“It was smart for him to wait, because now he can use the Ryan plan as a benchmark,” says John Kenneth White, a political scientist at Catholic University in Washington. “He can say, ‘We’re not turning Medicare into a voucher system.’ ”
Ryan has said his plan is not a voucher system, though critics disagree. The Ryan budget called for nearly $6 trillion in deficit reduction over the next 10 years, in part by ending Medicare as an entitlement and providing “premium support” for seniors in the private insurance market. But critics say it acts more as a voucher plan because the government's level of "premium support" does not keep up with rising health-care costs.
Medicaid, the federal health-care system for low-income people, would become a block-grant program to the states, limiting the federal government’s outlay.
“What’s striking to me is how reminiscent this is of the 1990s,” says a veteran congressional Democratic aide. “The political landscape changed for President Clinton, and he then played on Republican turf. What he’s trying to do is accommodate the tide that swept over Washington in last year’s election.”
Just as that worked for Clinton politically, so too can it work for Obama. “He has extraordinary leeway with the Democratic base, because he’s not getting primaried,” says the aide.