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Ryan's Budget Makes Plans For Medicare

LINDA WERTHEIMER, HOST:

This is WEEKEND EDITION, from NPR News. I'm Linda Wertheimer. If you are just joining us, we're following a big announcement this morning. The Republican candidate, Mitt Romney, has chosen his running mate. Congressman Paul Ryan of Wisconsin will share the ticket. For more, I'm joined in the studio by our health policy correspondent, Julie Rovner.

Julie, hello.

JULIE ROVNER, BYLINE: Hello.

WERTHEIMER: Now, Paul Ryan is something of a lightning rod for his budget plan and for the changes that it would make to Medicare and Medicaid programs. Can you give us a hint of what some of those changes would be?

ROVNER: Yes. And this was, of course, the budget plan that was approved by the House last year, and this year. And it would basically, for Medicare, it would change the program from what's now basically an open-ended entitlement - basically, Medicare pays whatever seniors wrack up in health care bills. It would say that the federal government's only going to pay a certain amount of money, and then seniors can take that, go out, buy a private insurance plan. And they would get more money in future years, but not necessarily as much more money as health costs go up.

So, basically, that leads to the Democrats' response - or Democrats' charge that it would end Medicare as we know it. And, in fact, the candidate, in introducing his running mate today, made a comment that I think had some Democrats rolling their eyes.

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ROVNER: And I think less watched is that the - Congressman Ryan's plan would also cut Medicaid. It would turn it back to the states in block grants. It would give states much more flexibility to do what they want, cover who they want, give them the benefits that they want. But it would also cut the funding significantly for them.

WERTHEIMER: Now, for electoral purposes, senior citizens are a very important voting bloc, maybe a more important voting bloc than the poor people who take advantage of Medicaid. So what do you think? Is Ryan taking some risks with Mr. Romney's electoral possibilities?

ROVNER: Yes, I - you know, the - one of the things that Mr. Romney was pointing out in that cut is that in 2010, because health law did, in fact, make some cuts to Medicare - not 700 billion. It was more like 500 billion. The Republicans really rode that to some electoral victories with the senior vote, which had long by a Democratic voting bloc, but in recent years, has gone more Republican. And the Democrats have really been anxious to use this Ryan budget to try to get back those seniors.

Interestingly, even in the laws - in the bills that the House has passed that would repeal the health law, they have actually left those Medicare cuts in place. They want it for deficit reduction. So this is going to - suddenly, Medicare is going to be a very hot issue. Seniors are a very important voting bloc, particularly in some of these important swing states like Iowa. So I think that you're going to see a lot of emphasis on seniors who do, in fact, vote in very, very large numbers.

WERTHEIMER: What about Social Security?

ROVNER: Oh, Social Security, again, is going to be an important issue - probably not as important as Medicare. Again, these are issues that, under the Ryan plan, they would not affect current seniors. They would only affect people who are under the age of 55. But that fact tends to get lost on seniors. They tend to worry about what would happen to them, possibly, now.

WERTHEIMER: If the camel's nose gets under the tent, something else might happen.

ROVNER: Exactly.

WERTHEIMER: What about women's health groups, quickly, Julie?

ROVNER: Yes. Congressman Ryan is a very, very anti-abortion vote. He has almost immediately endorsed by the National Right to Life Committee. They put out a statement. And, in fact, NARAL, the National Abortion Rights Action League, said that Ryan has cast 59 votes on reproductive rights while he's been in office. Not one has been pro-choice. So, certainly, that will shore up the support for Romney, who, of course, has switched positions on abortion.

WERTHEIMER: That's NPR's health policy correspondent, Julie Rovner. Julie, thanks very much.

ROVNER: You're very welcome. Transcript provided by NPR, Copyright NPR.