In it, but not of it. TPM DC
In other words, the spending cuts Republicans would realize in the first 10 years would be outpaced by deficit increasing tax-cuts, which Ryan also proposes. After that, debt projections under the plan improve decade-by-decade relative to current law. That's because 2022 would mark the beginning of the Medicare privatization plan. That's when, CBO finds, "most elderly people would pay more for their health care than they would pay under the current Medicare system."
If the current Medicare system were allowed to continue, CBO found that an average 65-year-old beneficiary's costs would be only 25 percent of what it'd be in the individual private insurance market. Under the GOP plan, those costs would jump to 68 percent.
In plain English, "the gradually increasing number of Medicare beneficiaries participating in the new premium support program [the GOP's Medicare privatization plan] would bear a much larger share of their health care costs than they would under the current program."
Note, that the CBO hasn't reviewed legislative language, so these numbers will likely be revised when an official cost-estimate is completed.