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By choosing Wisconsin Rep. Paul Ryan to be his running mate, presumptive GOP presidential nominee Mitt Romney put Medicare on the table as a major 2012 campaign issue.
Ryan, who has served as House Budget Committee chairman since the Republicans took control of the House of Representatives in 2011, has advanced plans to control federal spending by restructuring Medicare, the health insurance program for the elderly, Medicaid, the federal-state health insurance program for low-income and disabled people, and other entitlement programs.
But during his seven terms in Congress, Ryan has amassed a portfolio of health policy positions beyond these plans, which have won him widespread support from Republicans and equally widespread denunciations from Democrats. Kaiser Health News has assembled this resource to show how these positions have taken shape.
On reform philosophy, Ryan:
- Supports repeal of much of the 2010 health law, including the Independent Payment Advisory Board, Medicaid expansion, subsidies and the individual mandate. However, his House-passed budget plan included many of the Medicare trims that are now hot-button items in the campaign. Ryan has said that those Medicare cuts, totaling $716 billion, are included in his budget because they are part of the budgetary baseline.
- Throughout his career and most recently in the Roadmap for America’s Future, supported market-based reforms such as interstate insurance purchasing and the creation of association health plans, as well as efforts to decouple health coverage from the workplace, including removing tax incentives for employer-sponsored insurance and providing tax credits to individuals to purchase their own insurance.
- Backed a 2009 proposal – the Patients’ Choice Act – which emphasized proposals such as health promotion and disease prevention and included, among other provisions, state-based health exchanges, protections against pre-existing condition exclusions as well as insurance denials based on age or health status, and expanded health savings accounts.
In the health care marketplace, Ryan:
- Supports medical liability reforms that cap non-economic damages and assisting states in establishing "solutions to medical tort litigation."
- Consistently supported proposals to allow the reimportation of prescription drugs.
On Medicare and aging, Ryan:
- Proposed revamping Medicare to, among other things, change it from a defined benefit to a premium-support program. Starting in 2023, Ryan’s budget would give future Medicare beneficiaries (those currently younger than 55) a set amount – a voucher -- to purchase either a private health plan or the traditional government-administered program. His proposal also would increase the eligibility age from 65 to 67.
- In 2011, teamed up with Sen. Ron Wyden, D-Ore., for Medicare overhaul plan: Guaranteed Choices To Strengthen Medicare And Health Security For All.
- In 2003, voted in favor of Medicare Part D (Medicare Prescription Drug and Modernization Act of
2003).
On Medicaid, Ryan:
- Backs the idea of replacing current Medicaid program with a block grant plan in which states would receive a set amount of money to use for Medicaid programs.
- Opposed various expansions of the Children’s Health Insurance Program, arguing that the proposals expanded “bureaucracy-driven health care” and increased entitlement spending.
On abortion and contraception issues, Ryan:
- Opposed abortion rights provisions in an estimated 59 votes during his tenure in the House of Representatives – both on legislative proposals and procedural motions. He’s a member of the House Pro-Life Caucus and has a 100 percent rating from the National Right to Life Committee. He opposes all abortions, even in the cases of rape or incest, unless the mother’s life is at stake.
- Voted for an amendment to the 2011 continuing resolution that would have stopped federal support for Planned Parenthood.
This article was reprinted from kaiserhealthnews.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.
