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Subscribe to RSSThe Daily Rundown's Chuck Todd explains how the Obama campaign will take on the Romney-Ryan ticket.
From the moment Mitt Romney announced House Budget Committee Chairman Paul Ryan as his vice presidential running mate, the campaign debate has been full of charges and countercharges over some of the congressman's proposals on Medicare and the budget.
What are the facts? Here’s a guide to Ryan’s budget and his ideas for remaking Medicare.
If you are 65 years old or older and now receiving Medicare benefits, would Ryan’s Medicare proposal affect you? If so, how would it affect you?
No – if you’re receiving Medicare benefits now, Ryan’s proposal would not affect you.
His plan would gradually increase Medicare’s eligibility age from 65 to 67. But his phased-in increase in eligibility age wouldn’t start until 2023, 11 years from now.
Also starting in 2023, Ryan’s proposal would do away with Medicare’s open-ended payment system which now covers most medical costs for seniors. Ryan would limit Medicare spending for those born in 1958 and later, that is, people who turn 65 in 2023 or later.
People who turn 65 in 2023 or later years would get payments from the federal government to help them purchase private insurance; the payments would be higher for low-income people and lower for high-income people; they’d also be higher for sicker people and lower for healthier people.
The payments could grow over time no faster than the nominal annual growth rate in per capita Gross Domestic Product, plus 0.5 percentage points, but they might not keep pace with the increase in the cost of medical care.
Democrats have been on the offensive ever since Paul Ryan was announced as Mitt Romney's vice presidential pick. Gov. Bobby Jindal, R-La., responds to attacks from the left over Ryan's budget plan.
So Ryan’s proposal would not have any effect on seniors, that is, on people who are now receiving Medicare?
His Medicare proposal would not affect today’s seniors.
But – and this is a crucial point – Ryan’s proposal for another federal program – Medicaid, the joint federal-state health insurance program for the poor – would have an impact on those seniors who rely on Medicaid to help pay for nursing home care.
As the Kaiser Family Foundation has noted, “Medicaid is the nation’s largest source of coverage for long-term care, covering more than two-thirds of all nursing home residents” and the elderly and disabled “account for roughly two‐thirds of (Medicaid) spending.”
Ryan proposes to convert the federal portion of Medicaid into grants to each state, allowing each to tailor its Medicaid program to its own population’s needs.
The federal payments to the states would be indexed both to the inflation rate and to the growth in state population. But overall federal outlays on Medicaid would be cut by roughly one-fifth over ten years.
According to an assessment by the nonpartisan Congressional Budget Office (CBO), the spending path as designed by the Ryan’s plan might allow states to “improve the efficiency” of Medicaid in delivering health care to low-income people. But “even with significant efficiency gains,” states would need to increase their spending on Medicaid, CBO said, (and perhaps raise taxes in order to do that) or “make considerable cutbacks” in Medicaid.
“Cutbacks might involve reduced eligibility for Medicaid” or lower payments to health care providers, “or increased cost-sharing by beneficiaries – all of which would reduce access to care.”
If you are 45 years old how would Ryan’s Medicare proposal affect you?
The Daily Rundown's Chuck Todd is joined by Obama campaign adviser Robert Gibbs to discuss Mitt Romney's running mate and his stance on Medicare.
Since Ryan’s proposal, if enacted, would limit Medicare spending for those born in 1958 and later, a person who is 45 years old today would – once he or she became eligible for Medicare – receive benefits that would be less generous or less comprehensive than those now enjoyed by today’s Medicare recipients.
And since Ryan wants to gradually increase the age at which people are eligible for Medicare, a 45-year-old would need to wait longer to get covered by Medicare.
If Ryan’s Medicare plan became law, then starting in 2023, the CBO said, “Most elderly people would pay more for their health care than they would pay under the current Medicare system.”
What’s Ryan’s argument for treating future retirees – those born in 1958 and later – less generously than today’s Medicare recipients?
Ryan says the future costs for Medicare and Medicaid are unsustainable and will lead to tax and debt burdens that will be unbearable.
“We need to preempt and avert a debt crisis” which would force immediate cuts in Medicare and other programs, he told NBC’s David Gregory last year on Meet the Press. “And the way we propose to do that is do it on our terms and prevent people who are currently retired and people about to retire from having severe disruptions in their lives.”
Republicans have charged that President Barack Obama’s health care overhaul is now cutting Medicare spending by more than $700 billion. Obama, not Ryan, is the one hurting seniors, they say. Is this true and if so, are Obama’s Medicare “cuts” similar to or different from Ryan’s proposed reductions in future Medicare spending?
According to the CBO, if Obama’s health care law were repealed, then $711 billion in reductions in Medicare spending over the 2013–2022 period would not occur.
