Paul Ryan's Medicare Doublespeak


In his misleading attack on President Obama's plan for Medicare, Ryan hopes no one will notice he undermined his own.

ryan-615.jpgShannon Stapleton/Reuters

Before Paul Ryan had even wrapped his speech last night at the GOP convention, fact-checkers had their work cut out for them. The address repeated several misleading lines that have worked to great effect for the Romney campaign in recent weeks. Among them:

And the biggest, coldest power play of all in Obamacare came at the expense of the elderly. [...] Seven hundred and sixteen billion dollars, funneled out of Medicare by President Obama. An obligation we have to our parents and grandparents is being sacrificed, all to pay for a new entitlement we didn't even ask for. The greatest threat to Medicare is Obamacare, and we're going to stop it.

Ryan presents the $716 billion figure as an all-out attack by Obama against seniors. But what Ryan elides is that his own budget plan, which was passed by the House in 2011 and again in March of this year, contains the same exact cuts to Medicare. Ryan's speech also makes it sound as though Obama's cuts to Medicare have already taken place; in fact, the savings are to be spread out over 10 years. That's an important detail, because Ryan's and Obama's plans both take a similar approach to managing Medicare's budget down the road: They each cap the program's annual rate of increase at half a percentage point above the economy's rate of growth. By blasting Obama over Medicare, Ryan is attacking parts of his very own plan.

There's more. Ryan's speech implies that Obama's cuts to Medicare will directly harm seniors. That's not the case. Obama's cost savings come at the expense of health-care providers -- they're not aimed at beneficiaries. 

In fact, Ryan's critics say his is the more damaging proposal, as an important part of his plan uses a mathematical trick as a way to cut costs. Here's how. The Ryan plan makes Medicare a voucher program; seniors would receive a check for health care that they can spend however they like. But because the voucher's value would grow more slowly than the pace of health-care costs, analysts project that the benefit would actually become worth less and less over time. Here's how the non-partisan Center on Budget and Policy Priorities puts it:

Since under the Ryan budget, Medicare would no longer make payments to health care providers such as doctors and hospitals, the only way to keep Medicare cost growth within the GDP plus one-half percentage point target would be to limit the annual increase in the amount of the premium-support vouchers. As a result, the vouchers would purchase less coverage with each passing year, pushing more costs on to beneficiaries. Over time, seniors would have to pay more to keep the health plans and the doctors they like, or they would get fewer benefits.

Although Mitt Romney has distanced himself from Ryan's Medicare cuts, Ryan's historical role as his party's agenda-setter is a good reason to take the vice-presidential candidate's ideas seriously. And part of that means pointing out when he's dissembling.

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Brian Fung is the technology writer at National Journal. He was previously an associate editor at The Atlantic and has written for Foreign Policy and The Washington Post.

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