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CNN.com: Pelosi: The Truth About Medicare

Editor's note: Nancy Pelosi, the first woman Speaker of the House, is the House Democratic Leader.

The first presidential debate highlighted a clear choice on Medicare: President Obama's vision, guaranteeing the fundamental promise of Medicare for seniors today and into the future, versus Mitt Romney's blueprint for the eventual destruction of Medicare as we know it.

Ahead of the next presidential debate tomorrow in New York, it is important to make clear that either the Republican nominee does not know the facts or was willing to deceive the American people with false claims. Romney repeated the standard Republican falsehood that the Affordable Care Act cut $716 billion for Medicare beneficiaries. That is not true, and they know it.

Here are the facts, supported by independent critics, and they are indisputable:

The Affordable Care Act extends the life of Medicare by nearly a decade by reducing the rate of increase in payments to health care providers, by reducing costly taxpayer subsidies to insurance companies, and by reducing waste, fraud and abuse. The law requires hospitals to improve their quality of care, reduce infections and re-admissions, and increase efficiency. It places a premium on value, not volume, in medical procedures.

The Affordable Care Act does not cut a single benefit or add a single penny to the cost of insurance for any Medicare beneficiary. Even before the law fully takes effect, seniors are experiencing the benefits. The gap in prescription drug coverage -- the so-called "doughnut hole"-- is starting to close, and more than 5.5 million seniors have saved an average of more than $600 each year on prescription drugs. All 49 million Medicare enrollees now have access to free wellness visits, checkups without a co-pay, and free preventive care services like mammograms and other cancer screenings.

Romney claims that if you're 60 or older, "you don't need to listen any further." Actually, seniors need to listen carefully -- very carefully -- because Medicare will be bankrupt by 2016 under the Romney-Ryan plan.

According to a report last month from the Center for American Progress Action Fund and co-authored by Harvard economist David Cutler, the Romney blueprint would cost today's senior more than $11,000 during retirement and force them to pay more for prescriptions and premiums, while cutting off access to critical services and benefits.

Republican Newt Gingrich has said that Medicare will "wither on the vine." Republicans have been developing and pursuing this agenda for two decades -- an effort to take our country back to the era before Medicare, when tens of millions of seniors were impoverished by health costs.

It's not just today's seniors who should listen carefully to Romney's plan. For those under age 55, the Republican proposal is a voucher plan that ends the Medicare guarantee.

As the AARP made clear, the Republican proposal risks "simply increasing costs for beneficiaries while removing Medicare's promise of secure health coverage -- a guarantee that future seniors have contributed to through a lifetime of hard work."

AARP's words echo those of President Lyndon Johnson's on the day he signed the Medicare bill: "No longer will older Americans be denied the healing miracle of modern medicine. No longer will illness crush and destroy the savings that they have so carefully put away over a lifetime so that they might enjoy dignity in their later years. No longer will young families see their own incomes, and their own hopes, eaten away simply because they are carrying out their deep moral obligations to their parents, and to their uncles, and their aunts. And no longer will this nation refuse the hand of justice to those who have given a lifetime of service and wisdom and labor to the progress of this progressive country."

That's what President Obama and Democrats are fighting to preserve: the American Dream that says, if you work hard, play by the rules, and take responsibility, anyone can succeed, support his or her family, and look forward to a secure retirement. Voters, be aware this year: Medicare is on the ballot, and its future is in jeopardy. Democrats created Medicare and will always fight to strengthen it for our seniors and for their families. And under President Obama's leadership we are moving forward.