Updated

When it comes to the debate over Medicare's future, lawmakers appear all too willing to ignore a disturbing fact -- every household in America would have to pay $230,000 more in taxes to cover the unfunded promises made under the health care entitlement.

But Sen. Ron Wyden, D-Ore., citing the thousands of seniors who are becoming Medicare-eligible every day, is trying to charge through the Washington deadlock to address the problem with the help of Republican Rep. Paul Ryan of Wisconsin.

Wyden, a former legal aid lawyer who previously helped seniors with health care, is co-sponsoring a plan with Ryan to reform Medicare before budget problems leave the program in tatters.

"What we will see," Wyden predicted, "is a steady diet of benefit reductions for senior citizens and cost shifting. And that will all take place until the Medicare guarantee is threatened.

"And I'm just not going to sit by and let that happen," he said.

Medicare pays only 80 cents for every dollar private insurance pays, which makes it hard for many seniors to get a doctor.

Wyden said that's why more than 40 percent of seniors in Oregon already get Medicare from private insurance companies.

"A lot of them tell me, 'Ron, I'm going to those plans because, yes, they do offer me prevention and other kinds of services, but most importantly they guarantee that I will get to see a doctor,'" he recounted.

So Wyden joined Ryan in proposing something called premium support, which would allow health care insurers to compete for the business of seniors.

Here's what the plan entails:

  • Those enrolled would still have the Medicare guarantee. 
  • The insurance companies would have to cover everything Medicare covers. 
  • Seniors would get premium support, or government assistance for private plans, equal to the second-lowest bidder, meaning they'd always have two affordable choices for insurance. 
  • The level of support would be updated every year. 

"We think we have a program that's a guaranteed benefit," Ryan said. "That's guaranteed affordability, choice and competition."

Though premium support was originally a Democratic idea, many leading Democrats now disown it, including President Obama.

Obama said of the idea, "While we do need to reduce health care costs, I'm not going to allow that to be an excuse for turning Medicare into a voucher program that leaves seniors at the mercy of the insurance industry."

And House Democratic Leader Nancy Pelosi condemns anyone who favors such a plan, saying, "they want to end the Medicare guarantee. They want seniors to pay more, as the Medicare guarantee is terminated."

Wyden says that he voted against an earlier Ryan plan over such concerns but that the current plan would update the amount of support seniors get every year -- and that ideology cannot be allowed to block reform.

"I don't see it as an ideological issue," Wyden said, adding that both political parties have to come together.