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    Odd bedfellows: Sen. Ron Wyden and Paul Ryan

    The Oregon Democrat, known for such cross-aisle gestures, worked with Rep. Ryan on a Medicare reform proposal that died. Here's the context for this stillborn compromise.
    Oregon Sen. Ron Wyden (D)

    Oregon Sen. Ron Wyden (D) Oregon Military Department

    Ouch! Here is the Northwest's most-popular U. S. senator (at least judged by past election returns) caught with an embarrassing alliance with a Republican who must be demonized by his party in the coming months.

    It's not entirely new for Ron Wyden (D-Ore), or rather for his penchant for forming unusual alliances on big-picture issues. This time it's a Medicare proposal he launched last year with Rep. Paul Ryan (R-Wisc). Yes, that Paul Ryan.

    Last December, the two veteran lawmakers, each of whom sits on key budget committees, unveiled a plan to reform Medicare by combining public plans with private plans that would have a federal underpinning. Immediately controversial — particularly among Democratic leaders in Congress who have stoutly resisted privatization of Medicare — the plan went nowhere in the GOP-controlled House in 2012 and did not wind up in Ryan's controversial budget plan.

    But when Ryan was picked by Mitt Romney to join his ticket, Republicans immediately went on offense by claiming the Wyden-Ryan plan was evidence that Ryan works across party lines. Democrats at the same time were beginning what is sure to be a major offensive against Ryan's budget, which does go further toward privatization than his work with Wyden.

    Wyden was caught out with the Ryan pick and although he knew his alliance was unpopular within his party, he had not expected it to figure in the 2012 presidential race. Noting that he had voted in the Senate against Ryan's budget earlier this year, including its Medicare elements, Wyden defended his work but denied that it remains in the plans of the Romney-Ryan ticket.

    He told The Oregonian's Charles Pope that a key is the Affordable Care Act, which both Romney and Ryan pledge to repeal. "If you repeal the Affordable Care Act, what Mr. Romney is saying is, he just wishes for the best," Wyden told Pope. "The point really," Wyden said, "is that the far right is not willing to accept the principles of the white paper" he wrote with Ryan. "I have seen no evidence Mr. Romney will commit to protecting the Medicare guarantee of providing healthcare to all seniors who qualify." 

    Wyden began his political career as an advocate for seniors, and any suggestion that he is abandoning them reaches his inner soul. When I first met him in the 1970s, he founded and led an advocacy group for seniors in Oregon called Gray Panthers, and it put him in the news and on the political stage. He took out an incumbent Democratic Congressman, Bob Duncan in 1980 and in 1996 narrowly won the Senate seat opened by the resignation of Sen. Bob Packwood (R-Ore). He never looked back, winning three subsequent elections by wide margins.

    Wyden is given to big issues and attempting to form bipartisan solutions. In 2009 he joined with Sen. Bob Bennett, a Utah conservative, to forge a bipartisan health-care compromise. Five other Democrats, four other Republicans and Independent Joe Lieberman signed on. The next year, BennettÕs willingness to work with Wyden and other Democrats was a major factor in sealing his loss to a conservative in Utah. The proposal lost out to what became the Affordable Care Act.

    In 2010 Wyden joined Sen. Judd Gregg (R-N.H.) on a tax-reform overhaul; it didn't get anywhere and Gregg retired. Wyden did win one in 2010. With Sen. Scott Brown (R-Mass) he sponsored the plan to allow states to opt out of federal health-care reforms; it became part of the Affordable Care Act. Brown is still in the Senate, at least until November. All of Wyden's coalitions arise from his seats on Budget and Finance, where the big fiscal and health-care issues arise.

