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More Medicare Cuts, Cont'd

Are Democrats about to get behind more Medicare cuts, as part of a deal to reduce the deficit? Sam Stein of the Huffington Post says it’s a distinct possibility. The latest clue is a statement by Senate Finance Chairman Max Baucus, made after House Majority Leader Eric Cantor announced he was withdrawing from the bipartisan debt ceiling talks:

I think we should stay at the table. I think we should keep working, difficult as it is, and try to balance between Medicare cuts—additional Medicare cuts—so long as there is commensurate additional revenue. We need balance here.

I’m still in China, so my reporting ability is somewhat limited. But Baucus’s statement is consistent with what Hill sources have been saying for some time: That Democrats would probably embrace further cuts to Medicare as part of a deal to reduce the deficit.

Is that a good thing? Possibly. Senior Democratic aides have made clear that Democrats would not consider cuts that affect beneficiaries directly. Instead, they would consider only cuts that reduce payments to the providers and producers of care, ideally in ways that would actually increase (or at least not reduce) the quality of care.

The idea, in other words, would be to strengthen the payment reforms of the Affordable Care Act, perhaps by enacting some that were not politically feasible when Democrats passed that law. In his Huffington Post story, Stein cites one such possibility: Cuts to the medical device industry that Democrats had to withdraw from the Affordable Care Act in order to secure the vote of former Indiana Senator Evan Bayh, who frequently championed the interests of prominent health care companies. (For more on these possibilities, see my item on this from a few weeks ago.)

The question, again, is what Democrats will get in return. These Medicare cuts might not harm beneficiaries.  (Again, with any luck, they’ll actually improve the quality of care or at least make the Medicare program as a whole more efficient.) But, if enacted, they would make it easier for Republicans to blur distinctions between the party on an issue that decidedly favors the Democrats right now. If Democrats are giving up that political advantage, it had better be for real policy concessionsi.e., the sorts of revenue Baucus talks about in his quote.