There’s been some confusion surrounding whether or not the restructuring of Medicare that Rep. Paul Ryan, R-Wis., is proposing should be considered a voucher, because he keeps insisting it is not.
The basic idea of his proposal, which would kick in for future Medicare beneficiaries now 55 and under, is to give senior citizens a choice among several subsidized health care plans in order to encourage them to make economical choices that will help control costs. The value of the subsidy would vary, so that poorer and sicker beneficiaries would receive more and richer and healthier beneficiaries would get less.
Ryan in recent days has gone out of his way to draw a distinction between what he is proposing, which he refers to as “premium support,” and a voucher. Part of the confusion is that in his own “Roadmap for America’s Future” proposal did include direct vouchers.
Of course, despite the different mechanics of how the subsidy gets doled out -- whether people vouchers to buy plans or choose plans that then receive a subsidy – the ultimate economic effects are the same. So when I got a chance to ask Ryan a question during his appearance at the American Enterprise Institute, I pressed him on why he had gone to such great lengths to draw a distinction.
“They achieve the same kind of savings path,” he acknowledged of the two proposals. “The whole point is it works more like programs people are already familiar with. It works like the (Medicare prescription drug) benefits that seniors are familiar with. It works like the federal employee health benefit plan that I’m very familiar with as a federal employee. And it’s important to make these distinctions I think, so people don’t basically, inaccurately or incorrectly try and tell us what we’re doing or describe our plans. But from a budget saving standpoint, from a reliability of getting the savings going forward, it achieves the same result.”