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Medicare: How Paul Ryan's budget would change it

Medicare would be transformed under Rep. Paul Ryan's 2012 budget released Tuesday. Future Medicare recipients would get fixed payments to purchase private insurance.

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House Budget Committee Chairman Paul Ryan (R) of Wisconsin touts his 2012 federal budget, which proposes reforms to Medicare, during a news conference on Capitol Hill in Washington Tuesday.

J. Scott Applewhite/AP

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The long-term budget plan released Tuesday by House Republicans would fundamentally transform Medicare, the huge program upon which US seniors rely for health-care coverage.

Right now Medicare is a fee-for-service program which itself pays for health care procedures for most beneficiaries. Under the GOP plan, drafted largely by Budget Committee chairman Rep. Paul Ryan of Wisconsin, it would be changed into a program which subsidizes the purchase of health insurance by individuals.

Medicare’s spiraling costs make it the biggest driver of the nation’s long-term government debt, said Congressman Ryan Tuesday during an appearance at the American Enterprise Institute. That means the status quo for the program is unlikely to continue, he said.

“The question is not if we reform Medicare. The question is when and how we reform Medicare,” said Ryan.

Current Medicare beneficiaries, and those approaching retirement age, would not be affected by the GOP’s proposed changes. Instead they would apply to people currently 54 years of age and younger.

This cohort, when it enrolls in Medicare, would receive a fixed annual payment for insurance from Uncle Sam. This payment would be higher for those with greater health-care needs and would be adjusted for the cost of health care in particular areas.

Beneficiaries would then purchase insurance from private providers on a health exchange, a sort of supermarket where plans compete for customers. It is a structure derived from a plan drawn up previously by Ryan and Alice Rivlin, a Brookings Institution economist and former budget director under President Bill Clinton.

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