President Obama outlined his plan Wednesday to cut the nation’s deficit by $4 trillion in 12 years but also vowed to preserve entitlement programs, including Medicare, Medicaid and Social Security.

In his address, Obama mentioned plans for improving Medicare, including expanding the power of the Independent Payment Advisory Board created under the Affordable Care Act. The board would advise Congress on policy issues, such as streamlining funding formulas for Medicaid and the Children’s Health Insurance Program, the Bureau of National Affairs reported. The board also would hold oversight on prescription drug costs. The Medicaid and Medicare programs are the source of about four-fifths of all payments to nursing homes.

Obama’s proposals run counter to a Republican-led plan, which he said would turn Medicare into a voucher program and provide states with block grants to fund Medicaid.

“It’s a vision that says up to 50 million Americans have to lose their health insurance in order for us to reduce the deficit,” Obama said. “Who are these 50 million Americans? Many are somebody’s grandparents, maybe one of yours, who wouldn’t be able afford nursing home care without Medicaid.”

Republicans have vowed to fight the proposals, saying that Obama’s plans, which include tax increases, would stymie economic recovery. Obama said his Medicare reform would save $340 billion by 2021, $480 billion by 2023 and an additional $1 trillion in the next decade.