Medicare trustees criticize Ryan plan

Medicare's trustees on Wednesday criticized two key components of Rep. Paul Ryan's (R-Wis.) plan to overhaul the program.

Amid fierce attacks from Democrats over his proposal to convert Medicare into a premium-support system, Ryan has repeatedly pledged to preserve the program in its current form for people 55 and older. 

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But insulating Medicare from incremental changes would be counterproductive, Medicare trustee Robert Reischauer said.

"It implies that you want to keep that system unchanged, and quite frankly I don’t think that’s appropriate policy,” Reischauer said during a hearing of the Ways and Means health subcommittee.

The Medicare trustees haven't taken a position on the most unpopular part of Ryan's plan — converting federal Medicare funds into subsidies for private insurance.

Their criticisms on Wednesday touched the pieces of Ryan's proposal that are politically safer — elements Ryan has emphasized while defending his proposal from near-constant Democratic attacks.

Reischauer said Medicare should "evolve" for everyone, rather than be cemented in place for people 55 and older. Although that promise might help allay fears among seniors, the trustees said it could undermine incremental reforms that would improve Medicare's solvency.

"With every passing year it gets harder and harder to hold harmless even people who are older than 55,” Medicare trustee Charles Blahous said.

And as Reischauer elaborated on the changes he thinks should be allowed to take their natural course, he cited the Medicare innovation center — a new office created by the healthcare reform law. Ryan's plan would repeal almost all of the new law, including the innovation center and other attempts at payment reform that Reischauer said are promising.

The trustees' 2011 report said the Medicare trust fund will begin paying out more than it takes in by 2024. Although Republicans leapt at the findings, the trustees have previously said that healthcare reform extended the life of the Medicare trust fund by 12 years.

Medicare's chief actuary, however, has said repeatedly that such estimates may be unrealistic. The projections are based on the law as written, meaning they must account for payment cuts that Congress is likely to prevent.

Updated at 12:36 p.m.