Mitt Romney holds a town hall meeting at Gateway Convention Center in Collinsville, Illinois March 17, 2012.
By Michael O'Brien, msnbc.com
Updated at 9:38 p.m. ET –Mitt Romney won the Illinois Republican primary with some ease on Tuesday evening, allowing him to likely grow his delegate advantage over his rivals in the fight for the party's presidential nomination.
NBC News projected that Romney had won the contest, the lone presidential primary taking place on Tuesday, less than an hour after polls closed. The primary had offered Republicans maybe their best chance yet of a genuine one-on-one battle between the former Massachusetts governor and Santorum, his chief competitor for the nod.
"Elections are about choices. And today, hundreds of thousands of people in Illinois have joined millions of people across the country to join our cause," Romney told a throng of supporters in Schaumburg, Ill.
As a result of the Illinois vote, Romney's delegate tally is expected to rise, though though the state-wide popular vote had no technical bearing on the eventual allocation of delegates.
In Illinois, voters elect delegates separately on candidates' behalf. A total of 54 delegates were at stake on Tuesday, and a projection from NBC News has yet to be made.
Still, the primary, held in President Barack Obama's adopted home state (typically a Democratic stronghold in the general election), gave Romney a chance to further his campaign's case that he is the inevitable Republican nominee.
Presidential candidate Mitt Romney has focused almost exclusively on President Barack Obama in recent days instead of the other GOP candidates. NBC's Peter Alexander reports.
Romney achieved his victory with a similar coalition of voters that had tended to support him in previous caucuses and primaries.
The ex-governor ran better with more affluent and educated voters, as well as moderates and voters who described themselves as "somewhat" conservative. Thirty-five percent of primary voters said in exit polls that a candidate's ability to beat Obama was most important to them; Romney won 71 percent of those voters to Santorum's 17 percent. Similarly, 58 percent of primary voters said the economy was their top issue, and Romney bested Santorum among those voters by a 17-point margin.
Santorum continued to outperform Romney among downscale and less educated voters, along with the most conservative Republicans and evangelical Christians.
The difference in Tuesday's primary was that these voters made up a smaller share of the electorate than in states like Mississippi and Alabama -- the conservative hotbeds Santorum won last week.
Despite Romney's victory, the Republican race appeared poised to stretch on at least weeks longer. Former House Speaker Newt Gingrich has shown no willingness to leave the race, and Santorum's campaign has circulated its delegate math, which focuses on halting Romney's march to gather the 1,144 delegates needed to secure the nomination.
This would spark a contested convention when Republicans meet to formally make their nomination in August.
Romney had won 444 delegates heading into the Illinois primary, according to the latest NBC News projections. Santorum had accrued 183 delegates, while Gingrich had won 137 and Paul had received 34.
The Santorum campaign made its case to reporters on Tuesday why 1,144 was still an attainable goal for the former senator, though he would have to perform especially well in future contests in order to best Romney.
For Santorum, the Illinois primary had meant an opportunity to again upset Romney in a Midwestern nominating contest the frontrunner had been expected to win. Santorum battled the former Massachusetts governor closely in both Ohio and Michigan, but Romney's superior campaign organization and finances -- combined with millions in ads bought by a supportive super PAC -- ultimately carried the day.
But Romney started to pivot toward his general election target -- President Obama -- in his victory remarks on Tuesday evening. He only referenced his Republican challengers so as to congratulate them on a hard-fought campaign. He used the rest of his speech to test themes of his argument against the president.
"This election will be about principle. Our economic freedom will be on the ballot," he said. "I'm running for president because I have the experience and vision to get us out of this mess."
Romney was able to carry momentum into Tuesday's contest resulting from a commanding victory in last Sunday's Puerto Rico primary, which not only won him 20 delegates, but also raised questions about the prudence of Santorum's decision to campaign in the territory -- an expensive commitment which won him no delegates, and only a small share of the popular vote.
Organizational issues that had dogged Santorum in Ohio's primary also re-appeared in Illinois, where he failed to file the required delegate slates in four congressional districts, meaning he was ineligible to win 10 delegates.
