Raleigh, N.C. — Medicare spending represents roughly 15 percent of the federal budget. Ensuring the fiscal health of this entitlement has been a subject of national policy debate for more than two decades, and President Barack Obama's 2012 health care reform law has positioned the cost of health care as a key election this campaign season. So it's no surprise that Medicare has been a topic in both the presidential campaign trail and in Congressional campaigns like the one being waged in North Carolina's 7th District.
Last week, the Democratic Congressional Campaign Committee began airing a new ad targeting state Sen. David Rouzer, challenger to Democratic incumbent Mike McIntyre. The ad claims that the "David Rouzer’s budget would essentially end Medicare.”
This is an interesting claim, and not just because first-time Congressional candidates rarely have the time or inclination to develop their own federal spending plan. Similar claims about ending Medicare have been made by both parties regarding plans put forward by other candidates. Fact-checkers who have tested similar lines from ads in other races have rated them less than true.
Q: Is there a "Rouzer budget?"
In a word, no. While Rouzer's website does have an issues section, part of which discusses health care, the Republican doesn't offer up anything so detailed as a budget plan of his own.
Rather, this is an effort by the DCCC to link Rouzer to the budgets developed by vice presidential nominee Rep. Paul Ryan, R-Wis. The organization quotes Rouzer as saying that he "wholeheartedly" supported the Ryan plan, pointing to a video tape of a candidates debate from the primary.
In a news release Friday, staff for Rouzer's campaign said that he didn't endorse the 2012 budget resolution in question. However, reached Monday, Rouzer said in an interview that he does back Republican efforts to change Medicare so that it stays solvent.
"I support his (Ryan's) plan to address the program and make it secure for the future," Rouzer said. "To be quite candid, do I know every detail of it? No." Rouzer said there may be fine points upon which he and Ryan differ, but that overall he supports the ideas behind Ryan's effort.
Q: Would the Ryan budget that Rouzer supports really end Medicare?
Even assuming Rouzer was a wholehearted supporter of the Ryan budget, this commercial would not ring completely true.
Although this particular ad has not caught the attention of those who write fact checks for national news organizations, federal policy experts have dissected very similar claims made in different races.
PolitiFact, which is a project of the Tampa Bay Times and other news partners, said the president's assertion that Romney's plans would end Medicare was based on analysis of a plan that has since been updated. The website called the claim "mostly false."
Those viewing the ad will see references to a Wall Street Journal story and an article from USA Today, both of which discussed a version of the Ryan budget from 2011. The congressman and his legislative allies have since updated that blueprint.
FactCheck.org, run by the nonpartisan Annenberg Public Policy Center of the University of Pennsylvania, rated the "end Medicare" claim made in several Congressional races and an accompanying assertion that seniors would end up paying an extra $6,350 a year as "whoppers."
One thing both fact-checking organizations point to as a key flaw in the ads is that no version of the Ryan budget would have changed Medicare for existing seniors. Rather, changes would start taking effect for those who turn 65 in 2023 or after.
None of this has stopped various groups from using the claim with pictures of folks who have obviously passed 65 years of age. This makes good political logic – retired Americans vote in a higher percentage relative to the rest of the population and tend to vote against candidates they view as threatening Medicare – even if it's not factually accurate.
"Ryan’s new plan, released this year, is more generous in terms of what it would provide for subsidies, and it keeps traditional Medicare as an option for all beneficiaries, both current and future," Lori Robertson wrote for FactCheck.org.
Both PolitiFact and FactCheck.org, as well as health policy experts, say it's unclear exactly how much more seniors might be asked to pay under the Ryan plan, because his current proposal doesn't offer enough detail to fix a number to it.
It's worth noting that Republicans, including Rouzer, have fired back at this apparently bogus claim with a somewhat bogus claim of their own.
"Medicare as we know it has already ended – because Barack Obama and the Democrats chose to cut $700 billion from Medicare to pay for their takeover of health care," Jessica Wood, a spokesman for Rouzer, said last week. Rouzer repeated that assertion when interviewed Monday, saying that the Obama administration "stole" from Medicare to pay for the new national health care law. PolitiFact rated that claim "false" when made by likely Republican Presidential nominee Mitt Romney.
As Kaiser Health News noted earlier this month, both the Obama administration's health care reform efforts and the Ryan plan would squeeze hundreds of millions of dollars worth of savings out of Medicare. The difference is how they go about it. Obama's plan relies on government-mandated "carrots and sticks" to urge health care providers to cut costs and keep people healthier. The Ryan plan saves money by shifting how Medicare is administered, giving seniors vouchers to purchase insurance in a private, but still regulated, market. As summarized by the Associated Press:
Obama's plan relies heavily on cutting payments to health care providers. Critics say that could cause some doctors to stop seeing Medicare patients.
The Romney-Ryan proposal would give future retirees a fixed amount of money to pick their health insurance from competing private plans or a government program. It would limit taxpayers' burden, but also force many patients to pay more of their health costs.
Q: Is the DCCC ad on Rouzer truthful?
Viewers could be could be misled into thinking Rouzer had put forward his own detailed budget proposal. But it is fair, Rouzer acknowledged, to describe him as a supporter of GOP efforts to ensure Medicare is solvent. As for the claim that the "Rouzer budget" would end Medicare, other fact checkers expert in federal policy had rated it somewhere between a "mostly false" and "a whopper."
Bonus Question: So what has Rouzer actually said about Medicare?
Rouzer talks about health care in the context of how it affects business. He makes the case on his website that increasing health care costs and industry regulation are holding back the economy.
"We must enact free market reforms to our health care system in order to increase competition among health insurance companies, attract more of the very best and brightest to the health care profession, and increase transparency if we expect to reduce the cost of health care. The less costly health care, the less costly Medicare and Medicaid will become," Rouzer writes.
Rouzer, like virtually all Republicans, says the 2010 health care reform law, sometimes called ObamaCare, should be repealed. It's worth noting that this summer incumbent McIntyre voted in favor of a bill that would repeal that law.
McIntyre also talks about the need to lower the cost of health care on his website, although neither McIntyre's nor Rouzer's statements offer much detail.
"Mike advocates tackling health care reform in targeted ways, like strengthening Medicare and Medicaid; improving Medicare reimbursement rates for rural health providers, expanding the use of electronic medical records," reads McIntyre's website.