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And that is the issue. Home Finances Committee Chair Paul Ryan’s proposal for shifting rather more of Medicare’s costs to beneficiaries has been disowned by his Republican colleagues—and given Democrats an enormous political gift. The IPAB is under hearth and might be dumped. Earlier, more nuanced proposals, like these from the co-chairs of the 1999 Bipartisan Medicare Commission, have died for lack of political help. With an election beginning to loom, and both parties looking to the senior vote, the chances of accountable bipartisan options seem far, far, away. In the meantime, Part A and the federal deficit are rushing towards their respective precipices. It is political chapter in every sense.
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