As U.S. Rep. Paul Ryan shifts his focus away from recommending deep cuts to federal poverty-fighting programs to wholesale restructuring, let’s not forget the budgeting approach the Wisconsin Republican has espoused as chairman of the House Budget Committee.
Ryan’s budget blueprint, after all, exemplifies a key difference at stake this fall in the race between Emily Cain and Bruce Poliquin to represent Maine’s 2nd Congressional District in the U.S. House.
Ryan’s plan balances the federal budget within a decade through a combination of cuts to entitlement programs, cuts to programs that help the poor and middle class, and an avoidance of many hard choices that would seemingly be implicit in a budget-cutting plan.
Cain, a Democratic state senator from Orono, has expressed her outright opposition. Poliquin, the Republican former state treasurer, says he supports the Ryan plan. He told the BDN editorial board in May that he would like to see the plan balance the federal budget more quickly.
In using the Ryan approach to balance the federal budget, Poliquin and other supporters of the plan would be counting on an approach that stands to wreak havoc with the Maine state budget, which Poliquin takes some credit for reforming during his time as state treasurer.
Take Medicaid, for example.
It accounts for nearly a quarter of Maine’s state budget and is the state program that most often gives state lawmakers fits when they are trying to balance the budget. The state spent nearly $1 billion last fiscal year to provide health care for low-income and disabled residents and to cover long-term care expenses — mostly nursing home stays — for the elderly. The federal government matched the state’s spending with $1.7 billion.
The Ryan budget fundamentally would alter the state-federal Medicaid relationship by turning the program into a block grant, in which states would receive a fixed amount of funding and be entirely on the hook for the difference — even if spending rises above those fixed levels. And spending likely would rise to levels at which states would be on the hook for much more than they’re responsible for today.
That’s because funding under the Ryan block grant plan wouldn’t keep pace with expected growth in health care spending over time. According to the Center on Budget and Policy Priorities, that would work out to a 26 percent cut in Medicaid funding to the states by 2024. States would respond by cutting low-income people off the Medicaid rolls or digging deeper into their taxpayers’ pockets to make up the difference.
Plus, the Ryan budget proposes to repeal the Affordable Care Act — the health care reform law that, interestingly, brings the federal government closer to a balanced budget from the new revenues it raises. That means a major funding cut for those states that expanded Medicaid coverage, likely resulting in the loss of coverage for the more than 6 million low-income people who just gained it.
Combined with the Ryan plan to convert Medicare to a “premium support” system, in which seniors ultimately receive a sum of money and choose among private plans or traditional Medicare, Ryan’s budget would undermine several of the most cost-effective means available for covering low-income, disabled and older Americans.
As for investing in the future, Ryan’s plan cuts the Pell grants that help low-income students attend college and improve their economic prospects and it slices the food stamp program that’s critical to keeping low-income children well nourished so they can succeed in life.
As for making tough choices, Ryan chooses to grow just one area of the budget — defense — and the plan comes out with a “balanced” budget through hundreds of billions of dollars in unspecified cuts to programs that help low-income people.
The Ryan budget offers a good litmus test for the vision of government each candidate would support in Congress.