Well, the reactions are flying now that Rep Paul Ryan's anti-middle class hand is tipped.
From Paul Krugman:
"For all those older Americans who voted GOP last year because those nasty Democrats were going to cut Medicare, I have just one word: suckers!"
From Ezra Klein:
"In Medicaid’s case, the reform is block-granting. Right now, the federal government shares Medicaid costs with the states. That means their payments increase or decrease with Medicaid’s actual rate of spending. Under a block grant system, that’d stop. They’d simply give states a lump sum at the beginning of the year and that’d have to suffice. And if a recession hits and more people need Medicaid or a nasty flu descends and lots of disabled beneficiaries end up in the hospital with pneumonia? Too bad."
From Ryan Witt:
"Under Ryan’s plan, beginning in 2021, people over 65 would no longer be automatically covered under a government plan. Instead, each senior would be given a voucher with which to purchase their own private health insurance plan.
The problem for seniors is that insurance companies tend to charge older adults more for coverage. The risks for heart disease, strokes, cancer and many other diseases increases dramatically with age. Private insurance companies, unlike the government, must make a profit to continue in operation. Insurance companies only make a profit if they can charge more in premiums than they pay out in claims. Most older adults would not be covered by a group policy since they would no longer be employed. As a result, under the Republican plan, health insurance companies could demand much higher premiums from older adults."
From Jon Perr:
"When Ryan unveiled his Roadmap back in February, as Ezra Klein, Matthew Yglesias and TPM all noted, privatization of Medicare was the centerpiece. But because the value of Ryan's vouchers fails to keep up with the out-of-control rise in premiums in the private health insurance market, America's elderly would be forced to pay more out of pocket or accept less coverage."
Uwe Reinhardt made some predictions about this in February:
"Under the defined contribution approach envisaged by the Rivlin-Ryan plan, most of the risk of future health-care cost increases would be shifted onto the shoulders of Medicare beneficiaries. This feature makes the proposal radical."
Tomorrow should be interesting. We'll all be reading the plan itself. Let me just say this in advance; if one of the cornerstones in Ryan's scheme is a permanent extension of the "W Tax Cuts," the whole thing is bullshit.