Andrea Saul, press secretary for the Romney campaign, previews Tuesday's primary and talks about the delegate tally.
The campaign turns next to Saturday's caucuses in Louisiana. Gingrich, who again vowed to fight onward to Republicans' convention in Tampa this August, spent the day in Louisiana. The next batch of contests are on April 3 in Wisconsin, Maryland and Washington, D.C.
PEORIA, Ill. – Mitt Romney's final public appearance before voters here head to the polls was not a typical rally or economic-messaging event.
Instead, a crowd of more than 1,000 college students and area residents were treated to a town hall event, in which Romney made an economic pitch targeted directly at younger voters, while attempting to hold the line on his positions on issues that matter particularly to college students, like government's role in managing student debt or covering birth control.
On the manicured campus of Bradley University, where alum and Romney endorser Rep. Aaron Schock introduced him on Monday night, Romney expanded on his Monday afternoon economic speech, explaining in greater depth what he meant when he told an audience at the University of Chicago that he couldn't understand why young people would vote for Democrats instead of Republicans.
"I and my party are also devoted to making sure we don't pass on to you trillions upon trillions of dollars in debt. We have in the Democratic party people who are consumed with giving more and more benefits to me and my generation, and passing on those burdens to you," Romney said. "Every trillion dollars this president amasses, every year, guess who is going to pay that? Not me. I'm gone. I'm too old to pay it back. You're going to pay it back."
Romney has occasionally struggled to win over younger voters this primary season. In the tight race in neighboring Iowa he finished third among the 17 to 29-year-old demographic, behind Ron Paul and Rick Santorum. In his Ohio victory, Romney finished nine points behind Santorum with voters 18 to 29. In blowout wins in Florida and Arizona, Romney carried the youth vote by double digits.
On Monday evening, Romney told his mostly-younger audience that his economic agenda was designed with them in mind.
"My party, my vision, is about protecting economic freedom for you," Romney said. "I've had it for me. I've had economic freedom. I've achieved beyond my wildest dreams. I want economic freedom for you."
As the event moved to questions, Romney, who rarely delves into social issues unprompted, took a first question about birth control. Told by a young woman that she would like free birth control as part of her own "pursuit of happiness," Romney first appeared to stumble over the abruptness of the question, then gathered himself into a response that dealt with the economics of such a handout, not the morality.
"Look, let me tell you something,” Romney started. “If you’re looking for free stuff you don’t have to pay for? Vote for the other guy, that’s what he’s all about, O.K.? That’s not, that’s not what I’m about."
Likewise, Romney defended his opposition to federal funding for Planned Parenthood, for which he has been roundly criticized by democratic and women's groups in the last few weeks. Asked where women should go for mammograms or other care currently offered by Planned Parenthood after a Romney administration defunded it, the candidate responded:
"Well they can go wherever they’d like to go; this is a free society. But here’s what I’d say, which is the federal government should not tax these people to pay for Planned Parenthood," Romney said. "The idea of the federal government funding Planned Parenthood I’m going to say no, we’re going to stop that."
Regarding student loan debt – a pertinent issue for college students – Romney again opposed government handouts -- or any form of government relief for suffering students, for that matter -- but predicted President Obama would not do the same.
"Best thing I can do for student debt is get you a good job when you come out," Romney said. "And by the way, get ready for President Obama's claim ... I know he is going to come out at some point and talk about how he is going to make it vanish. And that's another -- here I'll give you something for free -- and I'm not going to do that."
Updated at 4:05pm ET In one week, the Supreme Court will hear oral arguments surrounding the key provision of the 2010 health care law – the individual mandate.
But outside of the courts, efforts in Congress to tinker with the complex and controversial law continue, including a vote this week to abolish a central piece of the 2010 health care law: the Independent Payment Advisory Board.
The intent of the board was to try and take the politics out of Medicare by giving some of its spending decisions to independent experts. The controversy around the panel’s very existence, however, shows just how difficult that goal will ever be to achieve.
