To the dismay of Democrats, a top House GOP leader has again proposed big changes to Medicare and Medicaid, along with full repeal of Obamacare, to help cut government spending by $5.1 trillion over the next 10 years.
The fiscal 2015 budget submitted by House Budget Committee chairman Paul Ryan (R-Wis.) last week also included a mention of a long-term solution to the Medicare physician payment issue to end the annual temporary patches for the sustainable growth-rate formula. But the document offered no details on that.
“By cutting wasteful spending, strengthening key priorities and laying the foundation for a stronger economy, we have shown the American people there's a better way forward,” Ryan said in a prepared statement.
His budget is seen as a political statement ahead of the November congressional elections and a possible presidential run by the 2012 GOP vice presidential candidate. It was immediately criticized by Senate Democrats. And House GOP leaders were scrambling to secure votes from Republicans angry about their leaders' parliamentary moves to pass the temporary doc-fix bill last week.
Ryan's budget would cut $129 billion from Medicare over the next decade. It calls for a policy of “premium support”—which Democrats call a voucher system—for Americans who currently are 55 and younger when they qualify for Medicare at age 65. That would give seniors the choice between traditional Medicare and buying a private plan on a new Medicare exchange. Premium-support payments would be adjusted based on individuals' health as well as their incomes.
Some Republicans have opposed Ryan's similar Medicare proposals in the past. Critics have said the proposal would significantly raise out-of-pocket costs for seniors.