This is the key point in Sarah Kliff’s demonstration that the argument that the ACA cuts $716 billion is accurate but misleading:
It’s worth noting that there’s one area these cuts don’t touch: Medicare benefits. The Affordable Care Act rolls back payment rates for hospitals and insurers. It does not, however, change the basket of benefits that patients have access to. And, as Ezra pointed out earlier today, the Ryan budget would keep these cuts in place.
There’s nothing wrong with Medicare cuts per se; indeed, spending less per capita on Medicare should be a progressive goal. It’s a question of what these cuts mean. Evidently, cutting payments to the rentiers Republicans have sought to reward through Medicare Advantage is an unequivocally good thing. And reductions in payments to hospitals that come because there are fewer uninsured patients that hospitals have to treat are also a good thing. And this is what the Medicare cuts Obama supported come from. The Medicare cuts Ryan supports, conversely, come from requiring people to pay much more out of pocket for the same things, preventing them from getting insurance that will get the same things covered, or denying them the ability to get insurance at all.
So, despite the efforts of the Gekko/Rand campaign (as well as their de facto allies among the “Obamney” nominal left) to blur the distinction, Medicare cuts aren’t inherently bad; it’s a question of what this means. Social Security cuts are another issue, and here Obama’s apparent interest in cuts is much more problematic.
…Relatedly, Ruth Marcus argues that if the Republicans have a plan to effectively eliminate Medicare, the Democrats need one too! I prefer the plan of trying to deliver the same services more efficiently, thanks.