The board fulfills a promise President Barack Obama made in his 2009 health care speech to a joint session of Congress: “We will also create an independent commission of doctors and medical experts charged with identifying more waste in the years ahead.”
IPAB supporters say that setting up a non-politicized cost-cutting process is necessary in order to control the growth in Medicare costs, with IPAB as a backstop if other cost-limiting parts of the law do not work.
IPAB would be akin to the idea of the Base Realignment and Closure Commission. Past BRAC panels have been successful in eradicating redundant military bases.
Mandel Ngan / AFP - Getty Images
West Virginia Democratic Sen. Jay Rockefeller said in 2009 that the Independent Payment Advisory Board is "a large idea with large consequences for the future."
“This is a game-changer,” said the father of IPAB, Sen. Jay Rockefeller, D-W.Va., in 2009 when he and other Democrats were drafting the law in the Senate Finance Committee. IPAB is “a large idea with large consequences for the future.”
This week’s vote, coming as early as Wednesday, will be an election-year propaganda event, allowing House Republicans to tell conservatives in their districts, “We killed part of Obamacare.”
The White House issued a veto threat Tuesday, in a Statement of Administration Policy, which said the bill "would repeal and dismantle the IPAB even before it has a chance to work. The bill would eliminate an important safeguard that, under current law, will help reduce the rate of Medicare cost growth responsibly while protecting Medicare beneficiaries and the traditional program."
From the start, Obama’s opponents started calling IPAB a “death panel” which would deny older people treatment they needed -- even though the law states that the board can’t ration care, restrict benefits, increase the premiums Medicare recipients must pay, or alter the eligibility for Medicare (which is open to most Americans aged 65 and older).
What’s important in this battle is not the all-too-familiar “death panel” rhetoric, but the 19 House Democrats who cosponsored the bill to abolish IPAB -- 15 of whom voted for the Affordable Care Act in 2010.
One of those Democrats, Rep. Allyson Schwartz of Pennsylvania, said, “The promise of health care coverage to our seniors must not be broken. Abdicating this responsibility, whether it is to insurance companies or to an unelected commission, undermines our ability to represent the needs of our seniors and disabled individuals. IPAB is the wrong approach to the right goal.”
Another Democrat who voted for the 2010 health care overhaul but voted last month in a House committee to abolish IPAB, Rep. Frank Pallone of New Jersey, said “IPAB, like other independent commissions, encroaches upon legislative authority ... It's not the job of an independent commission to make decisions on health care policy for Medicare beneficiaries.”
But it’s congressional involvement that is exactly the problem, say Rockefeller and other IPAB supporters.
When Congress tries to control Medicare spending, Rockefeller complained in 2009, there are “too many lobbyists involved and it's very, very difficult if you have a lobbyist that comes in … who represents an industry in your state which could gain an enormous advantage by having an increase in the reimbursement rates for Medicare , for oxygen or for something else.”
Rather than members of Congress deciding what Medicare will pay for, Rockefeller said, “These are decisions that should be made by professionals, people who are public policy professionals. They're not lobbyists. And they're not necessarily sitting with congressmen or senators.”
Uwe Reinhardt, a health care economist at Princeton University and an IPAB supporter, said Congress “micro-manages in the most amazing way” in deciding how Medicare operates.
And yet, he said, members of Congress are “beset by incredible conflicts of interest. With Congress, you really always have to worry: Whom do they represent: the people, or particular interest groups that give them money?” Companies that sell services to Medicare also contribute to congressional campaigns, he noted.
IPAB will be composed of 15 experts, yet to be appointed by Obama, who’ll be given the task of keeping per-capita growth in Medicare spending from exceeding a target: national income growth rate, plus 1 percent.
IPAB’s recommendations must be carried out by the secretary of the Department of Health and Human Services unless Congress acts to block them, by a two-thirds vote in each chamber, or passes its own bill which achieves the same cost reductions as the IPAB recommendations. Under Rockefeller’s original proposal, Congress wouldn't have voted on IPAB decisions at all.
