Under the microscope: Ryan's plans for Medicare, Medicaid and the federal budget

Aug 15 2012

News outlets examine how Medicare and Medicaid fare in the budget blueprint advanced by Rep. Paul Ryan, R-Wis., chairman of the House Budget Committee and GOP presidential hopeful Mitt Romney's vice presidential pick.   

Los Angeles Times: A Closer Look At Paul Ryan's Federal Budget Plan
Under Ryan's plan, which has passed the Republican-controlled House twice in slightly different versions, the Internal Revenue Service would tax the wealthiest Americans less, but many of the poorest ones more; Medicare would be transformed; Medicaid would be cut by about a third; and all functions of government other than those health programs, Social Security and the military would shrink to levels not seen since the 1930s (Lauter and Mascaro, 8/14).

The Associated Press: Ryan's Medicare Plan Would Be Tricky To Pull Off
The idea behind Paul Ryan's Medicare plan is to slow growing costs and keep the program more affordable for the long haul. But it's all in the details. The Republican-backed shift to private insurance plans could saddle future retirees with thousands of dollars a year in additional bills (Alonso-Zaldivar, 8/13).

The Fiscal Times:  No Matter Who Wins, Health Care Rationing Is Coming
Medicare has moved to the center of this year's presidential campaign for a single overriding reason: shrinking the nation's long-term government deficit demands dealing with health care costs. No one -- left, center or right -- disagrees with that analysis…But the debate is now focused on the government side of the ledger because Republican candidate Mitt Romney chose Rep. Paul Ryan, R-Wis., who has championed Medicare privatization, as his running mate. They are offering voters a stark choice on Medicare from President Obama and the Democrats. It can be distilled down to a single, simple question: Who will be on the hook if the health care delivery system fails to limit health care cost growth – individual seniors or the government (Goozner, 8/14)?

CQ HealthBeat: Ryan Prescription For Entitlement Costs Would Dramatically Remold Medicaid
Mitt Romney's selection of Rep. Paul D. Ryan as his running mate will mean sharper national scrutiny of his plan to remold Medicaid in addition to Medicare. Left-leaning analysts say millions more Americans would become uninsured under the changes he proposed to the health care program for the poor. Ryan says in his "Path to Prosperity" budget proposal that his plan would give states "greater flexibility to help recipients build self-sufficient futures for themselves and their families." It's the same plan that proposes to transform Medicare into a premium support program (Reichard, 8/13).

The Hill: Liberal Think Tank Says Ryan's Medicare Arguments Is Dishonest
Rep. Paul Ryan's (R-Wis.) budget proposal would keep the Medicare cuts in President Obama's health care law, the liberal Center for American Progress noted Monday. The political battle over Medicare has intensified yet again since Mitt Romney announced Ryan as his pick for vice president on Saturday. Ryan, the chairman of the House Budget Committee, is the author and champion of two budget plans that would dramatically overhaul Medicare (Baker, 8/13).

CQ HealthBeat: Premium Support Moves To Prime Spot In Policy Debate
Mitt Romney's choice of Rep. Paul D. Ryan as his running mate accelerates a national debate over a premium support-based overhaul of the Medicare program -- possibly teeing it up for prime consideration in Congress next year if the Republican ticket proves to be a winner with the voters. The premium support blueprint is controversial, to be sure. But it can't be laughed off as purely partisan, as doggedly as Democrats will try. It has proved to be attractive to such influential Democratic thinkers as former Congressional Budget Office (CBO) directors Alice Rivlin and Robert Reischauer. And it's an idea that has led pragmatic Democrats like Oregon Sen. Ron Wyden to think Medicare's core promise -- a guarantee of decent affordable health care during old age -- can be kept in a way that finds common ground with Republicans who insist that Medicare spending must be reined in sharply to defuse the debt crisis (Reichard, 8/13).

Des Moines Register: Iowans Look Anew At Medicare Ideas
Vice presidential candidate Paul Ryan's plan to overhaul Medicare in an attempt to slow ballooning costs and keep the program affordable promises to cast a long shadow in Iowa, experts said. Past proposals to change the federal health insurance program for seniors have collapsed under deep public skepticism, but there are signs people in Iowa and across the nation are taking a more nuanced view this election cycle(Krogstad, 8/14).

Medpage Today: Romney VP Pick Could Mean Big Medicare Changes
Ryan's proposal for overhauling Medicaid involves the use of block grants. The federal government would cap the Medicaid spending in each state and let the states figure out funding rates themselves. Also on his website, Ryan says constant forestalling of changes to Medicare's Sustainable Growth Rate formula for physician reimbursement is unacceptable. "Physicians should not have to wait on Congress to act every year in order to prevent pay cuts that are arbitrarily determined by an outdated formula," he writes (Pittman, 8/13).

Medpage Today: Campaign: Ryan's Medicare Policies Draw Fire
Several health care groups are opposing the policy ideas of new Republican vice presidential candidate Paul Ryan, claiming his proposals for Medicare and Medicaid reform would do more harm than good. … The American Academy of Family Physicians (AAFP) opposes premium support. As health care costs increase, the fixed government contribution for premiums would prevent great increases in support, forcing beneficiaries to pay more, AAFP President Glen Stream, MD, noted in an interview with MedPage Today Monday. …The Center for Budget and Policy Priorities, a liberal think tank, says over time seniors would be able to purchase fewer benefits. The group's March analysis of Ryan's plan also states a premium-support proposal would increase health care costs because private insurance plans seniors would purchase provide higher payments to providers (Pittman, 8/13).

The Texas Tribune: Ryan's Plan For Medicaid, Medicare Mirrors Texas Bills
If Republican vice presidential hopeful Paul Ryan's controversial plan for reforming Medicaid and Medicare sounds familiar in Texas, it should. The Wisconsin congressman's proposal bears strong similarities to bills that Texas Republicans advocated for -- and eventually passed -- during the last legislative session (Ramshaw, 8/14).

Meanwhile, Politico takes a look at Ryan's broader congressional voting record --

Politico Pro: Ryan's Record: Big-Spending Conservatism
Paul Ryan rose to the top of the political ranks on his reputation as a conservative budget hawk. But his voting record shows him to be far from a pure fiscal conservative. Ryan voted for the $700 billion bank bailout, the biggest Medicare expansion in U.S. history, a massive highway bill that included the "Bridge to Nowhere" and other big-ticket priorities when George W. Bush was president -- going to bat for a high-spending GOP agenda that the tea party base now looks on with regret (Restuccia and Kim, 8/13).