House
Speaker Paul Ryan said on a radio show on Dec. 6, 2017, that "we're
going to have to get back next year at entitlement reform, which is how
you tackle the debt and the deficit." (photo: Mark Wilson/Getty)
By Jeff Stein, The Washington Post
07 December 17
ouse
Speaker Paul Ryan, R-Wis., said Wednesday that congressional
Republicans will aim next year to reduce spending on both federal health
care and anti-poverty programs, citing the need to reduce America's
deficit.
"We're going to have to get back next year at
entitlement reform, which is how you tackle the debt and the deficit,"
Ryan said during an appearance on Ross Kaminsky's talk radio show. ". . .
Frankly, it's the health care entitlements that are the big drivers of
our debt, so we spend more time on the health care entitlements -
because that's really where the problem lies, fiscally speaking."
Ryan said that he believes he has begun convincing
President Donald Trump in their private conversations about the need to
rein in Medicare, the federal health program that primarily insures the
elderly. As a candidate, Trump vowed not to cut spending on Social
Security, Medicare or Medicaid. (Ryan also suggested congressional
Republicans were unlikely to try changing Social Security because the
rules of the Senate forbid changes to the program through reconciliation
- the procedure the Senate can use to pass legislation with only 50
votes.)
"I think the president is understanding that choice
and competition works everywhere in health care, especially in
Medicare," Ryan said. ". . . This has been my big thing for many, many
years. I think it's the biggest entitlement we've got to reform."
Ryan's remarks add to the growing signs that top
Republicans aim to cut government spending next year. Republicans are
close to passing a tax bill nonpartisan analysts say would increase the
deficit by at least $1 trillion over a decade. Trump recently called on
Congress to move to cut welfare spending after the tax bill, and Senate
Republicans have cited the need to reduce the national deficit while
growing the economy.
"You also have to bring spending under control. And
not discretionary spending. That isn't the driver of our debt. The
driver of our debt is the structure of Social Security and Medicare for
future beneficiaries," Sen. Marco Rubio, R-Fla., said last week.
While whipping votes for the tax bill, Senate Finance
Committee Chairman Orrin Hatch, R-Utah, attacked "liberal programs" for
the poor and said Congress needed to stop wasting Americans' money.
"We're spending ourselves into bankruptcy," Hatch
said. "Now, let's just be honest about it: We're in trouble. This
country is in deep debt. You don't help the poor by not solving the
problems of debt, and you don't help the poor by continually pushing
more and more liberal programs through."
Trump has not clarified which specific programs would
be affected by the proposed "welfare reform," though congressional
Republicans are signaling that they aim to impose work requirements on
food stamps and direct cash assistance for the poor.
"We have a welfare system that's trapping people in
poverty and effectively paying people not to work," Ryan told Kaminsky
on Wednesday. "We've got to work on that."
Liberals have alleged that the GOP will use higher
deficits - in part caused by their tax bill - as a pretext to accomplish
the long-held conservative policy objective of cutting government
health-care and social-service spending, which the left believes would
hit the poor the hardest.
"What's coming next is all too predictable: The
deficit hawks will come flying back after this bill becomes law," said
Sen. Ron Wyden, D-Ore., the ranking Democrat on the finance committee,
during a speech on the tax debate. "Republicans are already saying
'entitlement reform' and 'welfare reform' are next up on the docket. But
nobody should be fooled - that's just code for attacks on Medicaid, on
Medicare, on Social Security, on anti-hunger programs."
On the Senate floor during the tax debate, Sen. Bernie
Sanders, I-Vt., asked Rubio and Sen. Patrick J. Toomey, R-Pa., to
promise that Republicans would not advance cuts to Medicare and Social
Security after their tax bill. Toomey said that there was "no secret
plan" to do so, while Rubio said he opposed cuts to either program for
current beneficiaries. However, neither closed the door to changing the
programs for future beneficiaries.
"I am not going to support any cuts to people who are
on the program and need those benefits. But I want this program to
survive," Toomey said. To which Sanders responded: "He just told you
he's going to cut Social Security."
Many conservatives have long argued for cutting and
changing social safety net programs, arguing that anti-poverty programs
have failed and that Social Security spending is growing at an
unsustainable rate.
Still, members of both parties have long been
reluctant to cut benefits, especially for seniors, due in part to the
potential political cost of doing so. And in discussing changes,
Republicans, including Rubio, have largely confined their ideas to plans
that would affect new beneficiaries, rather than current ones.
But it may be particularly difficult for Republicans
to push those measures ahead of the 2018 midterm elections, in which
many in swing states and districts face well-funded Democratic
challengers hoping to ride an anti-Trump wave into office.
Ryan said he's optimistic, adding that Republicans
could target the Affordable Care Act and Medicaid next year in addition
to Medicare, despite their failure to repeal the health care law in
2017.
"What it is we really need to convert our health care
system to a patient-centered system so we have more choices and more
competition. Choice and competition brings down prices and improves
quality; government-run health care is the opposite of that," Ryan said.
"So I think these reforms that we've been talking about, that we're
still going to keep pushing, that will help not just make Medicaid less
expensive . . . but it will help Medicare as well."
onald Trump and the Republicans are trying to restrict American freedom and 
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