Romney attacked Obama for lacking a comprehensive plan to make Medicare's long-term cost growth sustainable, while also claiming that the savings he wrung from the program, via the health care law, were unacceptable. It's a partial contradiction based on a key distortion. Obama does, in fact, have a plan to rein in Medicare spending -- one that Romney actually acknowledged later in the same speech.
The Independent Payment Advisory Board (IPAB), created by the Affordable Care Act, would consist of 15 Senate-confirmed experts with the authority to cut Medicare payments to providers if costs exceed a certain level. (Obama and Rep. Paul Ryan, the author of the GOP plan, agree on what that level ought to be.) The approach sustains Medicare's structure as a government-run insurance plan that pays medical bills for the elderly.
That's in stark contrast to the Republican plan, backed by Romney, which would begin phasing out Medicare and replacing it with a market exchange where seniors shop between subsidized private insurance plans and a public option.
The former Massachusetts governor's claim about seniors losing access to their doctors is based on a 2010 survey by the Physicians Foundation, the Romney campaign told TPM. Physician sources point out that two years later, the survey's key findings have not materialized.
Romney's other argument is that the half a trillion in Medicare cuts under "Obamacare" will devastate the program. The savings were wrung from health care providers, and included some $136 billion in payment reductions to private insurers in Medicare Advantage.
"He is destroying the Medicare Advantage program," Romney said, "eliminating the coverage that millions of seniors depend on and reducing choice by two-thirds."
As it turns out, those cuts have made the program more competitive -- over the last two years, Medicare Advantage premiums have fallen and enrollment has risen, according to the Department of Health and Human Services.
More broadly, while Republicans rail against those cuts on the stump, they've voted overwhelmingly to sustain them -- both last year, and then again last week, as a lesser-known provision in the GOP budget. Romney has effusively praised Ryan, but hedged on key specifics in his plan. This appears to be one such area.
"Gov. Romney will repeal Obamacare, including President Obama's devastating cuts to Medicare," Romney spokeswoman Andrea Saul told TPM. "He is committed to strengthening and improving the program for both today and tomorrow's seniors."
President Obama and Democrats plan to run against the GOP Medicare plan, which conservatives broadly support but moderates and independents are wary of. Romney's speech Wednesday indicates that he plans to fight back with a questionable line of attack.