Even Obama campaign spokeswoman Stephanie Cutter on CBS’s Face the Nation Sunday referred to “the $700 billion cuts in Medicare that the president achieved through health care reform.” She said these cuts are “taking subsidies away from insurance companies, taking rebates away from prescription drug companies.”
But that’s not where all of the cost savings will come from: a significant portion of the $711 billion will come from curbing payments to hospitals and other health care providers. Other cuts may be ordered by the Independent Payment Advisory Board, an outside group mandated by the Affordable Care Act.
In contrast to Ryan’s future reductions (starting in 2023) Obama’s reductions in Medicare spending are taking place now – at least the Affordable Care Act orders them to occur and the CBO assumes they will occur.
But it is too soon to judge whether these reductions are providing the same level of care to seniors as before, but simply providing it more efficiently, or whether some seniors are getting (or will get) inferior care as a result of these reductions.
Republican national chairman Reince Priebus said on Meet the Press that Mitt Romney “appreciates and admires the work and the ideas that Paul Ryan has done. But Mitt Romney has his own plan” to reform Medicare. What is that plan?
As presented on Romney’s campaign web site, his proposal – although not fully detailed – includes most of the same ideas Ryan has proposed: not changing benefits for anyone now retired or close to retirement. But for future retirees, he would change Medicare from an open-ended payment system into one in which future beneficiaries would get a payment from the government to buy insurance coverage.
Romney’s proposal says, “If seniors choose more expensive plans, they will have to pay the difference between the support amount and the premium price; if they choose less expensive plans, they can use any leftover support to pay other medical expenses like co-pays and deductibles
Is Ryan’s budget plan, which was OK’d by the House last March, now in effect?
No, it isn’t. The House approved Ryan’s fiscal year 2013 budget resolution in March by a vote of 228 to 191, with no Democrats voting for the proposal and 10 Republicans voting against it. But the Senate has not adopted any budget resolution for FY 2013, which begins on Oct. 1. So in the coming fiscal year, as in the current fiscal year, Congress will operate without any budget. But spending will of course continue.
Apart from turning Medicaid over to the states and redesigning Medicare for future retirees, what else would Ryan’s FY 2013 budget proposal do?
It would cut overall spending by about 12 percent over the ten-year budget window, as compared to the spending plan proposed by Obama; it would cut cumulative deficits by more than 50 percent. Among other things it would limit federal aid to college students and concentrate it on lower income students.
Does Ryan want to cut taxes for rich people, as Democrats charge, and if so by how much?
His FY 2013 budget proposal seeks to have only two income tax rates: 10 percent and 25 percent. The current top income tax rate is 35 percent – so this rate reduction could mean a tax cut for some people -- but Ryan also says he wants to “broaden the tax base” and get rid of “the burdensome tangle of loopholes that distort economic activity” by abolishing many tax breaks. He hasn’t specified which ones he’d seek to eliminate.
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Vouchers are worthless for the "uninsurable" which, I'm guessing, is pretty much everybody over 55.
Vouchers are worthless and just another way to get more money into the hands of the insurance companies
It really puzzles me how so many of the other countries of the world appear to handle health care through government control, but we cannot do it. Can you say LOBBYISTS? You know, like the ones for the pharmaceutical companies who can charge Americans (where the drugs are made) more than Canadiens.
But one of the options with the vouchers is to select the traditional (current) Medicare plan. How does giving people more choice make things worse?
Ryan says that medicare and medicaid for old people are too expensive for the government - so what makes him think that retired people on a fixed income can afford to pay for their health care?
Rick, clearly he's not worried/concerned about that... If you've contracted a chronic debilitating illnes through no fault of your own, tough. If you lose everything you own in the process tough.
If you have a very physically demading job and you're forced to work until you're 67 or more, though. He's got his, always has and always will... That's the Republican "ideologue" pure and simple. You can write the amount of legislation from the right that benefits the working class on the head of a pin.
Looking at the Ryan and Romney plans for Medicare. One thing becomes blatantly clear. They do not want to change the system for anyone old enough to actually be concerned about what their Medicare benefits will be. So those of us under 55 get the shaft while they get elected.
There is little difference between Romney and Ryan and what they plan for this country and it disgusts me.
I may not vote enthusiastically for Obama come November, but I will vote.
Yes, hold your nose and vote Democratic, since any other vote is wasted. Has everyone heard about the Ryan Medicaid? When you become old and maybe Alzheimer's afflicted, and you have to go into a nursing home, Medicaid now pays when you run out of money (like my father had to.) Under Ryan, those funds may not be there. What happens, you get thrown out of the nursing home to live on the streets?
