The “Entitlement Reform” Nobody Really Wants

Just when you thought the fiscal talks couldn’t get any more absurd, there is growing evidence that the big sticking point may be an “entitlement reform” that nobody has any real reason to support: an increase in the age for Medicare eligibility. Ezra Klein sums up the chimera nicely this morning:

Though it’s emerged, alongside chained-CPI, as the GOP’s top ask in the negotiations, it’s disconnected from any larger theory about how to slow the rise in health-care costs. There’s no particular conservative — or even non-conservative — policy goal that raising the Medicare eligibility age advances.

Raising the Medicare eligibility age doesn’t increase competition in Medicare, as some variant of premium support might. It doesn’t reduce national health spending — actually, as Medicare is cheaper than equivalent private insurance, it increases it. It doesn’t force seniors to act as more discerning consumers of health care, as various forms of deductibles and co-pays might. It doesn’t substantially pare back “the nation of takers,” as many of the 65- and 66-year-olds thrown off Medicare will enter the exchanges or be caught by Medicaid.

And it shouldn’t be forgotten: Raising the Medicare eligibility age really will hurt some seniors.

As someone living very near the bullseye of any near-term increase in the Medicare eligibility age, I don’t have to be convinced of that. But I digress.

On Thursday, House Minority Leader Nancy Pelosi described the Medicare eligibility age as “a trophy that the Republicans want.” That’s exactly right. For Republicans, it’s a signal that they won something big on entitlements. In a party that’s confused about where to go on Medicare, it at least proves they’re going in a direction Democrats hate.

The White House doesn’t like the idea, but administration officials see its incoherence as a virtue. The reason it doesn’t cut national health expenditures is that a lot of the pain is blunted by other players, like Medicaid and employers. The reason it doesn’t significantly pare back the safety net is that Obamacare is law, and by the time these age changes phase in, it will be deeply entrenched law. Better to give Republicans a bigger trophy than a deeper cut, or so goes the theory.

This last “theory” was one of Jonathan Chait’s arguments for going along with the “reform” in his much-maligned column last week. But even Ezra’s summary of its absurdity doesn’t capture it all: polls show it is equally unpopular among Republicans and Democrats.

So you’ve got a “reform” that makes no substantive sense to anybody, and that nobody much likes, and it’s now the linchpin of the Great Big Fiscal Debate For the Ages. That’s a sign of how detached from reality these negotiations have become.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.