health care reform and Medicare

Medicare is looking like a big fat piggy bank for health care overhaul.

President Barack Obama and the Democrats want to pay for much of their plan to cover the uninsured by cutting hundreds of billions from the Medicare budget over the next 10 years.

From its inception, the health plan for seniors has been kept afloat by taxes out of workers' paychecks. Now, Medicare savings would count toward helping uninsured working-age children and grandchildren afford their own coverage.

Most seniors are willing to help younger generations. But having reached that point in life when you have to spend more time in the doctor's office than you'd prefer to, older Americans worry the cuts will mean lower quality care.

Benefits under traditional Medicare won't be cut. But seniors who've signed up for private insurance plans through Medicare Advantage could lose valuable extra benefits, according to the Congressional Budget Office.

For years, the government has been paying the private plans more than it costs traditional Medicare to deliver similar services. The plans used the money to provide extra benefits — mainly lower copayments and deductibles. Seniors on tight budgets responded by signing up, and now nearly one-fourth of Medicare recipients are in private plans.

As Obama and the Democrats wean private plans off their subsidies, beneficiaries will suffer the consequences.

"Some beneficiaries will lose additional benefits they have been fortunate to have been receiving," said Robert Berenson, a physician turned Medicare expert at the Urban Institute public policy center. "They are likely to see higher out-of-pocket costs, and it's likely that some plans will drop out of the program."

On the other hand, everyone on Medicare will save a little on their monthly premiums as payments to private plans are scaled back.