Obama Hides Medicare Means-Testing in Plain Sight--In His Big Budget

By John Aloysius Farrell, Thomas Jefferson Street blog

The problem—or maybe it's the genius—of Barack Obama's bold fiscal agenda is the way its sheer scope tends to dwarf some momentous policy choices hidden amid all those numbers.

Audacity's initial budget gives us an example. While everyone to the right of Evan Bayh has been hyperventilating about government spending, they've missed a rather historic moment: a Democratic president has proposed means-testing for Medicare.

Specifically, Audacity hopes to cull more than $8 billion from wealthy seniors by making the Part D prescription drug benefit more contingent on income.

It sounds like common sense. Then-President George W. Bush and GOP presidential candidate John McCain and Senate Republicans endorsed the idea last year. "Why should you be paying for my prescriptions?" the wealthy McCain asked his campaign audiences.

The answer rests in liberal dogma.

Social Security and Medicare are participatory programs, designed for all Americans—rich and poor alike. You work hard, kick a portion of your income into these two retirement funds, and are guaranteed a payout in your golden years. This gives these programs broad popular support—they are not welfare for the poor, they are guaranteed retirement benefits for all.

But as medical costs soared, and the population aged, Republicans, and some more conservative Democrats, suggested that the rich really didn't need such benefits, and that Medicare payments be contingent on an income—or, means—test. This was especially true of the new Part D drug benefit, which reflects the increasing importance, and growing costs, of prescriptions in modern medicine.

Liberals fumed. Means-testing of entitlement programs would send us down a dreaded "slippery slope," they argued. Soon Medicare, and then Social Security, would lose their broad-based popular support, and be merely costly welfare programs! Both Obama and then-Sen. Hillary Clinton voted against a Republican proposal to means-test Part D last year.

While the U.S. economy was humming, the Left could persuade the nation to put off this kind of tough choice. No more. And so, like Nixon going to China, Obama has put means-testing in a Democratic budget.

The president has not gotten much credit for his proposal, and he is sure to catch some grief on Capitol Hill, from liberals who want to preserve Medicare's status; from fiscal conservatives who say he isn't going far enough, and from opportunistic Republicans who will paint the proposal (as they did when Bill Clinton steered a modest tax hike on Social Security benefits through Congress) as an assault on the middle class.

Or (and this is where the genius label may prove true) the debate may be so focused on the other big items in Audacity's plans, that this potentially historic change (and others like it) will slide right through, and serve as a model for further means-testing of entitlement programs. There is no telling how far down a slippery slope we may slide.

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