The battle over USIP is only one of many skirmishes in a larger war, as House Members try to use both appropriations and authorizations to take a meat ax to government, with little consideration or debate about costs and benefits. The political war is about the size and scope of government. If it were about fiscal discipline, the first steps taken by Congress and the president would be to ameliorate the problems that caused the ballooning debt in the first place: deep tax cuts that have drained revenue, two wars and a Medicare prescription drug program unpaid for that account for up to four-fifths of the plunge from trillions in surplus in the late 1990s to double-digit trillions in deficits in this decade. The one trigger mechanism that actually brought a measure of fiscal discipline, pay-as-you-go rules, was eliminated this year.
That makes the special election in New York especially interesting. Make no mistake about it — Medicare drove the vote, enabling a Democrat to win 48 percent in a three-way race in a strongly Republican district. It is not just Democrats who say Rep. Paul Ryan’s (R-Wis.) budget ends Medicare as we know it; Sen. Olympia Snowe (R-Maine) said the same thing. And Republican presidential candidate Herman Cain called the plan not “premium support” but a voucher system.
For Republicans, the best way to get out from under their Medicare (and soon-to-be Medicaid) problem is to find a broader budget deal that includes, of necessity, some measure of entitlement reform and cutbacks in the future growth of Medicare and Medicaid that both parties buy into. But that will mean embracing many elements of the Affordable Care Act that they are trying to repeal and accepting a serious measure of tax increases.
Will Democrats take the opportunity for a compromise with embattled Republicans when the temptation to demagogue Medicare to the limit is so great? Can Republicans take on Grover Norquist for a higher purpose? Any debt limit compromise will have to include a credible trigger; can we achieve a version of PAYGO? These are the big questions ahead.
Norman Ornstein is a resident scholar at the American Enterprise Institute.