The list of problems with Paul Ryan's House Republican budget plan last year was lengthy, but one glaring concern tended to dominate the political conversation. Under the GOP proposal, the existing Medicare program would be scrapped altogether, replaced with a voucher plan, with underfunded vouchers that would leave seniors with less care.
The plan became a political fiasco for Republicans, while giving Democrats new hope about taking back Congress. GOP officials eventually gave up on the proposal, and knew the fight this year would have to be different.
This leads us to the Ryan-Wyden plan for Medicare, originally unveiled in mid-December, but now part of the House Republican budget plan released this morning. It's ostensibly a bipartisan "compromise" -- Ryan seems to have moved away from last year's right-wing proposal, and reached an agreement with Sen. Ron Wyden, an Oregon Democrat, on an alternative approach.
So, good news? A bipartisan deal on a major issue? Not really.
The Ryan-Wyden plan isn't identical to last year's proposal, but it's awfully similar in all the ways that count. The point is still to end Medicare's guaranteed benefits, and instead implement a voucher plan. As Medicare expert Paul Van de Water at the Center on Budget and Policy Priorities explained yesterday, "Although billed as a kinder, gentler form of premium support, the Ryan-Wyden plan has the same basic features as earlier proposals."
As Van de Water noted, the Ryan-Wyden proposal would:
* Shift substantial costs to Medicare beneficiaries rather than protect them from cost increases -- in part because the value of the voucher would likely fail to keep pace with health care costs.* Likely lead to the gradual demise of traditional Medicare by making the pool of Medicare beneficiaries smaller, older, and sicker -- and increasingly costly to cover.* Produce few budgetary savings beyond those that the health reform law already calls for, since both plans have the same target growth rate for Medicare costs.
There will be plenty more on this as the new House GOP budget plan comes under closer scrutiny, but let's make sure the debate gets off on an accurate foot: Ryan-Wyden is not a Medicare "compromise," and the vast majority of Democrats, including the Obama White House, will never support it.
For more background on this, I'd recommend the overview Ezra published three months ago.