The Obama campaign is releasing this ad this week in eight states: New Hampshire, Virginia, North Carolina, Florida, Ohio, Iowa, Colorado and Nevada.



"It's one of the hardest decisions a family can make: realizing a nursing home is the only choice. For many middle class families, Medicaid is the only way to afford the care."

Like Jon Cohn, I'm hoping that this issue will come up in the vice presidential debate tonight. It should, because the Romney/Ryan plan to block grant Medicaid, comes primarily from Ryan. While much of the focus of in the presidential campaign has been on Medicare, it's the Medicaid cuts that will be truly devastating for seniors. As Cohn points out, "two-thirds of the money that Medicaid spends goes to that minority of enrollees who are disabled or over 65, because they are the ones with really big medical bills." And among those seniors depending on Medicaid is 70 percent of the nation's nursing home population.

To get a scope of what the Romney/Ryan Medicaid plan looks like compared to President Obama's, just look at this graph created by Austin Frakt and Aaron Carroll at the Incidental Economist. The dashed lines in the middle are Medicaid spending, blue for Obama, red for Romney. (Click on the image to view it at full size.)

The Romney/Ryan campaign says it's all about giving states flexibility to structure the program in the best way for their populations. The only option, when cuts are that severe, is to scale back coverage. Drastically. So states will have flexibility, the flexibility to either drop sick kids, disabled people, or the elderly. Some choice.