Contrary to claims from opponents, the budget plan released today by House Budget Chairman Paul Ryan does not spell the end of Medicare. The plan lowers Medicare spending by $210 billion over the next decade—a modest reduction for a $6.6 trillion program. That sets the stage for the shift to premium support, which gives seniors a choice of competing health plans including traditional Medicare. A recent AEI study shows that competition could reduce federal spending by another 4.2 percent a year while maintaining basic benefits and without raising taxes—and without exposing the elderly to the risk of higher health care costs.