Is Paul Ryan's years-long dream of gutting Medicare about to come true?

With Republicans set to control both houses of Congress and the White House, Ryan (R-Wis.), who will serve another term as House speaker, "senses his moment," as Salon observes.

The Donald Trump transition website states that the administration will "modernize Medicare"—a euphemism, according to Jonathan Cohn and Jeffrey Young at the Huffington Post, that corresponds exactly to what Ryan has in mind.

Speaking Thursday on Fox News's "Special Report," Ryan said, "Medicare is going broke, Medicare is going to have price controls because of Obamacare," adding, "You have to deal with those issues if you are going to repeal and replace Obamacare. Medicare has serious problems [because of] Obamacare."

Those statements are false, Michael Hiltzik writes at the Los Angeles Times:

Medicare faces fiscal problems, but it's not going broke, and according to both the Medicare trustees and the Congressional Budget Office, the Affordable Care Act [also known as Obamacare] has in fact alleviated those problems rather than caused them. The trustees reported in 2010 that passage of Obamacare had postponed the projected exhaustion date of the Medicare trust fund by 12 years—to 2029 from 2017. Projections of Medicare spending growth have consistently come down, year after year, at least in part due to changes in the program imposed through Obamacare. The program's fiscal situation would be "substantially improved," the trustees said, because the ACA instituted new cost controls and provided new tax revenues for the program. Both those features would disappear if the GOP repeals the ACA, as is its intention.

Simply put, economist Dean Baker writes, Ryan's plan "will require seniors to deal with insurance companies who will profit by denying them care."

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"Ryan's plan," Gary Legum adds at Salon,

is to replace the totally-not-going-broke Medicare with what he calls "premium price supports." This is fancy wonk-speak for "vouchers that would be used to buy private insurance but would not keep up with the cost of inflation, thereby saddling seniors with enormous additional health care expenses out of their own pockets." Good luck stretching out those Social Security checks, folks! Assuming Ryan doesn't gut that next.

Josh Marshall adds at TPM:

I've heard a few people say that it's not 100% clear here that Ryan is calling for Medicare Phase Out. It is 100% clear. Ryan has a standard, openly enunciated position in favor of Medicare Phase Out. It's on his website. It's explained explicitly right there.

Given the likely threat to the broadly supported program, Jeet Heer argues at New Republic that Democrats should mount "a pre-emptive attack on the Ryan Plan" with "Bernie Sanders, Elizabeth Warren, and Keith Ellison" at the helm of an organizing committee.

He adds:

It's essential to hang Ryan around the neck of Trump, to make Trump feel the political cost of going along with Ryan's agenda. This should be a part of a larger message designed to challenge Trump's populist pretenses, pointing out all the policies he supports that go against the interest of the working class or enrich the wealthy.

Baker similarly argues it should be used as a "pressure point" and that "[w]e have to do our best to make everyone know that this is the Republican agenda."