we make to each other — through Medicare, and Medicaid, and Social Security — these things do not sap our initiative; they strengthen us,” Obama said. “They do not make us a nation of takers; they free us to take the risks that make this country great.”

Obama’s remarks were a nod to the hyper-polarized state of Medicare politics after the election. Obama has said he’s willing to make “modest” changes to Medicare to keep it solvent in the long term, but he wants to do it by bringing costs down — not by making structural changes to the program.

Republicans want structural changes, and they’ve noted that their ideas for changing Medicare into a “premium support” program — where it becomes a competition between traditional Medicare and subsidized private plans — did better with voters in the election than a lot of Democrats had predicted. Romney and Ryan easily won among seniors even though Obama attacked their Medicare plan at every turn.

But it’s the overall election results that give Obama the leverage that he has — and will force him to pay close attention to Democrats’ concerns.

The GOP Medicare premium support plan is clearly off the table for Obama, but other structural changes have become tougher, too. During the fiscal cliff talks, Democrats steered Obama away from considering an increase in the Medicare eligibility age, even though Obama has been open to it in the past. They’re a little bit more willing to talk about expanding means testing of Medicare premiums for upper-income seniors, but even that is a tough sell.

Instead, Obama talks about extending the life of Medicare by bringing down the cost of health care. But he’s already trying some experiments in how to do that, as part of Obamacare, and those experiments are just getting underway.

What’s more, Obama administration officials point out that the health care law already cuts future Medicare spending growth, largely by trimming payments to health care providers and private plans — and these are the exact cuts Romney attacked in the campaign, when he hammered Obama over and over for sanctioning $716 billion in Medicare cuts.

Obama’s speech also gave him a chance to recapture the broader, sweeping goals behind his health care reform law in a way that he rarely did during his reelection campaign.

When Obama talked about the health care law during the campaign, he usually boiled it down to its most popular parts — like covering everyone with pre-existing conditions, giving seniors more generous Medicare coverage of prescription drugs, letting young adults stay on their parents’ health plans, and keeping health insurance companies from charging higher premiums to women.

But in his inaugural address, Obama reminded his audience that the law was also intended to be the broader, finishing piece of the nation’s social safety net — a protection against the illnesses that can strike anyone without warning.

“Together, we resolved that a great nation must care for the vulnerable, and protect its people from life’s worst hazards and misfortune,” Obama said.

Minutes before Obama delivered his address, Ryan put out a statement congratulating Obama and resolving to put their differences aside.

“The president and I were political opponents. We had strong disagreements over the direction of the country — as we still do now,” Ryan said. “But today, we put those disagreements aside. Today, we remember what we share in common.”

This article first appeared on POLITICO Pro at 12:56 p.m. on January 21, 2013.

http://www.politico.com/story/2013/01/obama-medicare-social-security-changes-only-on-my-terms-86502.html?hp=l2