[CesseOveldset]

They arent vouchers.

Current Medicare beneficiaries, and those approaching retirement age, would not be affected by the GOP’s proposed changes. Instead they would apply to people currently 54 years of age and younger.

This cohort, when it enrolls in Medicare, would receive a fixed annual payment for insurance from Uncle Sam. This payment would be higher for those with greater health-care needs and would be adjusted for the cost of health care in particular areas.

Beneficiaries would then purchase insurance from private providers on a health exchange, a sort of supermarket where plans compete for customers. It is a structure derived from a plan drawn up previously by Ryan and Alice Rivlin, a Brookings Institution economist and former budget director under President Bill Clinton.

It is also similar to the health-exchange plan contained in President Obama’s health-care reform law. The GOP proposal released Tuesday calls for that law’s repeal.

This Medicare exchange would be “tightly regulated,” according to the Republican long-term budget. Insurers would have to promise to insure all Medicare beneficiaries, even the least healthy. Medicare: How Paul Ryan's budget would change it - CSMonitor.com