The GOP touted the benefits of preventive medicine before Obama signed health reform into law and claimed that it could help lower the nation’s skyrocketing health care costs. But they’re now denouncing this campaign as an “unconstitutional” “propaganda” effort:

– SARAH PALIN: “This is one of the stupidest things I’ve heard coming out of the Obama administration. Not only is this, of course, pending in court, and I think it will be deemed unconstitutional, but this is a propaganda piece, which I think violates many of the procurement laws and other laws applicable to government contracts. This is propaganda. It’s just promoting ‘ObamaCare.’” [Fox News, 5/22/2012]

– JOHN MCCAIN: “Outrageous waste of taxpayer $ to promote #Obamacare – ‘HHS signs $20M PR contract to promote healthcare law’ [Twitter, 5/22/2012]

– ROY BLUNT: “It’s unacceptable that Pres Obama intends to waste $20M on the taxpayer’s dime to sell U.S. on unpopular #ObamaCare” [Twitter, 5/22/2012]

– RON JOHNSON: “$20M for marketing #ObamaCare? This is a wasteful & inappropriate use of taxpayer dollars.” [Twitter, 5/22/2012]

President George W. Bush also used federal funds to promote the 2003 Medicare Modernization Act (MMA), which established the existing prescription drug benefit. In that case, however, an investigation by the Government Accountability Office and HHS’s own inspector General concluded that the federally funded campaign was “misleading” and “may also have illegally used public money to make what in effect were fake news reports about the law that did amount to propaganda.”

In February of 2004, the administration distributed brochures and launched a $12 million radio, television, and Internet ad campaign to promote the Medicare reforms. “We’re going to provide seniors with straight answers,” said then-Health and Human Services Secretary Tommy Thompson. “We’re going to let them know what benefits are coming and when.” Critics charged that the ads were misleading and some stations even stopped showing the spots.

In 2009, the GOP also defended Humana’s alleged use of federal dollars and data to send deceptive brochures warning Medicare customers that health reform will cut “important benefits and services.” Republicans rallied behind the insurer and accused Democrats of “trying to keep seniors in the dark about the consequences of congressional Democrats’ costly government-run health care bills.” But now they’re trying to undermine a campaign that will shine a light on prevention. Perhaps they’re worried that the more Americans learn about the law, the more they’ll like it.

Duckworth correctly pointed out that approving Rep. Paul Ryan’s (R-WI) budget proposal would end Medicare as we know it, but Walsh insisted that passing massive tax cuts for the rich would help save Medicare, according to the Chicago Sun-Times:

Duckworth continued: “You are on the front lines, giving money to people who don’t need it. Why are you so obsessed with ending Medicare? You call it a ‘Ponzi scheme.’”

“Tammy, I want to save it!” Walsh interjected. “Every Republican and Democrat in D.C. knows it’s gone in 10 years. What do you propose to do?”

“I propose to end the tax cuts for millionaires and billionaires to pay for it,” Duckworth said.

“Oh, Holy Cow, I would much rather be standing with a plan than with a president who has ignored Medicare,” Walsh told Duckworth. “If you’re going to continue down this road as the president is and say, ‘I’m just going to ignore Medicare,’ you, my dear, are ending it as we know it. And that is so wrong.”

Ryan’s budget plan would dramatically reshape Medicare and charge seniors more: led by Ryan, House Republicans voted to cut funds to Medicare, Medicaid, and other social programs so that they could protect defense spending. The Washington Post reports that Ryan’s plan is still a difficult issue on the campaign trail as Democrats continue to attack Republicans for supporting the plan.

But even if it may be proving a difficult topic for congressional Republicans, likely GOP presidential candidate Mitt Romney has staked out the same budget plan as Ryan.

Now, a new report from Fidelity Investments shows that the law is already lowering future costs for retirees. Health care costs have increased for years, but in 2011, the firm projected a decrease as a result of the changes included in the health law. Seniors will now pay $20,000 less for their medical bills through retirement:

Fidelity has calculated an annual estimate of medical expenses for retirees for more than a decade. For many Americans, health care is likely to be among their largest expenses in retirement. The estimate, which is calculated by Fidelity’s Benefits Consulting business, does not include any costs associated with nursing-home care and applies to retirees with traditional Medicare insurance coverage.