Here is a simple suggestion to get our politicians to fix Medicare. Make them use it instead of their elite government health care plan.
If the age limit to Medicare like Social Security is raised yet again, then the GOP namely Ryan's plan would mean working folks who pay thousand into these programs a year, are getting robbed. Most want live to age 67 in order to receive their JUST DUES. Are you people mad to support such a hideous and callous minded group of people..?
if you earn 50,000 a year, you pay $725 a year into medicare- not thousands
if you earn 30,000 a year you pay $435 a year into medicare- not thousands
you need to earn $69,000 a year to pay $1000 into medicare for the year.
Actually, there is no elite gov't health care plan. They get Blue Cross Blue Shield. I'm no fan of Congress, but that's a myth.
Ryan budget (Romney approved) will balance the budget by 2030, supposedly, says non-partisan CBO. Ryan's stipulations were strict adherence to his plan, no wars, no hurricanes, no tornadoes, no wildfires, etc.
PS. Why do we talk about Social Security and Medicare as part of the budget, other than what is owed to replace the previously stolen funds by Bush wars, etc?
Earlier this year, I attended an open meeting at my local VA where personnel from DC were asking Vets for ideas to improve services, a couple of inexpensive ones have already been implemented. The problem was there were only three Vets in attendance, even though a major mailing had gone out. We have to tell them where we see problems. The largest funding increases have been under Obama and efficiency has improved. I no longer have to see the doctor every six months to renew my scipts and take up his time, just an email takes care of that. If I feel I need to see a doctor, a phone call takes care of that, and it is quick.
Obama/Biden 2012, Clinton/Cutter 2016
I would like to point one fact that everyone seems to be ignoring. I (at75) do NOT get my Medicare for FREE. The premium of $99.90 is deducted from the payment I receive monthly. In addition, I pay an additional premium for a Medicare Advantage plan that covers things that Medicare doesn't. And it still isn't enough. If, for example, I get cancer, my co-pay for chemo would be more than my monthly income, which means if I get cancer, I will have to just die. Maybe it will pay for morphine, at end stage. I have no long term or nursing home benefits, because I can't afford them. So, please bear this in mind as you think about the cost of Medicare. I worked and paid into Social Security for 50 years and all I hear any more is the baying of the Republican blood hounds who just want to take me out because I cost too much.
OBAMA/BIDEN 2012
It's time to confront the lies of Obama and his thugs (not that the facts will deter them from continuing to lie)
Here are the facts from the Ryan-Wyden Medicare Reform Proposal
Our Plan includes the following parts:
Choice: Starting in 2022, a new Medicare program will begin offering seniors a choice among Medicare-approved private plans and the traditional Medicare plan – much like the choice of plans Members of Congress have. Any private plan that wishes to participate in this new program must provide at least as comprehensive a benefit as traditional fee-for-service Medicare, and the traditional program will be strengthened so that it can effectively compete in this new marketplace. This marketplace will supplant Medicare Advantage. Any senior at or above age 55 today will see no changes in the Medicare program.
Affordability: Coverage will be guaranteed through a new “premium support” system that encourages plans to provide high-quality care more efficiently. Private plans will compete directly with traditional Medicare based on their ability to provide quality coverage at an affordable lower cost. Premium support levels will be determined by the cost of the second-lowest-cost plan, as well as traditional Medicare. For the first time, seniors will be protected from catastrophic health care costs with a new limit on out-of-pocket costs for all seniors. Seniors who are eligible for Medicaid or other income assistance will be guaranteed ongoing coverage without any additional costs.
Protecting the Guarantee: In the event that these efforts do not stem the rising tide of Medicare spending, beginning in 2023 there will be a cap on cost growth of 1 percent over Gross Domestic Product, plus inflation. Any increase over that cap will be reflected in reduced support for the sectors most responsible for cost growth, including providers, drug companies, and means-tested premiums.
Protecting Seniors: This reformed Medicare program will include the toughest consumer protections in American government. The history of seniors’ programs has shown that whenever a new program is created, fraudulent schemes spring up to exploit its participants.To ensure ample protection from scam-artists and bad actors, the program will not only require insurance coverage protections such as guaranteed issue and risk adjustment,but it will also require the Centers for Medicare and Medicaid Services (CMS) to actively review marketing practices and benefit adequacy. For new private plans, CMS will retain the authority it currently possesses to assess bids in order to weed out junk plans and unqualified insurers. Seniors will be provided with simple, easy-to-understand information about the plans that are available in their areas during their annual open-enrollment period, explaining options and prices, and they will be told exactly how their current plan compares to the next-lowest-cost option. Traditional Medicare will always be offered as a viable and robust choice.
