In a postelection reversal, House Republicans are supporting nearly $450 billion in Medicare cuts that they criticized vigorously last fall when Democrats and President Barack Obama passed them as part of their controversial health care law.
The cuts are included in the 2012 budget that Rep. Paul Ryan, R-Wis., unveiled last week and account for a significant share of the $5.8 trillion in claimed savings over the next decade.
The House is expected to vote on the blueprint this week.
Ryan's spokesman, Conor Sweeney, said the cuts are virtually the only part of "Obamacare" — the term that Republicans use derisively to describe the health care law enacted last year — that the Wisconsin Republican preserved when he drafted his budget.
If left in effect, they would retain smaller payments over the next decade for hospitals, nursing homes, hospices and other Medicare providers that Democrats put in effect. In addition, federal subsidies would decline for seniors who purchase coverage through private insurance plans under Medicare Advantage, although Ryan proposed a small partial restoration in that area.
GOP in 2010: 'Let's save Medicare'
Last fall, in their drive to win control of the House, Republicans were harshly critical of the Democrats on the issue of cuts to a program that benefits millions of seniors.
"The new law's massive Medicare cuts will fall squarely on the backs of seniors, millions of whom will be forced off their current Medicare coverage," the GOP wrote in their Pledge to America, an election-season manifesto. In making the claim, Republicans cited the chief actuary at the Centers for Medicare and Medicaid, which oversees both programs.
In addition to the Pledge to America, House Speaker John Boehner, House Majority Leader Eric Cantor and individual Republican candidates all criticized the cuts.
The National Republican Congressional Committee featured them in ads attacking Democrats in numerous campaign commercials, and some individual candidates made use of the cuts as well.
Sweeney said the GOP budget puts the Medicare savings to a different purpose than Obama and the Democrats favored.
"The president's health care law takes hundreds of billions of dollars from Medicare to help fund a new, open-ended entitlement program," he said. "Chairman Ryan has put forward a budget that stops the raid on Medicare and ensures that all current-law savings and future reforms are devoted to saving Medicare."
Other Republican spokesmen echoed Sweeney.
"The fact is that Democrats robbed Medicare in order to pay for their massive government health care takeover," said Paul Lindsay, a spokesman for the NRCC. "Which is a huge contrast to the House Republican plan to take that savings and use it to strengthen that program for today's seniors."
In fact, some of the Republican criticism last year was couched in terms of diverting Medicare savings into another program. But much was not, in particular the television commercials seen by millions of voters and financed by the GOP campaign organization.
"Congresswoman Ann Kirkpatrick voted for Obamacare, costing us over $1 trillion and cutting Medicare for seniors," said an NRCC ad that ran during Rep. Paul Gosar's successful campaign in Arizona.
Rep. Sanford Bishop "voted to cut Medicare for our senior citizens by $500 billion," the NRCC said in a commercial that was part of an unsuccessful attempt to defeat a long-term Georgia Democratic incumbent.
"Let's save Medicare, and cut Schauer," the NRCC said in a third ad, this one part of a successful campaign in which Tim Walberg turned Rep. Mark Schauer, D-Mich., out of office.
For Democrats and the White House, the cuts were an admittedly controversial part of the health care bill they succeeded in passing a year ago over unanimous Republican opposition.
At the time, critics in both parties criticized them as politically unsustainable and predicted that Congress would buckle under pressure from providers to ease the reductions before they could take full effect.
Republicans and other supporters of private Medicare were particularly critical of the cuts in subsidies for subscribers, saying they would force insurance companies to raise premiums for their customers or perhaps cancel their coverage plans.
Ryan's plan: Wean Americans away from Medicare
Ryan's proposed budget has drawn crisp Democratic criticism for recommending a complete overhaul of the existing Medicare program for anyone currently under the age of 55.
But for all the controversy, it makes relatively few changes in the program in the coming decade.
Sweeney said it envisions savings from enactment of curbs on medical malpractice cases and restores about $10 billion of the $136 billion that was cut over the next decade from the subsidies.
A staff-written question-and-answer section on the committee's official website, presumably meant to reassure seniors, makes no mention of the cuts that were left in place.
"Q: I've heard that this budget cuts $30 billion from Medicare in the next 10 years. If no one over 55 is affected, how is that possible?
"A: (The budget) produces $30 billion in estimated Medicare savings over the next 10 years by advancing commonsense solutions such as curbs on abusive and frivolous lawsuits."