The law says IPAB can’t ration care or restrict benefits, so what could IPAB do to curb spending?
It could change how Medicare pays hospitals and doctors “in ways that would encourage more efficient delivery of care,” said Paul Van de Water, a health care analyst at the Center for Budget and Policy Priorities, a think tank that strongly supports IPAB. Medicare could reallocate its payments from medical specialists that get relatively higher reimbursements to specialists that get relatively smaller payments, or could pay primary care doctors more and specialty doctors less than it currently does, Reinhart said.
The fate of IPAB won’t be settled this week and will need to wait at least until the Supreme Court renders its judgment on the 2010 health care law -- and probably until after the November elections.
The vote this week is being muddled by House Republican leaders’ decision to tack on a separate provision putting a limit on damages awarded in medical malpractice cases. Almost all Democrats are likely to oppose that idea, and thus, the larger anti-IPAB bill.
But some Democrats still want to put their opposition on IPAB on the record. Schwartz said GOP leaders ought to bring a clean abolish-IPAB bill to a floor vote and forget about their attempts to limit malpractice awards
Conservative Republicans controlling the House unveiled a budget blueprint Tuesday that combines slashing cuts to safety net programs for the poor with sharply lower tax rates in an election-year manifesto painting clear campaign differences with President Barack Obama.
The GOP plan released by House Budget Committee Chairman Paul Ryan would, if enacted into law, wrestle the deficit to a manageable size in short order, but only by cutting Medicaid, food stamps, Pell Grants and a host of other programs that Obama has promised to protect.
To deal with the influx of retiring Baby Boomers, the GOP budget reprises a controversial approach to overhauling Medicare that would switch the program — for those under 55 today — from a traditional "fee for service" framework in which the government pays doctor and hospital bills to a voucherlike "premium support" approach in which the government subsidizes purchases of health insurance.
Carolyn Kaster / AP
House Budget Committee Chairman Paul Ryan released a budget blueprint that combines cuts to entitlement programs with lower tax rates.
Republicans say the new approach forces competition upon a wasteful health care system, lowering cost increases and giving senior more options. But Democratic opponents of the idea say the new system — designed by Ryan and liberal Sen. Ron Wyden of Oregon — cuts costs too steeply and would provide the elderly with a steadily shrinking menu of options and higher out-of-pocket costs.
Even as Ryan was describing his plan to reporters, it became election-year fodder for both parties.
"The House budget once again fails the test of balance, fairness, and shared responsibility," White House Communications Director Dan Pfeiffer said in a written statement charging that the GOP proposal would dole out tax cuts to rich while protecting tax breaks for oil companies and hedge fund managers.
"What's worse is that all of these tax breaks would be paid for by undermining Medicare and the very things we need to grow our economy and the middle class — things like education, basic research, and new sources of energy," Pfeiffer said.
House Speaker John Boehner, R-Ohio, predicted strong support for Ryan's budget. He also defended Ryan's proposal to cut agency spending below an amount that both parties agreed to in last year's compromise that extended the government's authority to borrow money.
"We all know that we've got a real fiscal problem here in Washington, and frankly we think we can do better," Boehner told reporters.
This year's GOP measure would produce deficit estimates that are significantly lower than a comparable measure passed by the House a year ago, claiming deficit cuts totaling $3.3 trillion — spending cuts of $5.3 trillion tempered by $2 trillion in lower taxes — below Obama over the coming decade. The deficit in 2015, for example, would drop to about $300 billion from $1.2 trillion for the current budget year. Last year's GOP draft called for a 2015 deficit more than $100 billion higher.
The measure would cut spending from $3.6 trillion this year to the $3.5 trillion range in 2013 and freeze it at that level for two more years.
The GOP plan doesn't have a chance of passing into law this year but stands in sharp contrast to the budget released by Obama last month, which relied on tax increases on the wealthy but mostly left alone key benefit programs like Medicare.
