The partisan tug of war over Medicare, Kaiser's president Drew Altman said, is that "Democrats will resist cuts in these programs and Republicans will resist any new taxes."
"These choices are also hard on legitimate policy grounds, especially when it comes to Medicare. And the most important reason they are hard is that so many seniors and disabled people on Medicare have low incomes and already pay a significant share of those incomes for their health care today," Altman wrote in an essay. "It will be difficult if not impossible to ask the majority of beneficiaries to pay more or make do with less."
Medicare also faces many other challenges, outside of the changes mandated by the new health care law.
Every few months, Congress has to work around cuts for Medicare providers. The system, set up two decades ago, was designed to control costs and while both Democrats and Republicans have historically agreed to not let them move forward, some doctors are afraid that the lame-duck Congress may end up in a partisan tangle.
Medicare payments would be cut by 23 percent if Congress does not act by Dec. 1.