The Republican budget will be rolled out with the fanfare that Paul Ryan has become very, very good at. It began with an evening Wall Street Journal op-ed ; it continues today with a speech at AEI. (The House of Representatives is only starting debate on one piece of legislation, so that's not where the action is.) In the meantime, Naftali Bendavid has details on his proposal to end Medicare as we know it:
Mr. Ryan's proposal would apply to those currently under the age of 55, and for those Americans would convert Medicare into a "premium support" system. Participants from that group would choose from an array of private insurance plans when they reach 65 and become eligible, and the government would pay about the first $15,000 in premiums. Those who are poorer or less healthy would receive bigger payments than others.
Ah, yes: The old promise-older-voters-nothing-will-change trick. It didn't work on Social Security reform in 2005, but we'll see how it works now. It's sort of what Republicans have to do, because they beat the brains out of Democrats in 2010 over the very idea of cuts to Medicare.
And this is what Democrats were hoping Republicans would do. They greeted the release of Ryan's 2009 "roadmap" with joy -- here was the GOP, on the record, for tax increases on lower-income people and for entitlement cuts for all. The splitting-the-baby with senior citizens was expected. There's a surge of Democratic hackery coming down the pike. (When Democrats ran wild against Republican cuts in 1995, the GOP wanted to increase the cost of premiums for wealthier people and allow people to opt out and go for private plans, and you saw what Democrats did with that.)
Ryan goes into a little more detail in his op-ed:
This budget will build upon the historic welfare reforms of the late 1990s by converting the federal share of Medicaid spending into a block grant that lets states create a range of options and gives Medicaid patients access to better care...
Starting in 2022, new Medicare beneficiaries will be enrolled in the same kind of health-care program that members of Congress enjoy. Future Medicare recipients will be able to choose a plan that works best for them from a list of guaranteed coverage options. This is not a voucher program but rather a premium-support model. A Medicare premium-support payment would be paid, by Medicare, to the plan chosen by the beneficiary, subsidizing its cost.
In addition, Medicare will provide increased assistance for lower-income beneficiaries and those with greater health risks.
It's telling that these items are grouped under "welfare" reform -- both are converted into welfare programs.