Paul Ryan's Budget: Take From The Poor, Sick, and Elderly

Paul Ryan's budget is out. The Wall Street Journal of all places has a rather snide review of it. In the budget, Ryan fails to provide any tax proposal, opting instead to wave his hands vaguely towards "a tax code that is simpler, fairer and more competitive." He also uses dynamic scoring to generate his revenue figures, which is this thing where you make-pretend your budget proposal will generate major economic growth, an especially odd move here given that Ryan has no tax plan. Whatever the tax system ends up looking like, Ryan is certain it will be be pro-growth.

While no tax plan and dynamic scoring fantasies are the amusing details that delight the wonks, the truly interesting parts of the budget are the spending cuts. The annual Ryan budget always provides an array of take backs from the poor, the elderly, and the sick. And this year does not disappoint.

Some highlights:

  • Convert food stamps into a block grant to each state. Ryan says this would take $125 billion from poor people, but in reality, it'd probably take more. As we saw with TANF, block granting a program is a way of eviscerating it.
     
  • Introduce means-testing and possibly child caps for Supplemental Security Income. Paul Ryan says this would take $5 billion from disabled people.
     
  • Block grant Medicaid to states and index the block grant to inflation and population growth. Block granting is how you destroy programs, as I mentioned above with food stamps. Indexing the value of the block grant to inflation and population growth means steep real cuts because health care costs are rising faster than inflation. Ryan says this reform would take $732 billion from poor sick people.
     
  • Turn Medicare into a voucher program. The proposal says "this is not a voucher program," but a voucher program by any other name is just as heinous. As far as I can tell, Ryan does not detail precisely how much this voucherizing will save. In his past budget, the Medicare voucher saved money the same way the Medicaid indexing saved money: by only increasing the value of the voucher each year by inflation despite the fact that health care costs are rising faster than inflation. This would mean shifting health care costs to old sick people, a shift that would fall especially hard on poor old people.
     
  • Hand wave a lot, but ultimately probably cut Social Security. The budget punts on Social Security, as it does many other things. It provides a process that requires the SS trustees to submit a proposal to eliminate the Social Security deficit any time there is a deficit projected across the 75-year time horizon. When that happens, the president is then required to submit legislation to Congress to close the projected deficit. Ryan no doubt wants to close any such deficits by taking money away from old people, but his plan leaves the question of how open.
     
  • Repeal Obamacare. Ryan is still looking to this for some reason, even though, as the WSJ points out, the CBO keeps saying this would increase deficits. Nonetheless, by Ryan's own account, this repeal would successfully boot 13 million poor people out of their health insurance by 2024 relative to current law, and this is only counting the Medicaid expansion piece of the law.

As has been the case every other year the Paul Ryan budget circus comes to town, we have here a proposal that doesn't even satisfactorily explain how it is supposed to achieve its deficit reduction goals. The only clear parts of the budget are those that aim to wreck the social insurance systems that makes the lives of vulnerable people livable.

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