First, federal Medicaid spending is currently forecast to double by 2040, from 2 percent of gross domestic product to 4 percent. Under Ryan’s budget, it is projected to be cut in half over that period. This dramatic turnaround will supposedly occur by turning Medicaid over to the states through block grants. Anyone want to bet that will work? If states can’t find huge efficiencies in Medicaid, expect them to pressure the federal government to avoid the fanciful reductions in federal support assumed in the Ryan budget.
It's kind of interesting really. This is nothing more than an argument that Mr. Orzag believes that Medicaid cannot survive on 3% per year increases in funding (which is what is in the Ryan budget) from the current baseline. Mr. Orzag is entitled to his opinion and he may prove to be right but this hardly proves anything. As I've written elsewhere, assuming the end to our slow growth period, as all forecasters have and assuming 1% annual efficiency in Medicaid spending, 3% growth in Medicaid is not a bad forecast over the next decade. In the longer run, it may be worse but this is hardly the ridiculous assumption that Mr. Orzag assumes it to be.
Second, the Wisconsin congressman has specified $4.5 trillion in tax cuts, counting on massive rollbacks of tax breaks — such as the mortgage interest deduction — to pay for them. But he offers no details as to how to achieve such reductions, and most serious tax analysts don’t think such changes are politically feasible.
Let's assume this is true. Mr. Ryan and Mr. Romney have specific two objectives, rolling back rates 20% and cutting deductions to offset. My Orzag is making the assumption that the first objective will trump the second if they are in conflict. He has no way of knowing this is true and, the projections in the Ryan budget actually appear to assume the first trumps the second sine the revenue line is revenue neutral to the current policy baseline. Again, Mr. Orzag is offering no proof just the least charitable read he can offer.
Third, Ryan assumes that other spending, including nondefense discretionary spending, will fall from more than 12 percent of GDP last year to less than 5 percentby 2040. Again, he provides scant details on how to get there.
This one is actually a bit funny. Mr Orzag may want to read the President's budget at some point. It assumes that total discretionary spending will fall to 5.0% of GDP by 2022. The notion that Mr. Ryan might go from 5 percent to below 5% by 2040 doesn't really seem all that difficult to imagine. You'd think as a past member of the Obama administration, Mr. Orzag might be aware of this fact.
Ryan says he would cut tax rates for all families, but that doesn’t mean the middle class would be any better off. Even after the Bush tax cuts, Ryan’s reductions would amount toabout $1,000 a year for families with annual incomes between $50,000 and $75,000— compared with a cut of more than $250,000 a year for those with incomes above $1 million.
This one is fun with numbers. According to the TPC, the average family with an income of between $50,000 and $75,000 pays 5.7 percent of their income in federal income taxes (which is what is being changed here). We'll charitably call that about $3500 per year. This family is receiving a tax reduction of about one third, using Mr. Orzag's own estimate (which comes from the partisan CBPP). The family with over $1,000,000 on average pays an average of about $600,000 in federal income taxes and receives about the same 1/3 reduction. Thus, the gap in the amount saved is caused not by the unfair change in the tax code but by the gap in their current tax contributions. As an aside, the tax rate changes in the Ryan plan do nothing to tax distribution. It's simple math.
Furthermore, unlike the proposal from the nonpartisan Domenici-Rivlin deficit-reduction commission, the Ryan budget does not include any provisions to create jobs immediately. With unemployment above 8 percent, we should couple any long-term deficit reduction with additional support for the economy today. That would help the middle class more than promises of a tax cut that will probably turn out to be a mirage.
Oh dear. So the Ryan plan is like the bipartisan Bowles Simpson plan in that it doesn't include immediate stimulus. It is interesting that Mr. Orzag wouldn't mention the Bowles Simpson plan which his boss created. With the deficit above $1 trillion already, perhaps Mr. Orzag should explain why the next trillion of deficits will do more than the first trillion. I'd also be curious if Mr Orzag would support all of Domenici Rivlin which, quite interestingly calls the same approach to Medicare as in the Wyden-Ryan plan (the current incarnation of Ryan's approach to Medicare).
“Both administrative costs (including profits) and payment rates to providers are higher for private plans than for Medicare,”the report said. That effect, according to the CBO, would outweigh any savings achieved by people choosing less costly health care.
But this assumption from the CBO is achieved by assuming that Medicare can continue to cost shift onto private insurance in perpetuity (which of course it cannot) and Mr Orzag also fails to mention that the plan would save the government a ton of money which the CBO concludes in the same report he cites.
Suffice it to say this piece which appears under the title "Five Myths About Paul Ryan's Budget" should probably be titled "5 Reasons Peter Orzag Has a Difference of Opinion with Paul Ryan." To classify something as a myth typically requires demonstrating it is not true. Mr. Orzag falls a long way short of that bar.