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Taking out the $716 billion, as Romney has pledged, moves the balance date to sometime in the 2040s. If the country waits until 2022 to reform Medicare, from a much larger base, moving to reduce debt, reduce government as a share of the GDP, or balance the budget, will require a different glidepath to bend the Medicare cost curve — meaning much larger and swifter cutbacks in the growth of the program than would be applicable now.
That’s not all. The $716 billion in cuts in growth of Medicare, mostly taken from providers, extends the solvency of the program by eight years, to 2024. Taking it out, according to Medicare’s actuary, would move the date for Medicare insolvency to 2016 — in other words, during Romney’s first presidential term.
Keeping the program intact would then require either that premiums paid by Medicare recipients go up or that provider payments go down — or that reforms in the interim, which in turn would deeply affect current Medicare recipients, could stave off insolvency or extend the life of the program. Any of those options will violate one of the promises on the table — protecting all 55-and-older Americans in the program from any disruption or change in their benefits while also restoring the $716 billion reductions in the 2010 health care law.
The political appeal behind pledging not to touch Medicare benefits for current and soon-to-be seniors is obvious. The political appeal of attacking the president for slashing the Medicare program by $716 billion and pledging to restore it is equally obvious. The political appeal of promising to cut deficits and debt and cap government spending at 20 percent of the GDP is also apparent.
But the combination of the three is utterly inconsistent and impossible. Something has to give — the question is what. It is that question the 113th Congress will have to confront immediately if Romney wins, with no palatable answer.
Norman Ornstein is a resident scholar at the American Enterprise Institute.