Rep. Paul Ryan (R-WI)

The proposed fiscal 2013 budget released by Rep. Paul Ryan (R-WI) Tuesday would repeal the Affordable Care Act and cut Medicaid spending by $810 billion over 10 years.

The Medicaid cuts would be achieved by granting states block grants indexed for inflation, according to the budget summary. Ryan contends that block grants give states more flexibility with the state-federal program, a notion that provider groups and some Republican governors dispute. Medicaid pays for the majority of skilled nursing care.

Ryan’s proposed overhaul of Medicare largely follows the “premium support” plan he pitched a year ago in his fiscal 2012 budget. That plan put all seniors in a privatized voucher program, wherein the federal government would subsidize premium payments, The Hill reports.

His 2013 budget would give seniors the option of selecting the traditional fee-for-service (FFS) Medicare plan or the premium support plan. The 2013 budget also features protections for low-income seniors and restrictions to prevent FFS Medicare from attracting the most medically complicated individuals. The premium support model is based on a plan engineered by Ryan and Sen. Ron Wyden (D-OR).

According to the budget summary — titled “The Path to Prosperity: A Blueprint for American Renewal” — the plan “will allow seniors to enjoy the same kind of choices in their plans that members of Congress enjoy.”

Click here to read the summary.