President Obama’s call to reduce Medicare and Medicaid spending by an additional $200 billion to $300 billion over the next 10 years to help finance health care reforms will “absolutely not” affect coverage, benefits or quality of care for Medicare beneficiaries, says Nancy-Ann DeParle, director of the White House Office of Health Reform.

Older Americans “can rest assured these are proposals that will help strengthen the Medicare Trust Fund and strengthen the Medicare program for beneficiaries,” DeParle said yesterday in an interview with the AARP Bulletin

Obama originally had called for cost savings in Medicare and Medicaid totaling $309 billion over 10 years.

But in a letter last week to the heads of two Senate committees working on health care legislation, the president suggested squeezing an additional $200 billion to $300 billion from the programs, for total savings of up to about $600 billion. The new savings, Obama said, would come through such measures as better management of chronic diseases, elimination of duplicate tests and providing more preventive care.

“We were very careful to look at proposals that would improve quality, eliminate waste, fraud and abuse and align incentives towards quality care and health outcomes,” DeParle says.

Critics contend that savings from those measures are uncertain.

Obama’s first plan for reducing spending by $309 billion included savings from cuts to what the government pays private insurers to cover about one in five Medicare beneficiaries. The private Medicare Advantage plans have been a favorite target of Democrats because the government pays those plans an average of $1,000, or 14 percent, more per beneficiary a year than it pays for traditional Medicare.

In the June 3 letter to Sen. Edward M. Kennedy, D-Mass., and Sen. Max Baucus, D-Mont., Obama also said he was open to requiring all Americans to buy health insurance, as long as any such plan includes “hardship waivers” to exempt poor people who simply cannot afford it.

DeParle says that in Massachusetts, where residents are now required to have health insurance, a hardship waiver is offered, but “very few people have actually taken advantage of it. Remember there will be subsidies for the poorest people in this new insurance program.”

The Senate Finance Committee, chaired by Baucus, is considering the hardship waiver, as well as tax credits for certain individuals so they can afford health care.

Kennedy and House Democrats are considering giving subsidies to the poor to help pay for insurance.

In his letter, Obama reiterated his support for a government-sponsored public insurance plan that would provide a safety net for people without coverage. The plan would compete with private insurers to help people get affordable coverage. This less-expensive alternative to private insurance could be of great help to people in their late 50s and early 60s who have lost employer insurance and are not yet eligible for Medicare, proponents argue.

“The public plan is something that we think helps strengthen the system and adds to the choices that are available to people,” DeParle says.

Republicans in Congress argue that a public plan is the first step toward national insurance.

Barbara Basler is a senior editor with the AARP Bulletin.