http://www.kaiserhealthnews.org/~/media/Files/2011/WydenRyan.pdf
Reading comments on this vine are very depressing. I think I am losing hope that we will ever do better as a country when it is so painfully obvious the majority of libs on this vine havn't even read the article but are spouting out distortions that are clearly refuted in the actual article which happens to be a very liberal MSNBC article. Also what is wrong with you libs you make me ill with your raise taxes taxes taxes taxes on the rich. Here is a novel idea how about we lower taxes for everyone and tell this out of control gov't they have to stop throwing our taxes away through phony energy companies and whatever other phony front companies they use to launder tax payer dollars to each party to buy votes of idiots. The rich are not the problem gov't is the problem and the old adage dems are for the poor and repubs are for the rich is such a myth Dems are for owning you from cradle to grave and promising every entitlement so they can own you like slaves as you must do as your told to get their entitlements.
Lot's of us want less government and smaller government.
Also, it would seem that besides having lobotomies, most Righties have also had humor-ectomies! That would certainly explain how easy it is for The GOP Mullahs to control them.
Why is it so difficult for people to respectfully disagree with one another and to debate topics on the issues? I personally find the insulting and name-calling disgusting and certainly it does nothing to incline me to change my mind (or vote) on any issue.
Liz contrary to most lies you will hear here where the majority of cuts to medicare in Obamacare come in is through smaller reimbursements to hospitals, medical device companies, dr's etc.. which in my mind will only hurt care because most dr's and med device companies have already been squeezed so hard since the 90's that they can barely stay in business as it is. Don't take my word for it though ask your Dr what he thinks and how easy it will be for him if reimbursements keep going down or if there is a full implementation of Obamacare.
You are right on this. It is already difficult to find doctors who will take Medicaid reimbursement (which I understand from professionals to be even less than Medicare). As cuts are implemented to reimbursements from Medicare, I am sure we will see the same thing. Even if people can find primary care doctors who will accept Medicare reimbursement, it is increasingly unlikely that the specialists or equipment providers or specialty pharmacies will do so. And absent providers who accept reimbursement, seniors are going to find themselves responsible for increasing amounts of out-of-pocket expenses.
I'm a registered Democrat:
But what REALLY gets me about the debate. Is the dishonesty of BOTH parties.
Frankly, the Federal Prison system should have members of both parties residing in it, over the Social Security issue.
The politicians like lumping everything into one word. "ENTITLEMENT"
So they lump Social Security and Medicare which are services the public has paid for over DECADES of PAYROLL DEDUCTION .
With Welfare and Medicaid which is safety net legislation.
In the private sector , If you misuse funds in a service designated account, you go to jail.
The Congress , did exactly this , and skated on.
So the far right , says anyone disagreeing with their further weakening of these paid for obligations is a worthless, welfare using loser??
Maybe, the public wants the government to actually live up to the deal they made? Rather than giving billions to every other country in the world? Or fighting wars that profit China more than us?? Or playing the world policeman, at their US citizen obligations expense??
While we defended the rest of the world , they founded public health care in their countries, educated their kids. Look at China & Germany.
But now the rich need a tax cut, while continuing to ship jobs to the third world, we keep the same policeman of the world concept, and generous benefactor status worldwide.
While we screw the US worker. Giving them less bang for their tax payer buck , year after year. Perhaps if we wave the flag enough , we can convince them that letting our countries infrastructure , education system , and default on senior obligations is patriotic.
My 2009 Federal Income Tax, Filed Married with 1 65+
Line 7 $67072.09, Line 38 $67072.09, Line 40a $13500.00, Line 42 $7300.00, Line 43 Taxable Income $46272.09, Line 40 Tax from Schedule $6106.00. Line 60 $6106.00 Federal Income Tax Paid. Medicare Paid $916.52. Social Security Paid $3918.92. Total paid to Federal Government $10941.44. Percentage of gross income paid to Fed 16.31%, percentage of Taxable income paid to Fed 23.65%. Romney, the percentage paid matters more to the 99% than to the 1% especially when the 1% are getting more in a day than an average laborer gets in a year.
Healthcare payments for one of us: Medicare Part B (Medical) $99.90, Medicare Part D (Drugs)$90.70, Supplemental Insurance (Covers what Medicare doesn't) $170.58, out of pocket drug costs $288.00. $4622.00 Current annual medical costs for healthy 71 year old
Master Ryan the people of this country know better, hell we been watching the GOP Teabagers doing for the last 4 years, then you want to turn it around and say It's President Obama really , even the stupid know better! Your a disgrace and a liar! Little Edie Munster! An Expose of GOP Obstruction and Negativity: The Party of Hell No Look up this video: REVEALED:THE GOP STRATEGY