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Candidates Differ on Medicare

POSTED: September 26, 2012, 9:30 am

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GOP vice presidential nominee Paul Ryan was booed and heckled on Friday when he told an AARP convention in New Orleans that he would repeal President Barack Obama's health law.

In contrast, Obama's remarks about Medicare --delivered by live satellite an hour earlier -- were warmly received.

Both candidates presented themselves as the protectors of seniors' health benefits and accused the other of being untruthful as they sought to galvanize support among one of the most important voting blocs. The remarks came as a USA Today/Gallup found the president remains more trusted to address Medicare's challenges in several swing states. In the nation's 12 top battlegrounds, including Florida, voters by 50 percent to 44 percent say they have more faith in Obama than his Republican challenger on Medicare.

Obama told seniors that repealing his health law and adopting Republican strategies on Medicare would boost the profits of insurance companies at the expense of seniors.

"No American should ever spend their golden years at the mercy of insurance companies," Obama told the conference via live satellite.

An hour later, Ryan argued the Democrats' health law would cause "steep cuts to real benefits to real people in real time," eliciting loud boos.

But the Wisconsin congressman got applause when he knocked a provision in the law that empowers an expert panel to make cuts to Medicare if Congress fails to act when spending exceeds certain targets. "We propose putting 50 million seniors, not 15 unelected bureaucrats, in charge of their own health care decisions," he said.

Obama repeated his oft-made argument that the Republican Medicare proposal would create a "voucher program" that would destroy traditional Medicare because insurers would lure the youngest and healthiest seniors into private plans.

"The traditional Medicare would end up collapsing and all seniors would end up at the mercy of insurance companies," he said.

Ryan, in turn, accused Obama of "turning Medicare into a piggy bank for Obamacare," by using $716 billion in cuts to Medicare to extend health care coverage to as many as 30 million Americans as part of his health overhaul.

Ryan repeatedly said his concerns about potential cuts in benefits to seniors were backed by the Centers for Medicare and Medicare Services Chief Actuary Richard Foster.

Ryan's budget plan, passed by the Republican-controlled House earlier this year, includes the same $716 billion in cuts.

Obama defended the $716 billion in Medicare cuts over the next decade, saying they reduce "waste, fraud and overcharging by insurance companies."

"It turns out contrary to what you have heard, Obamacare strengthens Medicare," Obama said. Of the term "Obamacare," he joked, "I don't mind the term. I do care and that is why we passed the bill."

Despite anxiety from many seniors, AARP endorsed Obama's health law in 2010 largely because it extends the solvency of Medicare by eight years until 2024 and gives seniors free preventive care and closes the "doughnut hole" in the Medicare prescription drug program.

Obama reminded attendees of those benefits. Because of the health care law, the average senior will save $5,000 from 2010 to 2022, according to a Health and Human Services report released Friday.

HHS also said that more than 5.5 million seniors and people with disabilities saved nearly $4.5 billion on prescription drugs since the law was enacted.

Ryan said his plan for Medicare would turn the program for people under age 55 into one similar to that enjoyed by members of Congress and federal employees, who get to choose among private health plans for coverage.

Ryan said he wants to bring choice and competition into the overall Medicare program, the same way it has helped hold down costs in the Medicare prescription drug program that Congress passed in 2003. Ryan noted the Medicare drug benefit costs have come in way under budget. He made no mention of the surge in generic drug use over the past decade, which most experts say is the cause of the massive slowdown in drug spending.

"You might have heard the word 'voucher' earlier. That is a poll-tested word to scare today's seniors," he said.

"A voucher is you go to your mail boxes, you get a check and you are on your own. No one is proposing that."

Ryan stressed that Republican plans to change Medicare and repeal the health law would not affect those on Medicare today or those older than 55.

Repealing the health law would cut benefits to seniors, including free preventive care they get now and help to pay for drugs that fall in the Medicare prescription drug doughnut hole. Ryan made no mention of how he would address those areas.

This article was reprinted from with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.

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