“This brief provides a side-by-side comparison of recent proposals to transform Medicare into a premium support program and slow the future growth in Medicare spending. These proposals each would convert Medicare from a defined benefit program, in which beneficiaries are guaranteed coverage for a fixed set of benefits, to a defined contribution or “premium support” program, in which beneficiaries are provided a fixed federal payment to help cover their health care expenses. The brief compares the premium support provisions of these proposals, including how the level of premium support for beneficiaries would be determined; whether traditional Medicare would remain an option; what protections would be provided for low-income beneficiaries; and whether and how the proposals would cap federal spending on Medicare. These differences have important implications for Medicare beneficiaries, the federal budget, health care providers and private health plans.

• Sens. Richard Burr and Tom Coburn, in “The Seniors’ Choice Act,” released on February 16, 2012;
• Sen. Ron Wyden and Rep. Paul Ryan, as proposed in “Guaranteed Choices to Strengthen Medicare and Health Security for All: Bipartisan Options for the Future,” released on December 15, 2011;
• Former Senator Pete Domenici and Dr. Alice Rivlin, in the “Domenici-Rivlin Protect Medicare Act,” initially released on November 1, 2011; and
• Rep. Ryan in “The Path to Prosperity: Restoring America’s Promise,” released on April 5, 2011, and scored by the Congressional Budget Office.
• The descriptions in this side-by-side comparison are based on summaries released by sponsors of each proposal; legislative language is not available at this time.