- Associated Press - Sunday, September 18, 2011

It’s a massive health care entitlement with unfunded future costs exceeding $7 trillion. Many conservatives are still upset about the way it was rammed through Congress.

But when the Republican presidential candidates were asked last week asked whether they would repeal the Medicare drug benefit, all refused — after all, Republicans created it.

GOP leaders say they want to pull the plug on the health care overhaul they call “Obamacare,” but that law is arguably less a driver of federal debt than the Medicare drug plan they are defending.

Debt and deficit are the focus of the Republican Party as the 2012 presidential campaign moves through the nominating process. Yet the reluctance of GOP candidates to renounce a costly entitlement program that voters like shows how politics can come into play when critiquing the federal ledger.

Passed by a GOP-led Congress in 2003 under President George W. Bush, the prescription program is immensely popular with older people, reliable voters who lately have been trending Republican.

Medicare recipients pay only one-fourth of the cost of the drug benefit. Because there’s no dedicated tax to support the program, the rest of the money comes from the government’s general fund. That’s the same leaky pot used for defense, law enforcement, education and other priorities. It’s regularly refilled with borrowed dollars that balloon the deficit.

Although Mr. Obama’s health care law costs far more than the drug benefit, it’s paid for, at least on paper. It includes unpopular Medicare cuts as well as tax increases on insurers, drug and medical device companies, upper-income people, and even indoor tanning devotees.

Asked last week at the tea party debate whether they would repeal the prescription program, GOP candidates would hear nothing of it.

Texas Gov. Rick Perry said he would not, even though he is concerned about its cost. Cracking down on waste and fraud might be the answer, he suggested.

“I wouldn’t repeal it,” said former Massachusetts Gov. Mitt Romney. He said he would restructure Medicare, but not for those now in the program or nearing retirement.

Texas Rep. Ron Paul noted that he had voted against the prescription benefit, but said repeal “sure wouldn’t be on my high list. I would find a lot of cuts [in] a lot of other places.”

Budget hawks scoff.

“I’m an equal-opportunity critic here,” said David Walker, a former comptroller general of the watchdog Government Accountability Office. “I think the Republicans were irresponsible for passing the Medicare prescription program in 2003 and I think the Democrats were irresponsible for passing” Mr. Obama’s health overhaul.

How big is the hole left by the prescription program? Over the next 75 years, its $7.5 trillion “unfunded obligation” exceeds the $6.7 trillion gap attributable to Social Security. Mr. Obama’s health care law, again on paper, is supposed to save the government money over the next decade.

“When they were designing the new health care law, the experience of the Medicare prescription bill was very much in their minds,” said Robert Bixby, executive director of the Concord Coalition, a nonpartisan group advocating fiscal discipline. “They didn’t want to have another unfunded expansion.”

Ironically, repealing Mr. Obama’s overhaul would take away the most important improvement to the program since it was created. Mr. Obama’s law gradually eliminates the dreaded coverage gap known as the “doughnut hole.” Millions of people will each save thousands of dollars as a result.


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