OCTOBER 6, 2008 
McCain Plans Federal Health Cuts 
Medicare, Medicaid Spending Would Be Reduced to Offset Proposed Tax Credit
By LAURA MECKLER






 
John McCain would pay for his health plan with major reductions to Medicare and 
Medicaid, a top aide said, in a move that independent analysts estimate could 
result in cuts of $1.3 trillion over 10 years to the government programs.
 


 Associated Press 
Democratic presidential candidate Sen. Barack Obama speaks at a rally at 
Victory Landing Park in Newport News, Va.
 
The Republican presidential nominee has said little about the proposed cuts, 
but they are needed to keep his health-care plan "budget neutral," as he has 
promised. The McCain campaign hasn't given a specific figure for the cuts, but 
didn't dispute the analysts' estimate.
 
In the months since Sen. McCain introduced his health plan, statements made by 
his campaign have implied that the new tax credits he is proposing to help 
Americans buy health insurance would be paid for with other tax increases.
 
But Douglas Holtz-Eakin, Sen. McCain's senior policy adviser, said Sunday that 
the campaign has always planned to fund the tax credits, in part, with savings 
from Medicare and Medicaid. Those government health-care programs serve 
seniors, poor families and the disabled. Medicare spending for the fiscal year 
ended Sept. 30 is estimated at $457.5 billion.
Mr. Holtz-Eakin said the Medicare and Medicaid changes would improve the 
programs and eliminate fraud, but he didn't detail where the cuts would come 
from. "It's about giving them the benefit package that has been promised to 
them by law at lower cost," he said.
 
Both Sen. McCain and his Democratic rival, Sen. Barack Obama, have recently 
sought to refocus on health care. The issue once ranked at the top of voters' 
domestic concerns, but has in recent months been eclipsed by energy and the 
economy.
 
Sen. McCain charges that the Obama plan, which would create a government-run 
marketplace in which people could buy coverage, would lead to government-run 
health care. Sen. Obama charges that Sen. McCain's plan would leave many people 
unable to get insurance.
Sen. Obama's campaign turned up the volume in a major push on health care over 
the weekend with two days of attacks from the stump, four new television 
advertisements, a series of health-care events across the country and fliers to 
voters' homes in swing states.
 


 
 
Sen. Obama is focused on Sen. McCain's plan to offer a new tax credit of $2,500 
per person and $5,000 per family toward insurance premiums. This would allow 
people to buy health coverage on the open market, where they may have more 
choices and might look for a better bargain.
In exchange, the government would begin taxing the value of health benefits 
people get through work. If an employer spends $10,000 to buy a worker health 
insurance, the worker would pay taxes on that money.
 
"It's a shell game," Sen. Obama told an outdoor rally of 28,000 people Sunday 
in Asheville, N.C. "Sen. McCain gives you a tax credit with one hand -- but 
raises your taxes with the other."
 
Sen. McCain's plan actually would lower taxes for most people. But that means 
the plan wouldn't pay for itself, because it cuts certain taxes more than it 
raises others.
 
The federal government imposes two taxes on wages, generally: an income tax, 
which funds the government's general operations, and the payroll tax, paid for 
by employers and employees, which funds Social Security and Medicare. If Sen. 
McCain were to apply both of these to the value of health benefits, he could 
fully pay for his new tax credits. That is what aides have in the past 
suggested he would do.
 
In April, when Sen. McCain gave a major speech about his health plan, Mr. 
Holtz-Eakin, the senior policy adviser, said the tax provisions alone were 
budget neutral -- meaning that health benefits would have to be subject to both 
income and payroll taxes.
 
Campaign officials have regularly implied since then that the tax plan was a 
wash. In the vice-presidential debate last week, Alaska Gov. Sarah Palin 
described Sen. McCain's proposed tax credits and said: "That's budget neutral. 
That doesn't cost the government anything, as opposed to Barack Obama's plan to 
mandate health-care coverage and have this universal, government-run program."
 
Mr. Holtz-Eakin said the campaign never intended to apply the payroll tax to 
health benefits. That means that most people would see a net tax cut, contrary 
to Sen. Obama's assertions. Only those with very rich benefits packages are 
likely to see a net increase in taxes. But it also means that Sen. McCain must 
fill a huge budget hole -- which the campaign says will come from cuts to 
Medicare and Medicaid.
 
The nonpartisan Tax Policy Center, a Washington think tank, estimates that the 
McCain plan would cost the government $1.3 trillion over 10 years. The plan 
would allow as many as five million more people to have insurance, it estimates.
 
Mr. Holtz-Eakin said the plan is accurately described as budget neutral because 
it assumes enough savings in Medicare and Medicaid spending to make up the 
difference. He said the savings would come from eliminating Medicare fraud and 
by reforming payment policies to lower the overall cost of care. He said the 
new tax credits will help some low-income people avoid joining Medicaid. The 
campaign also proposes increasing Medicare premiums for wealthier seniors.
 
Sen. Obama also would rely on some Medicare savings to pay for his health-care 
plan, which would offer subsidies to help consumers pay for premiums. The Tax 
Policy Center estimates that his plan would cost $1.6 trillion over 10 years 
and cover 34 million more people.
 
Write to Laura Meckler at [EMAIL PROTECTED]
 
 
http://online.wsj.com/article/SB122315505846605217.html
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