A funny thing happened on the way to the demise of Medicare Advantage. The program under which 16 million seniors purchase federally subsidized coverage through private health insurers, the carriers and Republicans warned, would be jeopardized by the $150 billion in cuts to providers over 10 years used to help fund the Affordable Care Act. But instead on declining, enrollment in Medicare Advantage has continued to grow since Obamacare was passed in 2010, approaching 30 percent this year. And when the Centers for Medicare and Medicaid Services (CMS) announced smaller than expected payment reductions for next year on Friday afternoon, stock prices for leading Medicare Advantage carriers Humana, UnitedHealth Group and Aetna surged.

Of course, none of these developments has stopped Republicans in Congress from demagoguery on the issue. In December, the National Republican Senatorial Committee (NSRC) charged, "By voting for ObamaCare, Democrats like Mark Pryor, Kay Hagan, Mary Landrieu and Mark Begich cut $717 billion from Medicare -- including $154 billion from Medicare Advantage -- which will hurt seniors." As South Dakota GOP Senator John Thune, chairman of the Senate Republican Conference, complained last week:

"Every senator who voted for this train wreck owes America's seniors an explanation for these Medicare cuts, which are already resulting in higher costs and reduced access to the doctors they had and liked."

Which is very funny, indeed. Because by voting for the Paul Ryan House GOP budget in 2011, 2012 and 2013, John Thune along with 95 percent of his Republican colleagues in Congress backed exactly the same savings from the Medicare program.
While repealing Obamacare, slashing Medicaid funding by a third and leaving roughly 38 million more people uninsured, the Ryan budget still runs up trillions in new red ink thanks to its massive tax cut windfall for the wealthy. Paul Ryan's blueprint does not, as Republicans claim, balance in 10 year because it does not identify a single tax break it will close to fill the gaping hole left by almost $5 trillion in tax cuts. And yet, the Ryan plan still assumes every single dollar in revenue generated to fund the Affordable Care Act. The same $716 billion in savings from Medicare Advantage providers, the capital gains and Medicare payroll tax surcharges for households earning over $250,000 a year and other new revenue raisers are all still in there. (Making matters worse, Ryan's proposed voucher scheme would inevitably lead to rationing of Medicare, as the underfunded "premium support" significantly shifts costs from Uncle Sam to seniors.) As Ezra Klein explained "Paul Ryan's love-hate relationship with Obamacare" last March:

Every Ryan budget since the passage of Obamacare has assumed the repeal of Obamacare. Kinda. Ryan's version of repeal means getting rid of all the parts that spend money to give people health insurance but keeping the tax increases and the Medicare cuts that pays for that health insurance, as without those policies, it is very, very difficult for Ryan to hit his deficit-reduction targets.

This issue first arose in January 2011, when the new Republican House majority asked the nonpartisan Congressional Budget Office (CBO) to "score" H.R. 2, the "Repeal the Job-Killing Health Care Law Act." Much to the dismay of Speaker John Boehner, Budget Chairman Paul Ryan and Majority Leader Eric Cantor, the CBO explained that repealing Obamacare would make the U.S. national debt worse. In July 2012 and again in May 2013, the CBO reached the same conclusion:

"Repealing the ACA would affect direct spending and revenues in ways resulting in a net increase in budget deficits of $109 billion over the 2013-2022 period."

As Republican radicals in the House and Senate shut down the government in their failed effort to "defund" Obamacare last fall, the ranking Democrat on the House Budget Committee Chris Van Hollen (D-MD) called his Republicans to task for perpetrating a hoax:

"[House Republicans] have to explain to the American people how they voted for a budget that includes all of the Medicare savings from ObamaCare, that includes the same level of revenue generated from ObamaCare and, in fact, would not even balance in 10 years, if not for the Affordable Care Act."

Nevertheless, the conservative Daily Caller predicted, the GOP will have the "MediScare Advantage" in the 2014 elections as vulnerable Democrats face the older electorate typical of midterm balloting. For his part, Utah Senator Orrin Hatch decried Obamacare Medicare Advantage reductions, declaring they "threaten a successful program for seniors, and must be overturned." That's a funny position for Hatch to take, since he voted for them three years in a row.