NPR

Obama, Romney Must Woo Seniors On Medicare Plans

For a week now, charges and counter charges have flown on the campaign trail about who would do what to Medicare. Did President Obama really cut $700 billion from the program? Does Republican challenger Mitt Romney really support a voucher system to replace the current program?

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Forget the glossy TV ads. The political fight over Medicare is now being waged with humble white boards. Mitt Romney used a dry-erase board in South Carolina yesterday to illustrate his argument that President Obama is, quote, "raiding" Medicare to finance the new health care law. Hours later, the Obama campaign responded with a white board of its own, saying Romney's Medicare plan would cost future seniors thousands of dollars a year.

NPR's Scott Horsley has been reading between the felt-tipped lines to see what the dueling plans would really mean for Medicare, now and in the future.

SCOTT HORSLEY, BYLINE: Mitt Romney knew when he picked Paul Ryan as his running mate that he'd be challenged over Ryan's controversial plan to replace Medicare with a voucher system. So all this week, Romney has been a launching preemptive attack on President Obama's approach to Medicare.

At a press conference in Greer, South Carolina yesterday, Romney introduced a visual aid.

(SOUNDBITE OF PRESS CONFERENCE)

MITT ROMNEY: I want to bring as much clarity as possible, so I've prepared a small chart, here.

HORSLEY: Using a dry-erase marker and a white board, Romney sketched out a comparison between the Republican plan and Mr. Obama's for people who are on Medicare now, or soon will be, and for those who are at least a decade away from retirement.

(SOUNDBITE OF PRESS CONFERENCE)

ROMNEY: The president's plan has a dramatic impact on today's seniors, people 55 years of age and older.

HORSLEY: The president's health care law does reduce Medicare spending by more than $700 billion over the next decade. But that savings is supposed to come from insurance companies, hospitals, drug makers and the like, not from cutting basic services to the 48 million Americans who are on Medicare.

Still, health care expert Joseph Antos of the conservative American Enterprise Institute warns seniors may find it more difficult to get the care they want.

JOSEPH ANTOS: If you take enough money out of the Medicare program, eventually you will run into access problems for senior citizens. There's just no two ways around that.

HORSLEY: Romney has promised to undo the president's health care law, and put that $700 billion-plus back into Medicare.

But doing away with Obamacare would also mean getting rid of some special help for seniors, says Medicare expert Tricia Neuman of the Kaiser Family Foundation.

TRICIA NEUMAN: The other thing that was in the health reform law were provisions that actually improved coverage by expanding the prescription drug benefit in the Donut Hole.

HORSLEY: Mr. Obama told supporters in Iowa this week that measure is already saving money for millions of seniors who take pricey prescription drugs. The president's also sparring with Republicans over how to handle future Medicare for people retiring at least a decade from now.

(SOUNDBITE OF SPEECH)

PRESIDENT BARACK OBAMA: They want to turn Medicare into a voucher program.

UNIDENTIFIED GROUP: No.

OBAMA: That means seniors would no longer have the guarantee of Medicare. They'd get a voucher to buy private insurance. And because the voucher wouldn't keep up with costs, the plan authored by Governor Romney's running-mate, Congressman Ryan, would force seniors to pay an extra $6,400 a year. And I assume they don't have it.

HORSLEY: That $6,400 figure is an estimate from the Congressional Budget Office of the additional costs seniors could face if the price of health insurance goes up faster than their government vouchers.

Antos, of the American Enterprise Institute, says Republicans are counting on competition to keep insurance prices in check.

ANTOS: The whole point of this is to provide a new set of incentives that would cause the health sector to reform itself.

HORSLEY: The president's plan also tries to deliver savings. It includes numerous pilot programs aimed at finding more efficient ways to deliver care. And it sets up an expert advisory board to recommend changes to Medicare if costs go up too quickly.

But while the Republican plan would shift any excess costs onto seniors, the president's plan requires that savings be found elsewhere in the health care system.

Here's Kaiser's Tricia Neuman.

NEUMAN: The idea of constraining Medicare spending is one that has been put forward by both sides. But how they would go about constraining the growth in spending differs quite a bit.

HORSLEY: The president and his Republican challenger have both tried to assure today's seniors nothing will change with their Medicare. But experts say some kind of change is inevitable if the program's to be preserved for decades to come.

Scott Horsley, NPR News, Washington. Transcript provided by NPR, Copyright NPR.

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