The subsidies seniors receive would be based on the value of Medicare at the start of the plan. The subsidies would increase at a rate indexed to GDP, which is growing much slower than health care costs. The upshot? Medicare beneficiaries would spend far more out of pocket under this system than in the current one. In its analysis of Ryan's budget, the Congressional Budget Office makes this point repeatedly.
"Under the proposal, most elderly people would pay more for their health care than they would pay under the current Medicare system."
"Under the proposal analyzed here, debt would eventually shrink relative to the size of the economy — but the gradually increasing number of Medicare beneficiaries participating in the new premium support program would bear a much larger share of their health care costs than they would under the current program"
According to the CBO, "a typical 65-year-old" with a private health insurance plan covering standard Medicare benefits could be liable for 61% of their total health care costs in 2022 under Ryan's plan. By 2030, the figure could be 68%. Ryan's plan would vary subsidies to seniors based on income and health status — poorer and sicker beneficiaries would get larger subsidies. But the details of this are still unknown. Who determines the health risk and how is that translated into dollars?
"...costs to individuals (beyond those covered by the premium support payment) would be higher under the proposal than under traditional Medicare, and some individuals would therefore choose not to purchase insurance...the number of older Americans without health insurance would be higher."
While a little over half are somewhat or very certain they'll be able to retire in comfort when the time comes, a full 44% have little or no confidence in it, according to the Associated Press-LifeGoes-Strong.com. survey.
Just 11% are strongly convinced they'll be well off when they retire, the poll showed.