As outlined in a memo the campaign released Saturday, Romney plans to repeal the Affordable Care Act in its entirety, and thus to spend over $700 billion more on the program in the coming decade than the government would spend if the health care law stands.
That commitment would leave Medicare poised for insolvency in 2016, years before he proposes to phase in the voucher system. Which means Romney would have two options: find new Medicare cuts or taxes to extend the life of the program, or preside over its demise.
On Fox News Sunday, Romney adviser Ed Gillespie
But raising the Medicare eligibility age is a benefit cut, and implementing the increase before 2016 would violate Romney's pledge to leave the program unchanged for people between ages 55 and 65.
Avik Roy, an outside health care adviser to the Romney campaign, admits that committing to billions of dollars in higher Medicare spending in the near-term will make it difficult for Romney to achieve its separate goal of reducing overall federal spending to modern lows. But he notes that Romney could make up the difference elsewhere in the budget or, by "mak[ing] other changes to the Medicare program, such as increased means-testing, that don't alter the program's basic structure."
Further means-testing of Medicare would amount to a benefit cut to current seniors.
These admissions rest on top of the fact that by repealing the Affordable Care Act, Romney would wipe out new Medicare benefits included in the law. Repeal would result in higher payments to doctors and hospitals, and the restoration of overpayments to insurers participating in Medicare advantage. But for beneficiaries, it would re-open the Medicare prescription drug donut hole and eliminate coverage for preventive services and annual checkups that the ACA created.