The estimate has increased an average of 6 percent annually since Fidelity’s initial calculation of $160,000 in 2002, with the exception of 2011 when the estimate declined $20,000. That one and only decrease in the history of the estimate was due to a one-time adjustment driven by Medicare changes that reduced out-of-pocket expenses for prescription drugs for many seniors.

Those Medicare changes included alterations to the so-called “donut hole,” the coverage gap for prescription drugs for older Americans. Under the law, generic medications in the “donut hole” will be discounted until 2020, when the gap will be eliminated. So far this year, that provision has saved Medicare recipients $3.4 billion, more than for all of 2010 and 2011 combined. Millions more have cut costs by taking advantage of free preventive health services.

This estimate can still change, however. According to the Associated Press, if the Supreme Court strikes down the health care law this summer, Fidelity analysts say they will “update” the number. In all likelihood, that revision would be considerably higher.

– Zachary Bernstein

CONSTITUENT: The two men that were your co-creators of your privatization of Medicare plan, Robert Reischauer and Henry Aaron, were on the hill last week. I think they spoke to the House Ways and Means Committee. [...] What’s interesting though, Brennan was on and they’re backing away from your plan, privatization of Medicare, basically because they’re saying it’s going to cost more and give us fewer services than the traditional plan. [...] Are you going to change your plan or how do you stand on that?

RYAN: Hank [sic] Aaron is an economist at Brookings Institute who has been in favor of a different version of what we call “premium support.” [...] Henry Aaron doesn’t agree with the way we’re doing it, but these other Democrats that have been working on the Medicare law for literally a couple of decades, would come to agreement on the best way to save and strengthen Medicare.

Watch it:

Ryan claims that his differences with Aaron are only in the implementation of the policy. In fact, Aaron has said that he no longer believes “premium support” is good policy at all. In testimony before the House Ways and Means Committee on April 27, Aaron conceded that there is no strong evidence the plan would lower the growth of health care costs; in fact, he claimed, private “Medicare Advantage plans are more expensive than is traditional Medicare.” Last year, he also said that “gains from being able to choose among competing insurance plans have been exaggerated.” In an email to ThinkProgress, Aaron confirmed that he has totally backed off the plan.

Instead, Aaron now believes that the Affordable Care Act can do a better job reducing costs and protecting beneficiaries. As he told the Ways and Means Committee, “The passage of the Affordable Care Act means we have put in place a key element of the premium support idea for the rest of the population, namely health insurance exchanges.” Aaron noted that those exchanges are similar to what advocates of “premium support” want to see for Medicare, except these do not put “the burden of cost control on beneficiaries.”

ThinkProgress intern Zachary Bernstein contributed to this post.

Jesse Kelly 2010 campaign flyer

In the ad, Kelly makes a widely-debunked claim that ObamaCare will “cut $500 billion from Medicare.” The legislation aims to achieve $500 billion in Medicare savings, which will extend the life of the program and provide better care.

But after his disclaimer, Kelly and his grandfather Hank Allgyer say:

KELLY: I’m committed to protecting Social Security and Medicare for our seniors.”

ALLGYER: Don’t let Ron Barber cut my benefits, Jesse. I’ve earned them.

KELLY: Don’t worry, Grandpa. I won’t.

ALLGYER: I know you’ll protect us.

Watch the video:

On his website, Kelly says he supports “preserving, protecting and strengthening Social Security and Medicare” and does not support “privatizing, eliminating or phasing out these programs in any way.” He advocates actions to prevent Social Security from “going bankrupt” but lays out five principles that would seemingly prevent any real action to do that:

1. Any solution must be bipartisan
2. I will not vote for any solution that privatizes social security
3. I will not vote for any solution that raises taxes
4. I will not vote for any solution that cuts benefits
5. I will not vote for any solution that raises the retirement age

By ruling out changing the amount of money coming in to the Social Security fund (raising taxes) or the amount going out (cutting benefits or changing the retirement age), he seems to take virtually everything off the table. But he hasn’t always had this view.

