Advocacy groups are urging seniors to carefully examine the health plans of President Obama and his Republican challenger Mitt Romney. Max Richman is president of the National Committee to Preserve Social Security and Medicare, "Medicare and Medicaid have often been key issues in many elections. But their importance has been dramatically elevated by Gov. Romney's decision to pick Congressman Ryan as his running mate."

Ryan has proposed vouchers to buy private insurance as an alternative to Medicare.  Critics say that could lead to greater out-of-pocket costs. In addition it might lure healthy seniors away from Medicare, leaving the government program to cover the sickest and most expensive patients. The Republican ticket is also proposing block grants for Medicaid. Ron Pollack of Families USA says the grants might not be enough to cover health expenses for the poor, “It would mean that the states could not make up this tremendous loss of federal dollars. There's no way especially under current fiscal conditions could sustain such a huge loss."

Medicaid pays for much of the long term care provided to seniors in nursing homes.