    The Wyden-Ryan proposal has all the complexity that comes with the subject of Medicare. As described by the New York Times' Robert Pear:

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    Posted Mon, Aug 20, 2:34 p.m. Inappropriate

    This article gets some key stuff wrong factually and should probably be pulled down until it's corrected. First and foremost, the 2012 Ryan House bill, which Republicans passed, does indeed include most of the Ryan-Wyden proposal to privatize, cap, and voucherize Medicare. The main difference is that the Ryan House bill would cap Medicare spending at GDP plus .5%, while the Ryan-Wyden proposal would cap it at GDP plus 1%.
    Wyden has refused to support the Ryan House bill because of that lower spending cap, because the Ryan House bill would cap and block grant Medicaid (which Wyden said would harm disabled and poor people eligible for both Medicare and Medicaid), and because the Ryan House bill would raise the Medicare eligibility age.
    Romney and Ryan now are trying to pretend (until after the election) they don't support Medicare voucherization, when in fact Romney has his own Medicare voucher proposal modeled on the Ryan-Romney proposal.
    BTW, Ryan's and Romney's claim that their proposal would not affect Medicare for people 55 and older is highly dubious.
    As Brookings’ Henry Aaron and other experts will tell you, it’s almost certain that traditional Medicare would go into a death spiral because it would attract sicker and more expensive beneficiaries while the private plans would attract healthier and cheaper ones. It would only take a slight difference in risk selection to produce rapid and dramatic changes in cost structure. The traditional program would rather quickly become significantly more expensive and probably unaffordable for all but a few beneficiaries, including those grandfathered into the old program. So it’s highly misleading to say nothing would change for people who are currently 55 and older.
    Also BTW, the Affordable Care Act opt-out provision that Wyden co-authored only allows states to opt out if they have their own law expanding affordable health coverage at least as comprehensively as the ACA does. And such an opt out can only occur starting in 2017.

    Posted Mon, Aug 20, 3:10 p.m. Inappropriate

    In regards to the Medicare "death spiral," I'd like to know why it isn't preferable to have the government act as re-insurer for people requiring unusually long or expensive treatment. That way, the most expensive patients are removed from the risk pool and rates will go down for all. Relieved of the burden of meeting actuarial targets, Medicare (and other government provided plans) could cater to those in desperate circumstances and all others could get reasonably priced coverage from traditional providers.


    Posted Mon, Aug 20, 2:36 p.m. Inappropriate

    Here's my article on the Romney Medicare proposal and the Ryan-Wyden proposal:

    Posted Mon, Aug 20, 7:52 p.m. Inappropriate

    Rather than continually knocking dwn others submissions, why don't you simply write your own Crosscut articles?
    BTW, I often agree with you.


    Posted Mon, Aug 20, 3:39 p.m. Inappropriate

    dbreneman, without trying to come up with a comprehensive response to what you're proposing, I'd say that would privatize the profits and socialize the losses. Taking the risk of people getting sick is part of the insurance business. So you want to leave the private insurers with the goodies -- taking premiums from people who need little or no health care -- and place the high-cost patients (and most of Medicare's costs come from a relatively small percentage of sick or dying patients) on the taxpayer's tab. Does anyone think that sounds like a good deal for taxpayers?

    Posted Tue, Aug 21, 8:07 a.m. Inappropriate

    It's one thing to "take the risk of people getting sick". It's someting entirely different to face bankruptcy because of a few very expensive cases. It's this reason that more firms don't self-insure, and that new insurance companies don't enter the market. There is a tremendous barrier to entry into a market when, out of nowhere and with no warning, you could be forced out of business due to a situation beyond your control. My acting as a re-insurer for exceptional cases, the government could open the insurance market to more competitors and bring rates down for everyone.


    Posted Mon, Aug 20, 9:56 p.m. Inappropriate

    Reaching across the aisle, like Paul Ryan and Ron Wyden did, and before that, Wyden and New Hampshire Republican Judd Gregg on tax reform, is exactly what we need in Washington, DC.

    Posted Mon, Aug 20, 10:58 p.m. Inappropriate

    John, and look what reaching across the aisle got Wyden -- a slap in the face. Ryan came back with an unacceptable House budget version of the Medicare voucher proposal that Wyden says would destroy Medicare. He looks like a chump. And he realizes that, and that's why he's distancing himself as far as he can from the Ryan plan.

    Posted Tue, Aug 21, 9:24 a.m. Inappropriate

    It's OK, even a good thing, for Republicans to "reach across the aisle", they get favorable notice in the NYT, Crosscut even.
    For Democrats, not so much.


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