Paul Ryan’s new Medicare proposal bears some striking resemblances to his earlier plan, passed by the House in April. There is one noticeable difference, though — Democratic support. Written together with Sen. Ron Wyden (D-Ore.), the proposal includes a cap on total Medicare spending and paves the way for more private competition among service providers. Wyden says the plan protects Medicare patients from premium increases that would put services out of reach for many seniors, a major concern with Republican fixes in the pass, though his fellow Democrats aren’t so sure. “We are concerned that Wyden-Ryan, like Congressman Ryan’s earlier proposal, would undermine, rather than strengthen, Medicare,” White House Communications Director Dan Pfeiffer said in a statement.