Ezra Klein: Some questions for Paul Ryan

Some questions for Paul Ryan
By Ezra Klein

I just watched Paul Ryan speak with Maria Bartiromo about his budget, and I was struck by how little he said about how his plan works in practice. Ryan’s office has refused repeated requests for interviews, but here are the questions I’d like to see asked — and followed up on:

1) In the Roadmap for America’s Future, you capped the growth in Medicare spending between inflation and medical inflation, In Ryan-Rivlin, you held it to GDP+1 percentage point. In your budget, you’ve brought it down to inflation, which is much lower, but you haven’t added any new cost controls. What makes you believe your targets are achievable? And what do we do if they’re not achieved?

2) The main cost control in your plan is that seniors will purchase regulated private health insurance on an exchange. But the Medicare Advantage program, in which seniors choose regulated private insurance options on an exchange and receive the savings through increased benefits, has proven more expensive than traditional Medicare. Why will your exchanges achieve such dramatically different results than the Medicare Advantage exchanges?

3) Alice Rivlin, your original coauthor on the premium-support model, believes the exchanges in your plan are functionally identical to those in the Affordable Care Act, and that if you believe one will have a dramatic impact on costs, so too should the other. How, specifically, do your exchanges differ from those in the Affordable Care Act?

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http://www.washingtonpost.com/blogs/ezra-klein/post/some-questions-for-paul-ryan/2011/05/19/AGucUIBH_blog.html