What's missing from Paul Ryan's new budget plan?

Rep. Paul Ryan (Wis.), the Republican Party's de facto leader on fiscal issues, on Tuesday released details of the House GOP's budget-deficit plan, a sweeping proposal that would dramatically reduce the size of government and overhaul health insurance programs that millions of Americans rely on. But for such a radical document, the consensus is that it looks awfully familiar — to the plan that Mitt Romney and Ryan ran on when they lost the presidential election last November.

Ryan's plan would cut spending by $4.6 trillion over 10 years, transform Medicare into a voucher program, and fund Medicaid through block grants, which would gives states greater control over the program's administration. The plan would balance the budget by 2023, all with no new taxes. In addition, Ryan's budget would repeal President Obama's health care reform law, scaling back an expansion that is designed to provide basic care to 40 million uninsured Americans.

The plan's similarity to the one rejected by voters in November took some commentators aback. "Like some sad fiscal remake of the movie Groundhog Day, this is also the same as Ryan's 2012 'Path to Prosperity' budget, and very much like Ryan's 2010 'Roadmap for America's Future' budget, only with a repeal of ObamaCare mystifyingly included," writes Heidi Moore in The Guardian.

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Ross Douthat of the New York Times complains that it's a step backwards, "a document that's arguably more unrealistic than the previous versions of the Ryan budget, and that does little or nothing to bridge the gap between the Congressional GOP and the electorate that just re-elected Barack Obama."

Democrats have already started attacking Ryan over the proposed changes to Medicare, namely a switch to a "premium support" model that would give seniors subsidies to buy their own health insurance on the private market. As Rick Newman of U.S. News & World Report writes, it would "only cover part of the premiums, forcing seniors to pay the difference, which would be a sizable expense."

But for all the budget's dramatic changes, Ryan left some programs entirely intact. Social Security, as the Washington Post's Ezra Klein points out, was apparently too hot to handle:

And defense spending, another budget gobbler, was also spared, apparently at the expense of a host of programs. According to Lori Montgomery at The Post:

That Ryan would leave out Social Security and the Pentagon has riled both liberals and conservatives, though for different reasons. As Derek Thompson at The Atlantic writes:

On the other side of the political spectrum, the Heritage Foundation takes Ryan to task for not being bold enough with his cuts:

Still, it's a remarkably conservative document coming so soon after the election, and more evidence that the Republican Party remains committed to its core fiscal message despite calls from some conservative commentators for reform.