DAVID GREENE, HOST:
On Capitol Hill today, the House is scheduled to vote on what's been dubbed the Ryan budget. It's the spending plan from budget committee chairman Paul Ryan that, among other things, changes the structure of Medicare and rewrites the tax code. Presidential candidate Mitt Romney has endorsed the budget plan, but some say Romney's rhetoric out on the campaign trail seems to sidestep one reality of the Ryan budget. NPR's Tamara Keith explains.
TAMARA KEITH, BYLINE: On the day the Ryan budget was unveiled, Mitt Romney said he was very supportive of the plan.
MITT ROMNEY: I applaud it. It's an excellent piece of work and very much needed.
KEITH: Which has Chris Van Hollen crying contradiction. Van Hollen is a Democratic congressman from Maryland and a member of the budget committee.
REPRESENTATIVE CHRIS VAN HOLLEN: Mitt Romney and the Republicans are trying to have it both ways.
KEITH: What they're trying to have, he says, is $500 billion in projected Medicare savings. Those savings are part of the Affordable Care Act, President Obama's healthcare law. They're achieved through slower payments to hospitals and a reduction in the overpayment of premiums to Medicare Advantage providers. And those savings are something Romney hits the president on, day after day on the campaign trail.
ROMNEY: There's only one president in history who's cut $500 billion out of Medicare and that's your guy, Barack Obama. And if I'm president I'm going to preserve Medicare. I'm not going to cut $500 billion out of the Medicare that we have.
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KEITH: But here's the rub. The Ryan budget assumes that very same $500 billion cut. Well, cut isn't the right word. Savings is more accurate. Because the reality is, in real dollars, Medicare spending will keep rising - just not by as much. Here's Congressman Van Hollen again.
HOLLEN: Their budget, the Romney Ryan budget, takes all of those savings that they complained about.
KEITH: Those savings are baked in to the Ryan budget.
REPRESENTATIVE TOM PRICE: It's more of an accounting process that occurs.
KEITH: That's Republican Representative Tom Price from Georgia, also a member of the budget committee. He says there's a big difference between what the Affordable Care Act does with the savings and what the Republican budget would do with that $500 billion. Price says the healthcare law uses the savings to pay for other parts of the Affordable Care Act. But the Ryan budget repeals most of the healthcare law.
PRICE: We believe that money ought to stay in the program so that we - what we call grandfather the grandfathers. The program doesn't change for anybody in or near retirement.
KEITH: In the future, the GOP budget would have seniors choose between traditional Medicare and private plans. And they'd get vouchers to help pay for their coverage. Democrats and advocates for seniors argue this would ultimately hurt Medicare and cost seniors more out of pocket.
Jon Oberlander is a professor of health policy at the University of North Carolina, Chapel Hill. He says, based on estimates from the non-partisan congressional budget office, the reduction in government spending on Medicare would be significant.
JON OBERLANDER: Compared to current law, including the changes in the Affordable Care Act, by 2050 the Republican budget would actually lower per-person spending in Medicare by about 35 percent, above and beyond what we already have in current law.
KEITH: The Romney campaign didn't get back to us with a comment, though Romney previously praised the Ryan budget for addressing long-term Medicare costs.
Tamara Keith, NPR News.
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