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How Paul Ryan's Budget Affects Health Care

LINDA WERTHEIMER: This is WEEKEND EDITION, from NPR News. I'm Linda Wertheimer. It is no coincidence that Mitt Romney makes his vice presidential announcement aboard the U.S.S. Wisconsin, since Congressman Paul Ryan is from the Badger State. The U.S.S. Wisconsin is one of the largest battleships ever built by the U.S. Navy. First launched in 1943, the vessel is 887 feet long. That is a bit less than one-fifth of a mile. She's capable of traveling at 33 knots. Now, the ship is primarily a destination for tourists at the Nauticus Maritime Center, though she served her country well during her 60-year history, eventually winning five medals for service. Now, I didn't know that ships could win medals. As we wait for the big announcement aboard the U.S.S. Wisconsin, let's take a look at some of Congressman Ryan's fiscal credentials. When you talk about the federal budget, you have to talk about health care, Medicare and Social Security. And all three topics are tied to Ryan, who has spent recent years advancing bold, controversial proposals to deal with them. Joining us is NPR health care correspondent, Julie Rovner. Julie, welcome. JULIE ROVNER, BYLINE: Good morning. WERTHEIMER: Now, in the past two years, there has come to be, in the House of Representatives, the Ryan budget. Now what does the Ryan budget do? ROVNER: Well, one of the most important things the Ryan Budget does is remake the Medicare program into something called premium support. This is an idea that's been kicking around for many years. It pre-dates Paul Ryan. But he would basically, what they'd say, privatize Medicare, turn Medicare from an open-ended entitlement on the part of the government, where the government basically pays all of seniors' medical bills to - it would limit it, basically. It would say we're going to give seniors a set amount of money. They're going to go out and buy health insurance, and they're going to buy as much health insurance as the federal government will pay for. And basically, if they spend more than that amount of money, the rest of money - the rest of the cost... WERTHEIMER: Cost of insurance? ROVNER: Well, no. The rest of it - it's going to - whatever goes over that is going to be on the senior or on the insurance company. It's no longer going to be on the federal government. So that will limit the federal government's risk. And that will be, yes, a good way to save money for the federal budget, but it will also change the face of how Medicare works. That's the really big change that it would make it Medicare, and that's something that obviously leads to the phrase that Democrats say: It would end Medicare as we know it. WERTHEIMER: Now, that's not the only thing. There are also big tax cuts. ROVNER: There are, indeed. WERTHEIMER: He's going to reduce spending and cut taxes. ROVNER: That's correct. This is a piece of the Republican mantra, which is that they say cut taxes, that people who pay taxes - particularly wealthier people - will go out and create more jobs, and it will boost the economy. And we should not forget Medicaid, which is now the biggest of the health insurance programs. They would turn Medicaid back to the states. They would cut Medicaid. They say states can do this with less money, and they would let states do whatever they want with Medicaid. So - basically, those three things would be huge, huge changes. And the Democrats are basically salivating, waiting to take this on. WERTHEIMER: Well, now, obviously, the ideas are popular among conservatives. And, as you say, Democrats are looking at the possibility that they could go to town on these ideas. What about moderate voters? What about independent voters? ROVNER: Well, that's going to be interesting, because that's clearly where this fight's going to be waged for those independent voters, in these swing states. You know, in 2011, right after the House voted for this budget, we saw in New York a special election, special House election, where the Democrats took a historically Republican seat, and they basically ran on the Ryan budget. So the Democrats have been very much looking forward to running on the Ryan Budget. I think they're going to be very happy to see Paul Ryan on the ticket for that reason. We will see how moderates, how independents, react to this, to making this the issue. But this will clearly be the issue. WERTHEIMER: And he advocates repealing the health care act, so that would be a big item. ROVNER: Absolutely. Although, interestingly, you know, he does advocate repealing the health car act, as does Mitt Romney. But one of the things that Mitt Romney really hates about the federal law, as opposed to his Massachusetts law, is that $500 billion cut in Medicare, Paul Ryan left that same $500 billion cut in his budget plan. WERTHEIMER: NPR's health care correspondent, Julie Rovner. Julie, thank you very much for coming in today. ROVNER: You're very welcome. WERTHEIMER: Now while we wait for the official announcement from the Romney camp, we're going to take a break from politics and visit with Tom Goldman in London at the Olympics. Transcript provided by NPR, Copyright NPR.