I knew I dumbed it down too much for this forum. I just couldn't find a cartoon that explained it clearly.
Try to read these words, it explains the differences very well (from TPM):
The Medicare cuts, passed in the Affordable Care Act, come in the form of reimbursement reductions to hospitals, Medicaid prescription drugs and private insurance plans under Medicare Advantage. The Congressional Budget Office projects that they’ll extend the solvency of Medicare by eight years.
AARP, the seniors’ lobby and chief gatekeeper of Medicare benefits, endorsed the Affordable Care Act despite its cuts, arguing that they wouldn’t affect seniors’ access to care. The law expanded benefits by closing the prescription drug coverage gap known as the “doughnut hole.” The hospital and drug industries also endorsed the legislation, believing that the additional customers via the coverage expansion would more than make up for the cuts.
Obama and Ryan agree that Medicare per-beneficiary cost growth needs to be capped at per-capita GDP plus 0.5 percent. But they disagree on what to cut in order to get there.
Ryan’s plan under the Path To Prosperity would end Medicare as an insurance program that directly pays medical bills for the elderly. It would be replaced with a fixed subsidy which seniors may use to buy competing private and public insurance policies on an exchange. If the value of the subsidy does not keep up with the growth of health care costs, seniors would make up the cost and pay higher medical bills.
The Congressional Budget Office projects that Ryan’s plan would raise seniors’ out-of-pocket expenses by $6,500 per year.
