All eyes on Paul Ryan: A closer look at Romney's VP pick

Romney: 'I have my budget plan… and that's [what] we're going to run on'

Mitt Romney on Saturday named House Budget Committee Chair Paul Ryan as his running mate, turning the Wisconsin Republican's plan to reshape the Medicare program into a presidential campaign issue.

Ryan's Medicare proposals

Ryan's fiscal year (FY) 2013 budget proposal—which passed the House in March and was approved again in a procedural move in early April—would establish a "premium support model" for Medicare. Specifically, the plan would transform the Medicare program from a fee-for-service program into one where beneficiaries can either purchase coverage on the private market or maintain traditional Medicare coverage.

The proposal also would reduce Medicaid spending and convert the program into a block-grant system, in which states would receive a fixed amount.

Ryan's FY 2013 proposal is modeled after a Medicare overhaul that Ryan outlined with Sen. Ron Wyden (D-Ore.). That proposal was a "less stringent version" of his FY 2012 Medicare reform plan, which would have required that all beneficiaries purchase coverage on the private market.

Supporters of Ryan's plan say the approach would reduce health care costs by giving Medicare beneficiaries an incentive to purchase low-cost plans while increasing competition among private health plans.

However, opponents of the plan—who call it a "voucher" program—say the subsidies likely will not be enough for most beneficiaries to purchase adequate coverage, which would increase out-of-pocket costs.

VP pick makes 'premium support' a campaign issue

Romney's choice of Ryan "accelerates a national debate over a premium support-based overhaul of the Medicare program," according to CQ HealthBeat. Moreover, the selection could pave the way for congressional consideration of such a plan next year, should the GOP gain power November.

However, Romney has yet to announce his stance on many details of Ryan's proposals. On Sunday, Romney said Ryan's plan would "make sure we can save Medicare," but did not explicitly say whether he embraced the proposal. 

According to Romney's website, Ryan's latest plan "almost precisely mirror's Mitt's ideas." Romney's health care plan would allow beneficiaries to choose "premium support," but would not affect current beneficiaries or those nearing retirement. Romney also says he would increase the Medicare eligibility age beginning in 2022.

Despite similarities, National Journal notes that key differences remain between Romney and Ryan's health care plans.

Romney notes, "I have my budget plan, and that's the budget plan we're going to run on."

Democrats take the offensive

President Obama and other Democrats on Sunday were quick to criticize Ryan's selection and sought to link Romney to the congressman's Medicare reforms.

In an interview on CNN's "State of the Union" on Sunday, Obama's senior campaign adviser David Axelrod called Ryan a "right wing ideologue" and said his proposed Medicare changes would put the program into "a death spiral." Meanwhile, the Obama campaign released an online video featuring Florida beneficiaries discussing the possible impact of the Ryan plan (Paletta, Wall Street Journal, 8/11; Reichard, CQ HealthBeat, 8/11 [subscription required]; Mascaro, Los Angeles Times, 8/11; Alonso-Zaldivar, AP/U-T San Diego, 8/13; Sanger-Katz, National Journal, 8/11; AP/Boston Globe, 8/12; Peoples, AP/U-T San Diego, 8/13).

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