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Presidential debate 101: Is Romney right about $716 billion in Medicare cuts?

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But PoltiFact clarifies that those spending reductions would come at the expense of insurance companies and hospitals, not Medicare beneficiaries. Obama’s goal, it says, is to slow the growth in the program's expenditures, not cut the current budget.

The Washington Post has a nifty pie chart that shows how the $716 billion in Medicare cuts is divvied up. The Post reports that 34.8 percent of cuts are attributed to hospital reimbursement rates, though it predicts hospitals should be able to make up some of that loss. Some of the cuts will be funds for hospitals to encourage them to see more uninsured patients. Because the Affordable Care Act expands insurance coverage to all Americans, the number of uninsured patients hospitals must treat will be reduced.

The next slice of the chart shows 30.2 percent of the cuts coming from Medicare Advantage payments, which addresses Romney's debate-night claim that 4 million people will lose Medicare Advantage under the Affordable Care Act. This is the often-mentioned scale-back of payments to private insurers. 

The Post and PolitiFact both point out that Medicare Advantage, a program in which the government pays for seniors to have private health insurance, on average costs more than private insurance, rather than keeping costs low. The National Committee to Preserve Social Security and Medicare reports that, on average, the US government pays 14 percent more per beneficiary per year for seniors in the Medicare Advantage program. It says payments to Medicare Advantage will not be eliminated entirely, but reduced gradually to bring them more in line with traditional Medicare.

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