Republican presidential candidate Jeb Bush called last week for a “phase out” of Medicare, which he said is not fiscally sustainable. But his statement was not entirely consistent with a report from the Medicare trustees showing that the hospital trust fund's fiscal future has improved.
At a New Hampshire event organized by the conservative advocacy group Americans for Prosperity, which is funded by the Koch brothers, the former Florida governor advocated replacing the current Medicare program with a new system.
“I think a lot of people recognize that we need to make sure we fulfill the commitment to people that … are receiving the benefits,” Bush said. “But then we need to figure out a way to phase out this program for others and move to a new system that allows them to have something because they're not going to have anything.”
But on Wednesday, the Medicare trustees issued their annual report and concluded that the Affordable Care Act—which Bush has denounced—has helped extend the life of the Medicare Part A trust fund by at least 13 years. They said the trust fund remains on track to cover all obligations until 2030, the same outlook as last year.
In 2030, the trust fund will be able to pay 86% of costs, according to the report. Still, the trustees' report said Medicare faces a “substantial financial shortfall.”
Medicare cost growth has slowed in recent years, which many experts attribute at least partly to the Affordable Care Act. That has improved projections for Medicare's solvency. The trustees' report found that the projection for Medicare's long-term costs as a percentage of the economy is down significantly due to the healthcare spending slowdown—from 6.84% of economic output over the coming 75 years to 6%.
There are more immediate financial problems facing the Part B program that funds physician and outpatient services. Part B is funded through general revenue. Due to higher Part B costs, some Medicare beneficiaries may have to pay significantly higher Part B premiums next year.
Bush has called the Affordable Care Act “fatally flawed” and a “monstrosity.” Earlier this year, he called for shifting Americans to a system of “catastrophic coverage” and what he called “consumer-directed” healthcare.
At the New Hampshire event, Bush responded to a woman who criticized his statement about Medicare by saying that “we're going to have to reform our entitlement system.” She replied: “It's not an entitlement. I earned that.”
Democrats immediately blasted Bush's statement calling for a “phase out” of Medicare, comparing it to controversial Medicare privatization proposals by Rep. Paul Ryan (R-Wis.) and to a 1995 statement by then-Republican House Speaker Newt Gingrich that Medicare would “wither on the vine.”
Sen. Bernie Sanders (I-Vt.), who's running for the Democratic presidential nomination, said the nation's goal should be to guarantee healthcare to all Americans, “not end a highly successful program which protects seniors and the disabled.”
A posting on Bush's campaign website states he is “committed to strengthening Medicare in a fiscally conservative way that maintains our nation's social contract and improves choices and quality for our seniors.”
But his comments at the New Hampshire forum suggested that influential Republicans continue to support Ryan's proposal to convert Medicare into a means-tested voucher program for Americans now under age 55, which many Republicans don't want to talk about during the election campaign.
In 2011, PolitiFact called the Democrats' claim that Republicans wanted to end Medicare the political “Lie of the Year.” Writing in Vox, liberal commentator Matthew Yglesias said Jeb Bush's comment last week revealed that “it was never a lie of any sort.”