Rep. Paul Ryan's (R-WI) budget unveiled Tuesday indicates a new, albeit somewhat minor, area of agreement with President Obama on Medicare: How much money it should spend per beneficiary. But they completely disagree on what to cut in order to get there.
Ryan's budget -- which replaces Medicare with subsidized insurance exchange where seniors can buy into a private plan or a public option -- limits the value of the subsidies to per-capita GDP+0.5 percent. In other words, it makes cuts on the beneficiary side.
President Obama's plan, as enacted under the Affordable Care Act, is to let 15 Senate-confirmed experts find the best way to hold down Medicare costs to the same level -- but only by cutting reimbursements to providers, without touching benefits. Its existing mandate is GDP+1 percent, but Obama last year supported reducing that to GDP+0.5 percent.
The contrast in broader visions remains stark as ever, however, with Obama and his party wanting to keep Medicare alive as an insurance plan with a coverage guarantee, and Ryan and the GOP pushing to replace that with a "premium support" or voucher system.