President Barack Obama proposes holding Medicare cost growth down by strengthening the Independent Payment Advisory Board and making Medicaid more flexible without using block grants.

If you (like most of us) were counting on Medicare to provide for your health care needs in retirement, it seems you may be standing on shaky ground. Medicare’s sustainability has been questioned for some time, and as the country turns toward the business of debt reduction Medicare cuts seem inevitable. The future of Medicare and Medicaid, as well as the source, quality, and type of care that seniors receive is in the hands of politicians now, so you may want to keep a weather eye on Capitol Hill.

I’ve previously directed your attention to the House Republican plan for debt reduction as championed by House Budget Committee Chairman Paul Ryan and how it could mean increased costs and fewer benefits for Medicare seniors.

Now President Obama has entered the fray with what may become the benchmark centrist or Democratic position. President Obama issued his position last week in a speech that can be read here in its entirety, but The Kaiser Health News has also done their part to pare down the position just to where it is relevant to healthcare and Medicare.

The President’s plan also calls for heavy savings and spending cuts, saving $480 billion by 2023 and at least an additional $1 trillion over the subsequent decade. While calling for these cuts, the President’s plan retains the ultimate goal of supporting Medicare and Medicaid. The substance of the proposal is to add onto the Affordable Care Act of 2010 with further reform designed to reduce waste, increase accountability, promote efficiency and improve quality of care, “without shifting the cost of care to our seniors or people with disabilities.”

The biggest reform and substantive change is strengthening of the Independent Payment Advisory Board (IPAB) created by the Affordable Care Act. The purpose of the IPAB is to analyze, track, and cut down on excessive costs by informing Congress and recommending action best suited to serve beneficiaries.

In this, the difference between the likely Democrat Position and the likely Republican position (neither party has allied itself to Obama or Ryan just yet) couldn’t be greater. Ryan’s plan relies on vouchers and privatization, whereas President Obama’s relies on cost control and third-party oversight.

Current estimates seem to indicate that Medicare beneficiaries will fare better under President Obama’s plan, but nothing is set in stone yet and there are more issues afoot (like ideology and debt-economics.) Politics is a tricky storm to weather, but if you still have to plan for your retirement, you are well-advised to pay attention to the goings-on on Capitol Hill … and perhaps renew that gym membership. Perhaps the best plan is try to stay healthy for as long as possible!