The Hill noted that as recently as April 18, his website called for partial privatization of Social Security. His earlier view that “Younger workers should have the choice of allocating a portion of their contribution into a personal retirement account in their name,” is has been completely erased from his positions page.

And, the same article notes, in a 2010 debate, Kelly said the nation must take steps to reform, privatize, and phase out entitlements. “You need to fulfill your promises in the near future while phasing out future generations, taking steps to privatize, vouchers, everything,” he said. “It’s not an option of should it be done. It must be done.”

Kelly, a construction manager and Tea Party favorite, infamously hosted an M16 automatic weapons shooting campaign event to help supporters “get on target” to “help remove Gabrielle Giffords from office,” just months before a gunman went on a shooting spree at a Giffords community event in Tuscon, leaving six dead and a dozen wounded — including both Giffords and Barber. Giffords resigned her seat in January to focus on her recovery.

His issues page has since been changed to remove the phrase “The Second Amendment of the Constitution is not just about hunting. It is about the right of a free people to defend themselves.”

The Kelly website makes no mention of whether the nation has always been at war with Eastasia, but Kelly apparently does not think Arizona voters can remember all the way back to April 2012.

-Zachary Bernstein

Interestingly, 48 percent of respondents — including 46 percent of Republicans — said they “support the Medicare program we have now, where people can choose the government run program or a plan from a private health insurance company.” Just 13 percent — and 26 percent of Republicans — would favor “a Medicare program solely run by private insurance companies.” The other results:

– 53 percent were opposed to raising taxes

– 60 percent opposed “increasing co-pays and deductibles so that out-of-pocket costs will increase”

– 72 percent support cutting the price Medicare pays for prescription drugs

– 57 percent are in favor of having people with higher incomes pay more for their Medicare benefits than people with lower incomes

– 54 percent support the proposal that doctors and hospitals be paid “based on quality and results, rather than the volume of care provided”

Currently, over 15 percent of the federal budget goes toward funding Medicare, and that number is expected to increase to roughly 18 percent by 2020.

– Fatima Najiy

Now, several health experts are warning of another unintended consequence: Medicare might not be able to function properly, potentially putting patient care and payments to doctors at risk. As some experts told NPR, the program could be thrown into complete chaos:

“The Affordable Care Act has become part and parcel of the Medicare system, encouraging providers to deliver better, more integrated, better coordinated care, at lower cost,” says Judy Feder, a public policy professor at Georgetown University and former Clinton administration health official. “To all of a sudden eliminate that would be highly disruptive.”

Sara Rosenbaum, a professor of health law and policy at George Washington University, puts it a bit more bluntly: “We could find ourselves at kind of a grand stopping point for the entire health care system.”

And it’s not just Democrats warning of potential problems. Gail Wilensky, who ran Medicare and Medicaid under President George H.W. Bush, says she doesn’t think it’s likely that the court will strike down the entire health law. But if it does, she says, “it seems like it takes everything with it, including those aspects that are only very peripherally related to the expansion of coverage.”

As Rosenbaum noted, if the law is ruled unconstitutional, “Hospitals might not get paid. Nursing homes might not get paid. Doctors might not get paid. Changes in coverage that have begun to take effect for the elderly, closing the doughnut hole might not happen. We don’t know.”

This uncertainty is already spilling over into the market: the ratings service Moody’s reported earlier this month that for-profit hospitals could be hit particularly hard if the law is overturned. As the report said, “Uninsured patients enter the health care system through the emergency room and often wind up admitted and accumulating bills they don’t have the means to pay. The continued rise in uncompensated care costs would limit operators’ revenue growth and profit margins and constrain cash flow.”

-Zachary Bernstein

Last week, the Obama Administration announced that it would drastically scale up a program that uses competitive bidding to buy medical equipment for Medicare beneficiaries. The decision was made after the results of the first year of the competitive bidding program showed that competitive bidding saved $202 million in spending in 9 metropolitan areas, reducing Medicare expenditures on durable equipment by 42 percent, without sacrificing the quality of or access to care for Medicare beneficiaries. The Centers for Medicare and Medicaid Services (CMS) plans to expand the program to 100 metropolitan areas by 2013, and the entire country is expected to benefit from the program by 2016.

