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Originally published September 24, 2012 at 11:12 AM | Page modified September 24, 2012 at 4:29 PM

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Romney plan: a different sort of Medicare

The Associated Press asked the Romney campaign five questions about how his Medicare plan would affect consumers on critical matters of...

The Associated Press

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WASHINGTON — The Associated Press asked the Romney campaign five questions about how his Medicare plan would affect consumers on critical matters of costs and benefits.

Broadly speaking, Romney calls for shifting people now age 54 and younger into a different sort of Medicare. Once eligible, these people would get a fixed payment from the government, adjusted for inflation, to pay for either private insurance or a government plan modeled on Medicare. Current beneficiaries and those nearing retirement could stay in the traditional program.

Romney says it's time for bold action because Medicare faces insolvency in 2024. Private insurance plans would get waste out of the system while protecting quality and affordability, he says.

Some Medicare questions for consumers to keep in mind, along with answers from the Romney campaign and the views of experts:

Q: What happens if Romney's fixed health-insurance payment for future retirees fails to keep up with rising medical costs?

A: Thousands of dollars in costs could get shifted to retirees, punching holes in household budgets. Health-care inflation is now in a lull, but historically it has grown faster than the economy, overall inflation and workers' wages.

Romney's campaign says lower-income Medicare recipients would get more money from the government for their health insurance.

Competition among insurers will keep costs in check, the Romney campaign says. The government payment will be based on competitive bids. Earlier this year, the nonpartisan Congressional Budget Office analyzed a similar Medicare plan by Romney's running mate, Wisconsin Rep. Paul Ryan. It found that by 2030, seven years after the proposal would take effect, Medicare would be spending about $2,200 less on a typical 66-year-old than would be the case under current policies.

Q: Will there be a set of guaranteed benefits that private plans must cover in Romney's revamped Medicare?

A: The Medicare prescription-drug program and private-insurance plans now available through Medicare Advantage have a floor of protection. The Romney campaign website says, "All insurance plans must offer coverage at least comparable to what Medicare provides today."

"Comparable" can mean similar in dollar value, but quite different in terms of coverage. Insurance companies can design benefits to cherry-pick healthier customers.

A high co-payment for home health care, for example, would discourage frail patients.

Q: Romney has said he would repeal Obama's health-care overhaul. Would he reinstate Medicare benefits improved by the law? They include closing the prescription-drug coverage gap — the "doughnut hole" — and expanding coverage of preventive care with no co-pays.

A: The campaign is silent on this issue.

Q: Romney would turn the Medicaid program for low-income people over to the states, sharply limiting its future growth. The costliest Medicaid cases are some 9 million elderly and disabled people who also have Medicare, more than 1 million of them in nursing homes. Would Romney require states to institute special protections for this vulnerable group?

A: The campaign says Medicaid spending would grow under Romney's plan, and states would have the flexibility to design programs that serve low-income people most effectively.

Q: Romney's privatization plan would not affect current beneficiaries or anyone joining Medicare before 2023. But does Romney also guarantee to protect traditional Medicare from any future cuts?

A: The campaign is silent on this issue.

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