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Where The Candidates Stand On Medicare And Medicaid

Memo Pad

Where The Candidates Stand On Medicare And Medicaid


by Suevon Lee, ProPublica


Medicare and Medicaid, which provide medical coverage for seniors, the poor and the disabled, together make up nearly a quarter of all federal spending. With total Medicare spending projected to cost $7.7 trillion over the next 10 years, there is consensus that changes are in order. But what those changes should entail has, of course, been one of the hot-button issues of the campaign.

With the candidates slinging charges, we thought we’d lay out the facts. Here’s a rundown of where the two candidates stand on Medicare and Medicaid:


Big Picture

Earlier this year, the Medicare Board of Trustees estimated that the Medicare hospital trust fund would remain fully funded only until 2024. Medicare would not go bankrupt or disappear, but it wouldn’t have enough money to cover all hospital costs.

Under traditional government-run Medicare, seniors 65 and over and people with disabilities are given health insurance for a fixed set of benefits, in what’s known as fee-for-service coverage. Medicare also offers a subset of private health plans known as Medicare Advantage, in which roughly one-quarter of Medicare beneficiaries are currently enrolled. Obama retains this structure.

The Obama administration has also made moves that it says would keep Medicare afloat. It says the Affordable Care Act would extend solvency by eight years, mainly by imposing tighter spending controls on Medicare payments to private insurers and hospitals.

In contrast, Rep. Paul Ryan, Mitt Romney’s running mate, has proposed a more fundamental overhaul of Medicare, which he says is on an “unsustainable path.” On his campaign website, Romney says that Ryan’s proposals “almost precisely mirrors” his ideas on Medicare. But he’s been fuzzy on other aspects of the plan.

A Romney-Ryan administration would replace a defined benefits system with a defined contribution system in which seniors are given federal vouchers to purchase health insurance in a newly created private marketplace known as Medicare Exchange. In this marketplace, private health plans, along with traditional Medicare, would compete for enrollees’ business. These changes wouldn’t start until 2023, meaning current beneficiaries aren’t affected – just those under 55.

Under the Romney-Ryan, the vouchers would be valued at the second-cheapest private plan or traditional Medicare, whichever costs less. Seniors who opt for a more expensive plan would pay the difference. If they choose a cheaper plan, they keep the savings.

Who’s covered

In the current system, people 65 and over are eligible for Medicare, which Obama has said he would keep for now.

Romney has proposed raising the eligibility age for Medicare beneficiaries from 65 to 67 in 2022, then increasing it by a month each year after that. In the long run, he would index eligibility levels to “longevity.” Ryan’s budget plan proposesraising Medicare eligibility age by two months a year starting in 2023, until it reaches 67 by 2034.

Many others looking to keep Medicare solvent have also proposedraising the age of eligibility.

The Congressional Budget Office estimates that raising the minimum age from 65 to 67 would reduce annual federal spending by 5 percent. But it would also result in higher premiums and out-of-pocket costs for seniors who would lose access to Medicare.

Obama’s health care law also adds some benefits for seniors, such as annual wellness visits without co-pays, preventive services like free cancer screenings and prescription drug savings.


  1. Dominick Vila September 17, 2012

    Barack Obama is committed to the preservation of Social Security, MEDICARE and MEDICAID, and those not hesitate to make tough decisions to maintain their solvency without impacting the benefits we receive.
    Mitt Romney-Paul Ryan pledged to dismantle MEDICARE and gut MEDICAID, while at the same time pledging to restore MEDICARE wasteful spending during the next 10 years. The latter guarantees the end of MEDICARE for everyone. Gutting MEDICAID, a program used by millions of senior citizens to pay for nursing home care is beyond anything any former President or presidential candidate has ever said.
    Barack Obama supports and defends the interests of the middle class, Mitt Romney promises to defend the ability of the wealthy to get richer.

    1. William Deutschlander September 17, 2012

      Well said! The TRUTH!

  2. Lovefacts September 17, 2012

    I don’t know how anyone can say that those 55+ won’t be affected by the Romney/Ryan voucher plan. 55 now = 76 in 2023. Nothing like trying to get insurance with pre-existing conditions when you’re 76.

  3. SaneJane September 17, 2012

    I thought they were the party of “business”. How many for- profit businesses are going to join a bidding war to insure old sick people. Insanity.

    1. Ed September 18, 2012

      Not to worry, the insurance companies will join together to fix prices. Liker all businesses they HATE competition!

      1. Johnny September 18, 2012

        No, they will “independently” decide at the exact same time to set the exact same prices.

  4. gargray September 17, 2012

    Wate a minuet! Don’t they take Medicare out of your social security checkevery month? It is not paid by the government it is paid by the working force of this country. Everyone pays into social security if you ever worked in your life. Some didn’t pay into the program BUT ARE DRAWING IT NOW. We pay congress’s wages and insurance to.

    1. Ed September 18, 2012

      Both Social Security and Medicare are “payroll taxes” which are taken from your pay during your working life. Medicare comes in two parts, Part A and Part B. Part A covers hos[pital expenses and is paid for by your previous “payroll tax” contribution Part B pays the doctors (THIS IS WHERE THE REAL FRAUD GETS DONE.) Because the repubs HATE to see any service provided without someone making a profit, the congress decreed that Part B should be paid for out of your Social Security benefits. Which actually is a double tax. What the right calls “entitlements” actually are entitlements, but not in the derogatory sense the right uses. The “better class of people” call it a return on investment. Actually both Social Security and Medicare are “a return on investment” of the monies you paid in during your working life. If congress had not limited these “paroll taxes” to people making less than $180.000.00 a yaer the Social Security fund would be flush and the “double tax” described above would not be necessary.

  5. Mary September 18, 2012

    It’s easy for Congress to talk about taking away medical benefits for the poor and elderly….They get to keep the medical plan they have while in office for the rest of their lives no matter how long they served!!!!!! Sooooo if a Congressman serves only one term he is covered for the rest of his life by the cadillac of medical plans paid for by …. yup … you guessed it…. WE THE PEOPLE!!!!!


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