The savings in the first round of the competitive bidding program came from lowered prices for things like oxygen equipment, power wheelchairs, and mail-order test strips for people with diabetes. Instead of paying suppliers based on the current fee schedule that leaves Medicare paying prices well over market value, competitive bidding requires suppliers to compete for their contracts by offering better prices. The results of the first year of the program show that competitive bidding reduced the amount paid by Medicare for an oxygen concentrator from $2,079.72 per year to $1,393.92 per year and saved Medicare beneficiaries an average of $137 a year in cost sharing. Total savings on oxygen equipment alone during the first year of the program were over $59 million.

The savings that resulted from competitive bidding are no surprise— they’re matter of common sense and simple economics. As such, competitive bidding has enjoyed bipartisan support for quite some time. Yet this week’s announcement marks a hard-won victory for CMS, which has had a rocky time implementing competitive bidding against a lobby of suppliers invested in preserving the status quo.

Competitive bidding for durable medical equipment was first mandated as far back as 2003, with the passage of the Medicare Modernization Act. It was implemented in July 2008, but was only in progress for two weeks before all the contracts were terminated by a subsequent law supported by suppliers that delayed this reform. One of the primary concerns cited by suppliers was that small suppliers would be pushed out, unable to compete with larger companies. But the report released by CMS this week shows that approximately 51 percent of the suppliers who won bids were small suppliers.

Now that reform is under way, Medicare officials project that the competitive bidding program will save at least $42 billion over the next ten years, which is an important step in a larger effort towards reducing rising Medicare costs. Last year, the Center for American Progress proposed expanding competitive bidding in Medicare as part of a broader series of cost containment reforms that could save $100 billion or more in health care costs. We recommended not only requiring competitive bidding for all durable medical equipment, but also expanding the program to all medical devices and laboratory tests, among other products and services. Expanding the scope of the program to include medical devices, laboratory tests, and procedures such as outpatient radiological exams (like CT scans and MRIs) would increase the cost saving potential of competitive bidding, but would also require more technical expertise to implement. So CAP has proposed establishing a Medicare Competitive Bidding Committee, composed of individuals with private sector experience in acquisitions and experts in competitive bidding that would oversee the process to ensure preservation of quality and access.

Competitive bidding expansion and other payment and delivery system reforms are smart alternatives to the draconian Medicare cuts like those proposed by the Ryan Plan, which would shift the cost burden onto seniors and offer nothing in the way of meaningful reform for the healthcare system.

Representative Dan Benishek (R-MI)

Benishek couldn’t even get through his opening remarks before attendees began criticizing his support for Rep. Paul Ryan’s (R-WI) proposed budget that would increase the cost of health care for seniors by providing “premium support” vouchers to eligible senior citizens.

“If you have a better idea as how to keep Medicare sustainable over the long term, I’d be happy to hear it,” offered Benishek.

He may have regretted those words after the event, because for half an hour, Benishek fielded several suggestions on how to increase funding for Medicare, ranging from ending oil subsidies to increasing taxes on the wealthiest two percent, suggestions that Benishek summarily dismissed.

Benishek also displayed a shocking lack of self-awareness about his level of knowledge of some key facts. “There are no government subsidies for oil,” he told one woman who suggested ending the very real subsidies given to oil corporations to help defray the cost of Medicare. Watch a portion of the town hall:

At one point, the discussion turned to health care reform. Benishek, who served as a medical doctor before he was elected to Congress in 2010, was thrust onto the national stage after his predecessor Bart Stupak cast the deciding vote in favor of the Affordable Care Act in 2010. He told the audience that the United States has the best health care system in the world, before he was literally laughed at by several attendees.

“We have the highest life spans in the world,” argued Benishek. Several women in the audience quickly pointed out that in fact, many countries with universal health care place higher than the United States in terms of life expectancy, including Canada, Sweden, Norway and the Netherlands. The United States ranks 50th, just behind South Korea and Bosnia and Herzegovina.

