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Senior Citizen Politics
Romney's Choice of Rep. Ryan Key to Politics of Campaign Medicare Debate
Senior citizen issues like Medicare and Social Security take center stage in presidential race as GOP's Romney picks vp
with controversial ideas on entitlements
Aug. 13, 2012 - KHN’s Mary Agnes Carey and Marilyn Werber Serafini discuss how Medicare reforms could figure into
November’s presidential election now that presumptive GOP presidential candidate Mitt Romney has chosen Rep. Paul Ryan, R-Wis., to be his
Following is transcript:
Mary Agnes Carey: Good day, this is Health on the Hill. I’m Mary Agnes Carey. Presumed GOP presidential nominee
Mitt Romney’s choice of Wis. Republican Paul Ryan to be his running mate has put new energy into Gov. Romney’s quest for the White House.
The announcement has also given President Obama and Democrats fresh ammunition to attack Romney and Ryan on the issue of
entitlements. The Republican-controlled House has twice approved a plan that would make major changes to both Medicare and Medicaid. With us
to discuss Ryan’s proposal and what it means for the presidential race is Marilyn Werber Serafini of Kaiser Health News. Marilyn, thanks for
Medicare Prescription Drug Plan Premiums to Remain Steady for Third Year
Annual enrollment period begins Oct. 15 and ends Dec. 7, 2012
Aug. 7, 2012
Cuts by Affordable Care Act in Medicare Payments to
Advantage Plans Did No Harm
Medicare Rights Center releases report: doomsayers wrong saying a reduction in plan payments would increase costs, decrease
benefits, diminish plan choices
Revamping Medicare: A Guide to the Proposals, Politics and Timeline
Immediate pressure is to reduce the deficit by the end of this year to stop automatic 2 percent spending cuts from going
into effect in 2013
By Marilyn Werber Serafini, KHN Staff Writer
Republicans Push New Budget Proposal Changing Medicare, Cutting Deeply
into Medicaid: Media Views
Health on the Hill video examines changes in GOP proposal, Summaries of news reports from across American - see video
March 21, 2012
New Ryan Budget Would Drastically Transform Medicare, Medicaid With Cuts
again pushes for senior citizens to buy private insurance but makes modification to previous proposal to allow room for traditional Medicare -
See video - March 21, 2012
Medicare Commission Wants Some Cuts, Equalization, End to
How Doc Fees Decided
MedPAC tells Congress it also wants changes in low-income drug assistance to encourage more genetics
March 19, 2012
Presidential Candidates Court Senior Citizens with Positions on Medicare
Romney would give seniors money to buy insurance; Obama would keep program, reduce the cost
By Marilyn Werber Serafini, KHN Staff Writer
Election Year Politics, Renewing Older Americans Act Play Key Roles for Seniors in 2012
NCOA says entitlements are top priorities but sees no major changes this year
Jan. 25, 2012
Politics for Senior Citizens
Marilyn Werber Serafini: My pleasure.
Mary Agnes Carey: Let’s talk a little bit about Paul Ryan. As we know, he heads the House Budget Committee. He has
a budget plan they’ve passed twice with major changes for Medicare. Tell us about those.
Marilyn Werber Serafini: Paul Ryan has been talking about Medicare, and he has
had a plan on the table to fundamentally restructure Medicare for a number of years. Now, the House has passed his plans as part of their
budget resolutions for the past two years, but he had a couple year head start on that.
He started out with a true voucher program: Give people a set amount of money; let them buy private plans in the private
marketplace. That has evolved over the years. The current plan that he is talking about – the most recent plan that the House passed this year
as a part of its budget resolution, which went no further, but it passed the House – would have specified a certain about of money that would
go to individuals to purchase insurance. Now that insurance could be a private plan – it could be the traditional government-run Medicare
Mary Agnes Carey: This is fee-for-service.
Marilyn Werber Serafini: Fee-for-service. So, all of these plans, including
the government-run plan, would bid. The second lowest bid would be the amount that the government would cover. So if a person chose a plan
that cost more, they would have to pay the difference. If there was a plan that cost less, then the person could actually, potentially get a
Now, the amount that he would cap federal spending at would be the growth of gross domestic product plus half of a
percentage point. It’s important to point out that’s different from today, because Medicare currently pays whatever it takes to cover a set
amount of benefits for each individual beneficiary.
Mary Agnes Carey: So there's currently no cap on growth in spending?
Marilyn Werber Serafini: That’s correct.
Mary Agnes Carey: Now Gov. Romney has also advanced a Medicare plan. How is that similar or different from what
Paul Ryan wants to do?
Marilyn Werber Serafini: It’s really the same thing. Right before Ryan came
out with his latest plan, Romney came out with essentially the same plan.
Mary Agnes Carey: And how do the ideas from Mitt Romney and Paul Ryan, how are they similar or different from what
President Obama and Democrats have proposed on Medicare?
Marilyn Werber Serafini: Well, they actually have a surprising number of
similarities, although the differences are much bigger than the similarities. So let’s start with the similarities.
They both set a cap on federal spending at the growth of gross domestic product plus a half of a percentage point. In
fact, President Obama laid down that marker first. He did it as part of budget deficit reduction negotiations this past year. As soon as he
did that, Paul Ryan said: Well, if he can do it, I’m going to go down to that mark too. Because previously, Paul Ryan had been at gross
domestic product plus 1 percent.
But here’s the difference, at least on that front: The big difference is that Paul Ryan, if under his plan Medicare
spending exceeded that level, it would automatically be brought down to the growth of gross domestic product plus half of a percentage point.
Under the Affordable Care Act, that is the same target. However, there is a specified formula for decreasing spending if
that target is exceeded. And that formula might or might not take spending down to that level. So it is not as strict.
And that's really one of the major differences. Similarities? Again, both of them say they would preserve traditional
Medicare for people who were currently in the program. Everybody age 55 and above, Ryan says, would still be allowed to get Medicare exactly
as they have it today.
The biggest difference is the benefits. Would you have Ryan saying -- if you want the benefits that you have today, would
you be able to still get them without paying more money? And there’s really a question about that, because [Ryan] says that you would, because
his basic plan would have the same benefits guaranteed as traditional Medicare. But critics say you might have to pay more for the same kinds
Mary Agnes Carey: But, if I understand it correctly, neither President Obama nor Democrats are suggesting a
premium support or voucher plan at this point, right?
Marilyn Werber Serafini: That's correct.
Mary Agnes Carey: Let’s talk a bit about Ron Wyden. He's a Senator from Oregon, a Democrat, who has worked with
Paul Ryan to put out a framework for Medicare overhaul. How will that play into the presidential race?
Marilyn Werber Serafini: Well, it depends which party you're talking about. If
you're the Republicans, you're going to say: Look, we have this bipartisan plan.
OK. Is it really bipartisan? Yes. Sen. Wyden did come together on a plan with Paul Ryan. He is the only Democrat who came
together with him, so I'm not sure that makes it a major bipartisan plan.
Plus, it's really important to note that Sen. Wyden and Paul Ryan came together on a plan, then Paul Ryan came with a new
plan, a new revised plan, which Sen. Wyden did not endorse. It is stricter. It brings the level of spending down further than two had agreed
Mary Agnes Carey: Thanks so much, Marilyn Werber Serafini, Kaiser Health News.
Marilyn Werber Serafini: Thank you.
information is reprinted from
kaiserhealthnews.org with permission from the Henry J.
Kaiser Family Foundation. You can view the entire Kaiser
Daily Health Policy Report, search the archives and sign up
for email delivery. © Henry J. Kaiser Family Foundation. All
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