The Ways and Means of Strengthening Medicare

This week, U.S. Representative Kevin Brady (R-TX) was elected by his colleagues to become the new chairman of the House Ways and Means Committee, succeeding new House Speaker Paul Ryan (R-WI).

For those of us who are concerned about the future of the Medicare program and believe its sustainability and fiscal health for future generations hinges on structural modernization, the Brady ascension is a promising development.

Months before the nation even knew there would be a shakeup in the House leadership, Congressman Brady – then chair of the Ways and Means health subcommittee – did an interview with National Journal in which he made clear his intention to begin developing Medicare modernization legislation with an eye toward action in 2017 with a new President and Congress.

Like Ryan, Brady said he supports an improved Medicare in which private plans would compete on the basis of value, as is happening today with the successful Medicare Advantage and Medicare Part D prescription drug programs.  As he put it, this is a “step toward saving Medicare in the long term, which is offering better and smarter personalized Medicare options for seniors.”

(As this debate begins, by the way, Brady will have evidentiary support provided by the Congressional Budget Office.  A CBO report in late 2013 found that a modernized Medicare based on consumer choice and private sector competition would reduce federal outlays AND beneficiary out-of-pocket spending.)

The Brady leadership of Ways and Means will be interesting to watch and an important policymaking period in terms of strengthening our nation’s healthcare infrastructure.  While the new Chairman lays his groundwork, this issue will also be at the center of the 2016 campaigns.  As the Washington Post reported this week, there is a divide in the Republican party with leaders like Ryan and Brady calling for Medicare modernization and some candidates, notably Donald Trump and Mike Huckabee, insisting that the program must be left alone.

It’s an important discussion to have.  In the end, though, we can’t ignore the Medicare Trustees’ judgment that the program will become financially insolvent in just 15 years.  Policymaking on big, complex issues is never a rapid process.  That’s why we need to begin now and we wish Chairman Brady a strong wind at his back as he takes on this important and necessary endeavor.