The resulting political battle is sure to spill beyond the Capital Beltway into the presidential race and contests for control of the House and Senate this fall. As if to underscore that reality, Ryan released a campaign-style video Monday evening telling viewers that "Americans have a choice to make" in a none-too-subtle appeal to voters.
"It's up to the people to demand from their government a better budget, a better plan, and a choice between two futures," Ryan said. "The question is: which future will we choose?"
The Budget panel is slated to debate and vote on the measure Wednesday and in hopes of a vote by the full House next week.
The Senate has no plans to debate a budget and will instead rely on last summer's bipartisan budget and debt pact to govern this year's round of spending bills.
The annual budget debate in Congress plays out on an arcane battlefield of numbers and assumptions, often difficult to understand even by Capitol Hill veterans. Basically, however, the so-called budget resolution sets broad parameters for follow-up legislation. Sometimes that is just a round of agency budget bills; other times lawmakers take on taxes and benefit programs like Medicare whose budgets otherwise run on autopilot.
The lower deficit figures build on cuts to annual agency budgets imposed last year and rely on new savings comes from benefit programs outside Social Security and the costly Medicare and Medicaid health care programs for the elderly and the poor. That means big cuts to food stamps, student loans, welfare, farm subsidies and other programs whose budgets now mostly run on autopilot.
On taxes, the measure calls for eliminating a host of tax deductions and credits in order to produce a far simpler income tax code with just two rates for individuals: 10 percent and 25 percent. But Ryan doesn't say the income levels at which the new rates would apply, nor does he specify which popular tax breaks — like the child tax credit or the mortgage interest deduction — might be spared.
Medicaid would be sharply cut and awarded to states as a flexible block grant.
Just as Obama's budget was dead on arrival last month with Capitol Hill Republicans, the House GOP plan is a nonstarter with Democrats controlling the Senate.
On Monday, two powerful Senate committee chairmen sent top House GOP leaders a letter protesting a GOP plan to cut agency operating budgets funded annually by Congress below levels negotiated just last summer. Instead of going with a $1.047 trillion cap on agency budgets as called for under last summer's debt and budget pact, the House panel is looking at cutting domestic agencies by $19 billion more.
Senate Budget Committee Chairman Kent Conrad, D-N.D., and Appropriations Committee Chairman Daniel Inouye, D-Hawaii, warned that breaking with the agreement only guarantees delays later this year and "represents a breach of faith that will make it more difficult to negotiate future agreements."
Also at issue, though, are across-the-board spending cuts set to take effect in January, punishment for the failure of last year's super committee to come up with a new package of $1.2 trillion in deficit cuts over the next decade as part of last summer's deal to let the government keep borrowing.
Those cuts, including $55 billion from defense accounts and $43 billion from non-defense accounts approved by lawmakers each year, are universally opposed by defense hawks and liberals alike.
The GOP plan would reverse the cuts by requiring various committees and try come up with at least $261 billion in other savings over the coming decade, including curbs to food stamps, federal employee pensions, and further cuts to federal health care programs. Republicans are likely to reprise a bid to tighten oversight of the child tax credit to make sure illegal immigrants don't claim it.
The measure would produce a $797 billion deficit in the upcoming 2013 fiscal year, as opposed to $977 billion under Obama's budget. The deficit would fall to $241 billion by 2016, compared to a $529 billion deficit in 2016 under Obama's plan.
"The country wants to be spoken to like adults, not pandered to like children," Ryan said Tuesday on "CBS This Morning."
The Wisconsin Republican said, "If you want to save Medicare and keep it from going bankrupt, you must reform the program, and that's what we intend to do."
Ryan said he has grown weary of the GOP being accused of endangering the benefits that senior citizens have come to expect. "We preserve the program for people in and near retirement," he said. "We want to take all the empty promises our government is making and make sure they're not broken promises."
House Budget Committee Chairman Paul Ryan joins Morning Joe to preview his 2012 budget plan. The plan would get rid of the current six tax brackets in favor of two tax levels and would get rid of the Alternative Minimum Tax.