As he did a year ago, House Budget Committee Chairman Paul Ryan (R-Wis.) outlined a premium-support model for Medicare and state block grants for Medicaid in the fiscal 2013 budget blueprint he released Tuesday.
Promising no disruptions for those in or near retirement, Ryan's plan this year proposes that Medicare would provide a payment and a list of guaranteed options that includes a traditional fee-for-service option. Ryan and Sen. Ron Wyden (D-Ore.) introduced this design last December, and Wyden promoted the idea on his website Monday.
Under the plan, workers currently under the age of 55 would be offered a choice of private health plans and the traditional fee-for-service option in a Medicare Exchange starting in 2023. All plans would participate in competitive bidding that would then determine the dollar amount of the federal contribution seniors would receive to purchase insurance coverage. The second-least expensive plan or the fee-for-service Medicare option—whichever is cheaper—would establish a benchmark for a premium-support amount for the plan.