"But while saving large sums for the federal government, the proposals on Medicaid and Medicare could shift some costs to beneficiaries and to the states.""COULD"? Is that some kind of attempt to fudge the obvious? The plan is quite clear, and has been ever since Ryan rolled out his loathsome "roadmap": cut spending by taking away the safety net and thus reducing people's ability to access heath care. Throw them a tiny, inadequate bone guaranteed to shrink as their hunger grows, and direct them to the free market to waste what little they get on high deductibles and high co-pays. The fact that they will get less health care, and by extension become sicker and sicker, is offset in callous right-wing minds by the Holy Grail of reduction in health care spending.
There is nothing innovative or admirable about this kind of thinking. Of course you reduce government spending by cutting off money to sick people and people who are trying not to be sick. We could also save money by cutting off the funding to arm our military while telling them to buy their own weapons in the free market. We could save money by cutting off payments to Congress while telling them to buy their own offices and perks. But how many people would join the military or run for office? The real thinking behind this kind of proposal was revealed last year by Republican South Carolina Lt. Governor Andre Bauer when he said that feeding the poor just allows them to keep breeding. To these extremists, the needy or potential needy are nothing but stray, breeding animals, and their solutions are the equivalent of the shelter killing room.