In it, but not of it. TPM DC

Paul Ryan Reverses Himself Yet Again On Medicare Cuts

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But even that was a reversal after Ryan and his GOP colleagues strenuously objected to the Medicare cuts before Obamacare passed, warning as he did during the 2012 campaign that the lower provider payments would harm services for current seniors.

In other words, Ryan and Republican leaders started off opposing the ACA's Medicare cuts, then turned around and twice passed budgets that kept them, then campaigned against those cuts in the 2012 election, and are now embracing them again.

Ryan also revealed Sunday that his plan to replace Medicare with a limited subsidy for seniors to buy their own insurance won't affect people currently older than 55. His budget will include the tax hikes from the fiscal cliff, which help him balance federal spending and revenues in 10 years without targeting older Americans with his Medicare plan.

Lost in the partisan health care wars is the fact that the idea of reducing Medicare's long-term spending by cutting provider payments was embraced by Republicans long before the Affordable Care Act passed. In the 2008 election, John McCain's campaign proposed Medicare provider cuts that were similar to what Obama eventually enacted.

Ironically, Obama attacked McCain at the time for proposing such an idea.

About The Author

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Sahil Kapur is TPM's senior congressional reporter and Supreme Court correspondent. His articles have been published in the Huffington Post, The Guardian and The New Republic. Email him at sahil@talkingpointsmemo.com and follow him on Twitter at @sahilkapur.