“I don’t believe that’s true,” said Benishek. “How can you not know that, you’re a medical doctor?” one woman replied.

The confrontational town hall meeting almost didn’t even happen, after a member of the public, armed with a camera, refused to stop recording. A representative from the Chamber of Commerce, which sponsored the event, threatened to shut down the entire proceedings.

-Zachary Bernstein

ROMNEY: I’d be willing to consider the President’s plan, but he doesn’t have one. That’s right: In over three years, he has failed to enact or even propose a serious plan to solve our entitlement crisis.

Instead, he has taken a series of steps that end Medicare as we know it. He is the only President to ever cut $500 billion from Medicare. And, as a result, more than half of doctors say they will cut back on treating seniors. He is destroying the Medicare Advantage program, eliminating the coverage that millions of seniors depend on and reducing choice by two-thirds.

To control Medicare cost, he has created an unelected, unaccountable panel with the power to prevent Medicare from providing certain treatments. The result will be fewer treatments and services available to patients in need, and nowhere else to turn.

Watch it:

Romney rarely lets the facts get in the way of his rhetoric, but these oft-repeated accusations ring particularly hallow — and are hardly rare. The savings achieved in Medicare through the Affordable Care Act will help stabilize Medicare by eliminating overpayments to private insurers and slowly phasing in payment adjustments that encourage greater efficiency. As a result, the law extends the life of the Medicare trust fund by eight years and allows seniors to retain all of their guaranteed Medicare benefits. Medicare beneficiaries are already paying less for prescription drug coverage and receiving preventive care as a result of the law, while enrollment in Medicare Advantage has increased and premiums have fallen. The law, in other words, does exactly the opposite of Romney’s claim: it expands Medicare “as we know it.”

That doesn’t mean that it solves all of our health care cost problems. It doesn’t and Obama has proposed accelerating some of the law’s cost-control mechanisms to further lower the growth of spending. But Romney has labeled such efforts “rationing” and is offering an alternative “premium support” scheme that transforms senior’s guaranteed Medicare benefit into a voucher and significantly reduces the government’s contribution to the program. As a result, seniors will likely pay more for their health care, while the market clout and purchasing power of traditional Medicare — which has led on delivery reform and efficiencies — will shrink. So if the question is, which candidate ends Medicare for seniors, it’s hard to see how Romney’s plan to push future retirees into private insurance doesn’t fit the bill.

“We’re told that Medicaid would simply be handed over to the states,” Obama explained. “But here’s the deal the states would be getting. They’d have to be running these programs in the face of the largest cut to Medicaid that has ever been proposed.” According to the Center on Budget and policy Priorities, the Ryan budget would reduce federal spending on Medicaid by $810 billion and would provide states with smaller “block grants” to run their health care programs. “A cut that according to one nonpartisan group would take away health care for about 19 million Americans,” Obama said, before turning to the GOP’s proposal to transform Medicare into a premium support structure:

OBAMA: Instead of being enrolled in medicare when they turn 65, seniors to retire a decade from now would get a voucher that equals the cost of the second cheapest health care plan in their area. If Medicare is more expensive than at private plan, they will have to pay more if they want to enroll in traditional Medicare. If health care costs rise faster than the amount of the voucher, as, by the way, they have been doing for decades, that’s too bad. Seniors bear the risk. If the voucher is not enough to buy private plan with bit specific doctors and carry need, that’s too bad. Most experts will tell you the way this voucher plan encourages savings is not through better care or cheaper costs. The way these private insurance companies save money is by designing and marketing plans to attract the youngest and healthiest seniors, cherry picking, leaving the older and sicker seniors in traditional Medicare where they have access to a wide range of doctors and guaranteed care, but that makes the traditional Medicare program even more expensive and raises premiums even further. The net result is our country will end up spending more on health care and the only reason the government will save any money is at — is because we have shifted it to seniors. They will bear more of the costs themselves. It is a bad idea. It will ultimately end Medicare as we know it.

