GOP's Ryan prepares Medicare 'premium assistance,' Medicaid block grants in budget proposal

House Budget Committee Chairman Paul Ryan, R-Wis., gave a preview Sunday of the budget proposal he is expected to unveil on Tuesday.  In an appearance on "Fox News Sunday," Ryan outlined what to expect from the House GOP proposal and how the plan would affect Medicaid and Medicare.

The New York Times: House Republicans Propose $4 Trillion In Cuts Over Decade
House Republicans plan this week to propose more than $4 trillion in federal spending reductions over the next decade by reshaping popular programs like Medicare, the Budget Committee chairman said Sunday in opening a new front in the intensifying budget wars (Hulse, 4/3).

Los Angeles Times: House Republican Budget Plan Would Revamp Medicare
House Budget Committee Chairman Paul D. Ryan's broad overview of the plan, which he described Sunday, is the clearest picture yet of how the party plans to reduce government spending over the long term. It also telegraphs the central role the issue will play in the GOP's pitch to voters in 2012 (Hennessy, 4/4).

The Wall Street Journal: GOP Aim: Cut $4 Trillion
The plan would essentially end Medicare, which now pays most of the health care bills for 48 million elderly and disabled Americans, as a program that directly pays those bills. Mr. Ryan and other conservatives say this is necessary because of the program's soaring costs. Medicare cost $396.5 billion in 2010 and is projected to rise to $502.8 billion in 2016. At that pace, spending on the program would have doubled between 2002 and 2016. Mr. Ryan's proposal would apply to those currently under the age of 55, and for those Americans would convert Medicare into a "premium support" system. Participants from that group would choose from an array of private insurance plans when they reach 65 and become eligible, and the government would pay about the first $15,000 in premiums (Bendavid, 4/4).

Kaiser Health News: GOP Proposals On Medicare Could Shift Costs To Beneficiaries
Amid the buzz about a possible government shutdown over this year's budget looms a more difficult question: What to do about entitlement programs, especially Medicare? ... Republican leaders have called for a major overhaul of Medicare, a $520 billion program that covers nearly 47 million older and disabled Americans. Given the political peril involved in tampering with Medicare, the question is: How serious are the Republicans? The answer: Plenty serious (Carey, 4/3).

USA Today: GOP Budget Plan To Cut More Than $4 Trillion
Discussing entitlements, (Rep. Paul Ryan) said the plan would change Medicare, the federal health care plan for seniors, by creating a "premium support" system that allows seniors "to pick the (private health) plan of their choosing, and then Medicare subsidizes that plan." However, the plan would allow Americans who are now 55 and older to keep the current Medicare programs (McCoy, 4/4).

CNN: House Budget Chairman To Propose Medicare, Medicaid Changes
Starting 10 years from now, in 2021, elderly Americans would receive government help in paying health insurance premiums instead of enrolling in the government-run Medicare program, Ryan said. He rejected the label of "vouchers" for the payments, calling them "premium assistance" payments instead. The plan is modeled after one Ryan proposed last year with Alice Rivlin, budget director under President Bill Clinton. The Ryan-Rivlin plan said the amount of assistance would be calculated in part by taking the average federal cost per Medicare enrollee (4/3).

Politico Pro: Paul Ryan: Don't Call It A Voucher Program
House Budget Committee Chairman Paul Ryan said Sunday that the budget blueprint he'll propose on Tuesday would slow the growth of Medicare by turning it into a "premium support" program — not a voucher program. But the plan it's based on — a proposal he developed with former Office of Management and Budget Director Alice Rivlin — was described by the Congressional Budget Office as a voucher program. Ryan insists there's a difference, though. Appearing on Fox News Sunday, Ryan said that while his "Roadmap" plan did propose a Medicare voucher program, his latest budget plan — and the Ryan-Rivlin plan that inspired it — is "very different" from a voucher (Nather, 4/3).

The Fiscal Times: Shutdown Countdown: Congress Desperate For A Deal
[Ryan] favors converting Medicaid to a system of block grants to the states, so that the states can "customize" coverage for the poor. Medicaid is jointly funded by the federal government and the states, and many GOP governors are seeking ways to reduce their mounting cost burdens.  "We want to give governors freedom," he said (Pianin, 4/3).

Politico Pro: Advocates: Kids Affected By Medicaid Cuts
[Ryan said] the budget he'll propose Tuesday would save money by turning Medicaid into block grants. "It would be taking a sledge hammer to the success we've had covering kids," said Jocelyn Guyer of the Center for Children and Families at Georgetown University's Health Policy Institute. "Cuts at the level that Congressman Ryan [is] talking about are absolutely devastating."  Medicaid and the Children's Health Insurance Program currently cover one out of every three children in the United States (Feder 4/4).

Modern Healthcare: House GOP Budget To Include Medicaid Block Grants, Medicare Changes
House Republicans will propose significant changes to the federal government's major health programs — including block grants to Medicaid — in the budget they will unveil this week, the chairman of the House Budget Committee said Sunday. ... The budget proposal will be released in the same week that federal lawmakers must agree on how to fund the government for the remaining six months of the year, or otherwise face a government shutdown, as the latest temporary funding mechanism ends on April 8. Wallace asked Ryan if he expects his ambitious 2012 plan to cut trillions of dollars from the national debt to be dead on arrival, given that legislators have had difficulty agreeing on billions in spending cuts for the rest of 2011 (4/3).

Roll Call: Ryan Offers Glimpse At Fiscal 2012 Budget Plan
While the Wisconsin Republican made the case that the elements of his proposal are needed to put the nation's soaring debt on a "downward trajectory," he acknowledged that the package, which he plans to release Tuesday, could provide fodder for Democrats in the 2012 election cycle. "We are giving them a political weapon to go against us, but they will have to lie and demagogue to make that a political weapon," Ryan said on "Fox News Sunday." "They are going to demagogue us, but it's that demagoguery that has always prevented political leaders in the past from trying to fix the problem. ... Yes, we will be giving political adversaries things to use against us in the next election, and shame on them if they do that" (Hunter, 4/3).

Fox News: GOP Budget Plan To Cut More Than $4 Trillion Over Decade, Rep. Paul Ryan Says
Ryan, R-Wis., in an interview with "Fox News Sunday," accused Obama of "punting" and said Republicans' plan would exceed the fiscal goals set by the president's fiscal commission — which issued a report calling for $4 trillion in cuts. That report never made it out of committee. "We can't keep kicking this can down the road," Ryan said. "The president has punted. We're not going to follow suit" (4/3).

USA Today: Larger Debt Debate Looms On The Hill
Their efforts represent the most serious assault on federal deficits since a 1997 deal between President Clinton and a Republican Congress led to four years of surpluses. Since then, a decade of tax cuts, wars and recessions have sent the nation deeper and deeper into debt (Wolf, 4/4).