Ryan : Ryan 's proposals for Medicare , Medicaid sharply differ from Obama 's . He says Aaron Carroll 's Obama plan could change quality of care , increase cost to seniors . He says plan for block grants to states to pay for Obama would result in benefit cuts to poor , old . Carroll : If benefits are n't cut , and already low provider reimbursements are n't further reduced , then by 2021 about 19 million people , or one-third of all people on Medicaid , will need to be dropped from coverage . Medicaid 's approach is different ; ideally a compromise would keep best of both plans .
Ryan : Ryan 's proposals for Medicare , Medicaid sharply differ from Obama 's . He says Aaron Carroll 's Obama plan could change quality of care , increase cost to seniors . He says plan for block grants to states to pay for Obama would result in benefit cuts to poor , old . Carroll : Medicaid 's approach is different ; ideally a compromise would keep best of both plans .