Watch it:

Indeed, a Center for American Progress analysis of Congressional Budget Office (CBO) data finds that new Medicare beneficiaries could actually end up paying as much as $1,200 more per year by 2030 and $5,900 more per year by 2050 for health care benefits. The Republican budget would shift these costs to beneficiaries by limiting the growth in Medicare spending per beneficiary to growth in the economy plus 0.5 percentage points — a rate that is much slower than the projected growth rate under current law.

As a result, under their budget, CBO projects that average spending would rise to only $7,400 in 2030 and to only $11,100 in 2050. Since the Republican budget would convert Medicare spending into vouchers, these dollar amounts would be the amounts of the vouchers, on average. In other words, “CBO projects that government spending per beneficiary would be $1,200 lower in 2030 (the difference between $8,600 under current law and $7,400 under the Republican budget) and $5,900 lower in 2050 (the difference between $17,000 under current law and $11,100 under the Republican budget).”

The Republican budget never specifies how it planst to enforce its cap on Medicare spending and in the absence of any other enforcement mechanism, it’s likely that the cap would be enforced by limiting the amount of vouchers provided to beneficiaries. After all, we know that capping the vouchers is the clear policy goal of Republicans—we need look no further than the budget they proposed last year. The vouchers, therefore, would likely be capped at CBO’s projected spending per beneficiary under the Republican budget: $7,400 in 2030 and $11,100 in 2050. And since these amounts would be much lower than actual costs, beneficiaries would be left to pay the difference.

Like last year’s Ryan/Wyden reform plan, beginning in 2023, the guaranteed Medicare benefit would be transformed into a government-financed “premium support” system. Seniors currently under the age of 55 could use their government contribution to purchase insurance from an exchange of private plans or — unlike Ryan’s original budget — traditional fee-for-service Medicare. That annual government contribution will no longer be indexed to an arbitrary indicator of inflation plus 1 percent, but would increase with health care costs and rely on market competition to control health care spending. Individuals who choose a plan that costs more than the benchmark would pay the difference, while those who enroll in a lower-cost plan would receive a rebate. Lower-income seniors would also be eligible for additional assistance.

Finally, the budget adopts President Obama’s a per capita cost cap of GDP growth plus 0.5 percent (while repealing the ACA’s Independent Payment Advisory Board), which would act as a “fallback to assure the federal government budgetary savings” and encourage providers to adopt greater efficiences. But since it’s unclear how this cap would be enforced, it’s likely that the cap would limit the government contribution provided to beneficiaries. Since the proposed growth rate is much slower than the projected growth in health care costs, CBO estimates that new beneficiaries could pay up to $1,200 more by 2030 and more than $5,900 more by 2050.

But that’s not the only problem with Ryan’s plan:

1. Ryan breaks up the large market clout of Medicare and pushes seniors into less efficient private insurers. As Rick Foster, Medicare’s chief actuary, admitted during a recent House Budget Committee hearing, since traditional Medicare is far better at advancing delivery system reforms, securing lower reimbursement rates with health care providers, and operating under minimal administrative overhead, transferring Medicare beneficiaries from free-for-service Medicare into the private health market would not contain overall health care spending. It would only shift costs.

2. Seniors who enroll in traditional Medicare will likely pay more for their benefits. That’s because under Ryan’s budget, private plans will be able to cherry-pick the healthiest beneficiaries from traditional Medicare and leave sicker applicants to the government. The budget states that enrollees would be “guaranteed a plan that is at least the value of the traditional fee-for-service Medicare option,” but private insurers could still attract a healthier population by simply ratcheting down services that sicker beneficiaries rely on (like chemotherapy) and building up coverage for healthier applicants (like preventive services). Should they succeed, traditional Medicare costs will skyrocket, forcing even more seniors out of the government program. Seniors who are priced out of traditional coverage over time would enroll in private plans and receive care through more restricted provider networks relative to what they currently enjoy (where nearly all hospitals, doctors, nursing homes participate). Ryan pledges that “CMS would also conduct an annual risk review audit of all insurance plans participating in the Medicare Exchange,” but as the experience with Medicare Advantage demonstrates, existing tools are still insufficient to address cherry picking.

