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Ryan: GOP ready to take on health programs

Republicans in charge of the House are facing two unappealing options on the budget.
Paul Ryan
House Budget Committee Chairman Paul Ryan, R-Wis., gives the GOP response to President Obama's budget submission for Fiscal Year 2012, on Capitol Hill in Washington on Feb. 14.J. Scott Applewhite / AP
/ Source: The Associated Press

Republicans in charge of the House are facing two unappealing options on the budget.

One is to lead with their chins and offer politically toxic cuts to Medicare, Medicaid and, perhaps, Social Security. Or, they could play it safe — but then endorse trillion-dollar deficits that would enrage their Tea Party backers.

Rep. Paul Ryan, the party's point man on the budget, is gearing up for a fight on the former, betting that American voters won't rebel this spring when he offers up controversial cost curbs on those popular benefit programs.

Even those tough proposals wouldn't balance the budget anytime soon. But Ryan says Republicans elected to take on Washington's budget mess must keep their promises in spite of the political consequences.

"I think the country's ready for this kind of discussion even though we are going to lead with our chin and they're going to demagogue us," said Ryan, R-Wis.

In a wide-ranging interview Thursday with The Associated Press, the chairman of the House Budget Committee said the House Republicans' budget proposal for the 2012 fiscal year that begins Oct. 1 will propose fundamental changes to Medicare and Medicaid, the giant health care programs that cover 100 million Americans and whose combined costs rival the defense budget.

Ryan offered no specifics, saying details are still being hashed out.

"What I'm going to put forward is a serious and honest attempt to fix this country's fiscal problems," he said.

'I see a willingness to embrace big things'
Ryan, 41, a rising figure in the GOP, has been tasked with both schooling the 87 Republican freshmen on the brain-numbing intricacies of the budget and devising a plan to wrestle the deficit under control. Both are big challenges.

"I see a willingness to embrace big things, I see a willingness to tackle the problem," Ryan said, describing the sentiment among Republican freshmen elected on a wave of concern about the growing scope and reach of government.

"When you walk people through just how deep this hole is ... it really does leave a lot of jaws dropping," he said.

Even if successful, Ryan acknowledges, the government's budget still won't balance for quite some time.

Majority Leader Eric Cantor, R-Va., conceded this week that the government's budget can't be balanced this decade without cutting into current retirees' Medicare and Social Security benefits, something Republicans have said they're unwilling to do. But many Tea Party activists and junior lawmakers still believe the red ink can be reduced to zero with just a bit more pain, according to Ryan.

"They literally think you can just balance it, you know, (by cutting) waste, fraud and abuse, foreign aid and NPR (National Public Radio)," Ryan said. "And it doesn't work like that."

A political third rail?
Endorsing reduced Social Security checks for future seniors or raising the retirement age is viewed by many Republicans as well as Democrats as political suicide without cover from President Barack Obama. And some see the effort as futile when Republicans control only the House and a presidential election just over the horizon.

Under the arcane — and decidedly imperfect — congressional budget process, Ryan is directly responsible for writing a sketchy, nonbinding blueprint each year for running the government. The resolution doesn't require the president's signature, but it does set the framework for changes to spending or tax policy in follow-up legislation.

Ryan said he'll lay out the policy prescriptions that form the basis for his measure, which he says he'll unveil in April. Even if it's a dead letter in the Senate, the House's budget resolution will put lawmakers on record behind the cuts.

Ryan was a GOP appointee to Obama's fiscal commission, but he voted against its deficit-reduction plan, saying it didn't do enough to slow the exploding cost of federal health care programs. The commission, however, brought welcome attention to the magnitude of the budget problem.

Ryan's road map
Ryan has been calling for big changes to the social safety net for years. Known as "the road map," his approach calls for individuals to take on more of the financial responsibility for retirement, including the costs of health care. The government would provide a floor of protection for everyone, particularly the poor and those in failing health, but middle-class people who desire more than a basic plan would have to pay extra.

He's also proposed allowing younger workers to divert part of their Social Security taxes to personal investment accounts, an idea that's lost currency among other Republicans, given President George W. Bush's failed 2005 Social Security overhaul and the recent swoon in the stock market.

The plan Ryan rolled out last year for Social Security would gradually increase the full retirement age, from 67 to 70. It would also reduce initial benefits for middle- and high-income retirees.

Under the road map, Medicare would be converted into a voucher system that offers seniors a fixed payment to pick their coverage from a range of private insurance plans overseen by the government. Today's Medicare recipients and those nearing retirement would remain under the current system, in which the government determines what's covered and sets payments for providers.

As far as Medicaid, the federal-state program that covers low income people and many nursing home residents, Republican governors have been clamoring for a lump sum payment from Washington, a block grant that they could use to design their own state programs without close federal supervision.

Ryan refused to be drawn into specifics on whether and to what degree his past proposals will be part of the plan he will announce next month. But he hinted that big changes are in store.

"If you want to be honest with the fiscal problem and the debt, it really is a health care problem," he said Thursday. "If you look at the future of our debt, it primarily comes from our health care entitlements. We have to reform those if we are going to get this debt crisis under control."

Many Democrats and even a few Republicans in the Senate say the only way to tackle the nation's financial problems is to address both taxes and spending. But don't expect Ryan's budget plan to include any new taxes.