Obamacare vs. Medicare Part D: Similarities and Differences
From the Washington Post’s Ezra Klein to Forbes’ Carrie Sheffield, many pundits have spent the week comparing the glitchy Obamacare rollout to the problem-filled Medicare Part D rollout under George Bush. Certainly, there are similarities in that the initial weeks of Medicare Part D were glitchy and prevented seniors from getting access to the medications they needed because their new plans hadn’t kicked in. Both parties called Medicare Part D a disaster but the problems were initially fixed and the program now has 90 percent support among the public. That’s where the similarities end.
It’s true that the Medicare Part D rollout was even more unpopular than the Obamacare rollout is now and presently has 90 percent satisfaction among those enrolled. In that, there may be hope for Obamacare. The differences between the two, however, far outweigh the similarities.
For one, the biggest standoff between Obama and the Republicans is on how spending for this bill will affect the deficit. In reality, there are revenue increases and spending cuts that offset the costs of the Affordable Healthcare Act and, so far, the program seems to be hitting its projections. On the other hand, Medicare Part D never had any revenues or cuts to offset the cost. As Bruce Bartlett points out in The New York Times, the “deficit increased by virtually the entire cost of the [Medicare Part D] program.”
According to the Congressional Budget Office, the Affordable Care Act is still expected to cause a “slight reduction in the deficit during the first ten years, with greater reductions after that.”
As Jonathan Cohn of The New Republic points out, by ensuring the costs of the plan are offset, “Obamacare’s architects guaranteed they’d make some people angry. And that is the biggest difference between what Bush did and what Obama did. Medicare Part D was all gain, no pain—the program gave millions of senior citizens access to drugs, without asking anybody to pay for it immediately. Instead, the program passes along the bill to future generations, for whom higher deficits mean fewer resources for public or private spending.”