3. The “premium support” credits won’t keep up with health care costs. Fortunately, the vouchers seniors will receive are no longer indexed to inflation. They instead rely on actual average bids in any given geographic area and would do a better job of keeping up with health care costs every year than the original Ryan proposal. But seniors in high cost Medicare areas could still experience a cost-shift and would be responsible for the difference between the amount of the premium credit and the actual cost of the policy.

So there, in a nutshell, is the problem — at least from a policy perspective. Despite its concessions, the new budget moves the health care system closer to the Ryan ideal, in which future Congresses would be able to reduce federal costs by eating away at the premium credit seniors receive. The plan does little to address the root of the cost problem — changing how we pay doctors and hospitals by moving away from fee-for-service payments — and instead limits the government’s commitment by shifting more costs to beneficiaries.

But Romney is worth an estimated $250 million, so he has the resources to afford insurance without Medicare. Most beneficiaries who have paid into the program throughout their careers do not have Romney’s vast resources and rely on Medicare benefits. And there is nothing wrong with accepting benefits when they’ve already paid into them. Rather than make a show of not enrolling in Medicare, Romney could better serve the program’s beneficiaries by not planning to destroy Medicare as we know it.

The only problem? None of the issues Romney’s questions point out are true. Here’s why:

QUESTION: Why Is President Obama Ending Medicare As We Know It By Allowing It To Go Bankrupt In Less Than 15 Years?

FACT: Medicare is not going bankrupt. The Congressional Budget Office reports that one portion — Medicare Part A or hospital insurance — will become “insolvent.” As Igor Volsky has reported, “Dedicated revenues will not be sufficient to pay all of its bills and the hospital fund will meet about 90 percent of its commitments, rather than the full 100 percent. In the succeeding years that shortfall will slowly widen and then contract, so that in 2085, Medicare could pay out 88 percent of its obligations.” By lowering annual payment updates to providers, savings from the Affordable Care Act will extend the life of the trust fund by nine years.

QUESTION: Why Is President Obama Ending Medicare As We Know It By Funding Obamacare Through $500 Billion In Medicare Cuts For Today’s Seniors?

FACT: The health law does not cut Medicare’s current budget. As ThinkProgress has previously explained, it slows the growth in the program by removing $500 billion from future spending over the next 10 years — not cutting from current senior’s benefits. The cuts help stabilize Medicare by eliminating overpayments and slowly phasing in payment adjustments that encourage greater efficiency. As a result, the law extends the life of the Medicare trust fund by nine years and allows seniors to retain all of their guaranteed Medicare benefits.

QUESTION: Why Is President Obama Ending Medicare As We Know It By Creating An Unaccountable Board To Ration Care For Today’s Seniors?

FACT: The proposal is statutorily prohibited from rationing benefits or increasing co-pays and will go into effect unless Congress acts to alter the proposal or discontinue automatic implementation. And the board will be composed of doctors, economists, and consumer representatives who will be confirmed by the Senate and will be tasked with designing a savings plan if health care spending increases beyond a certain threshold.

QUESTION: Why Is President Obama Ending Medicare As We Know It By Destroying Medicare Advantage For Today’s Seniors?

FACT: Far from destroying Medicare Advantage, the choices available through the program are “stronger than ever,” the White House reported in February. Nancy-Ann DeParle, White House deputy chief of staff for domestic policy, explained that premiums for Medicare Advantage are lower and enrollment has been higher since the Affordable Care Act made the changes to Medicare Advantage, which Republicans derided. “As reported last year, 99.7 percent of people with Medicare still have access to Medicare Advantage plans,” DeParle said.

QUESTION: Why Is President Obama Ending Medicare As We Know It By Ending Access To Care For Today’s Seniors?

FACT: As has been explained, the Afforable Care Act does not cut current benefits, is not disappearing, and has actually expanded options for seniors enrolled in Medicare Advantage. And many presidents have made changes to Medicare since 1965, including Republican idol Ronald Reagan, without ending care for seniors or destroying Medicare. Reagan even instituted a series of reforms that are strikingly similar to some of the payment changes included in the Affordable Care Act (policies Romney now refers to as cuts or price controls).