Opening Act: Wyden-Ryan-mentum

I’m in Iowa today, far away from the real news, broken by Lori Montgomery last night. Sen. Ron Wyden and Rep. Paul Ryan are introducing a bipartisan Medicare reform bill. They explain it in an op-ed.

For future retirees, starting in 2022, our plan would introduce a “premium support” system that would empower Medicare beneficiaries to choose either a traditional Medicare plan or a Medicare-approved private plan. Unlike Medicare Advantage, these private plans would compete head-to-head with traditional, fee-for-service Medicare on a federally regulated Medicare exchange…

Low-income seniors who qualify for both Medicare and Medicaid would continue to have Medicaid pay for their out-of-pocket expenses. Other lower-income seniors would receive fully funded savings accounts to help offset any increased out-of-pocket costs, while wealthier seniors would receive less help.

All health plans that participate in the Medicare exchange would be required to offer benefits that are at least as comprehensive as those covered by traditional Medicare, and participating plans would be forbidden to charge discriminatory premiums and would be required to cover everyone regardless of age, gender or health status.

The direct federal contribution to health plans that cover the sickest seniors would be higher than it would be for plans that cover healthier seniors, thus ensuring that more help goes to seniors with greater health-care needs.

Democrats spent 2011 casting Ryan’s premium support plan as the end of Medicare. They won a special election on it. The president was outspoken against it. Democrats would “save” Medicare as we knew it. Ryan and Republicans stuck together and argued that Medicare couldn’t continue to exist as it does now – the spending crush wipes us out within a decade. This was true. In the supercommittee negotiations, some of the leaked Democratic plans would have reformed Medicare by keeping the program but raising ages. There was no Democratic talk of fundamental reform. There is now.

Eddie Vale, spokesman for the pro-Obamacare group “Protect Your Care,” emailed this morning that Ryan had basically caved, admitted his own plan had been too radical. But this plan, he said, was “‘better’ than Ryan’s original plan in the same way getting run over by a car is better than being run over by a bus.”