Paul Ryan's American tragedy: What GOP's next big budget fight is really about

Paul Ryan's infamous Medicare privatization plan may never become reality -- but will still have dire consequences

Published March 27, 2015 5:00PM (EDT)

  (AP/J. Scott Applewhite/Manuel Balce Ceneta/Reuters/Jim Bourg/Photo collage by Salon)
(AP/J. Scott Applewhite/Manuel Balce Ceneta/Reuters/Jim Bourg/Photo collage by Salon)

The House and Senate GOPs have each passed their budget resolutions! After some trying scuffles about whether insane amounts of military spending should be on the books or off the books, and a long Thursday recording attack ad material in the Senate, the first stage in producing a non-binding statement of values that, at most, will allow the GOP to get an Affordable Care Act repeal vetoed an all-powerful piece of legislation guiding a restless nation to sunnier harbors.

Now the hard part begins. House and Senate negotiators will go to conference to mesh together two blueprints that follow a similarly draconian muse but aren't identical. With no Democratic votes on the table, they'll have to come up with something palatable to both the House hotheads and the blue-state Senate Republicans that give the GOP its edge in the chamber.

The figure who's going to present the biggest stumbling block isn't even one of the budget chairs anymore, but his imprint is still all over Rep. Tom Price's House budget. We're talking about Rep. Paul Ryan and his Medicare privatization plan, also known as "Ryancare," also known as "ruin a perfectly good and popular single-payer system by giving old people some depreciating coupons to go and shop around for private health insurance plans, because that's exactly how they need to be spending their golden years, Jesus H. Christ..."-care.

The House budget includes Ryancare, the Senate budget does not. The House needs Ryancare to win over its most conservative members, the Senate needs to avoid it to win over its more moderate members. Two Medicare #hottakes go into conference, only one comes out.

John Boehner has more of a buffer to work with in the House. He can afford to lose over two dozen votes. As we know from the example of, well, every difficult vote from the past four years, John Boehner is more than capable of losing more than his allotment of defections.

Mitch McConnell, though, can only afford to lose three votes from his conference. His best bet would be to just ignore right-wing grandstanders like veteran Senate leader Ted Cruz and defense hawk Rand Paul and try to keep people like Susan Collins, Mark Kirk, Kelly Ayotte, Ron Johnson, Pat Toomey on the team.

For Collins, at least, that means Ryancare is going to have to go.

Collins did say she would support the Senate GOP budget despite concerns about spending on domestic programs. But she warned that she may not support a final budget agreement produced by conference negotiations with the House if it goes too far on entitlements, particularly Medicare.

“This is not the House bill, which for example, has the privatization to some extent of the Medicare program, the premium support. And that is not in this budget,” Collins said.

Her major concerns center around the House provisions that provide premium support vouchers for young workers when they are eligible for Medicare.

This is the first year that a unified Republican Congress has had to work together to pass a budget resolution. When Paul Ryan was coming up with all these funny ideas in the early 2010s, House Republicans didn't need to worry about the concerns of their counterparts in the Senate. So the Ryan budgets were crafted as an expression of House conservatives' id.

Now, though, Paul Ryan's ghost has to be meshed with Senate Republicans's will in a joint statement of purpose, and it's not clear how that will... happen. House conservatives, chastened after the DHS debacle, weren't as totally obnoxious as they're capable of being during passage of the House budget. Perhaps they will remain that way during debate of the conferenced resolution, since the whole goal here is getting a reconciliation bill repealing Obamacare to the president's desk where it will not become law. Or House conservatives, to whom "difficult reelection races" are a foreign concept, will cause a fuss and demand that Republican senators from Ohio and Maine and Illinois vote for a budget that privatizes Medicare.


By Jim Newell

Jim Newell covers politics and media for Salon.

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Budget Editor's Picks Gop House Medicare Paul Ryan Reconciliation Senate Susan Collins The Right