Nearly half of Medicare recipients have incomes at or below 200% of poverty -- $21,780 for an individual, $29,420 for a couple. At a time of growing concern about federal deficits and the national debt, few dispute the need to take on Medicare. The health insurance program for seniors and others with certain disabilities already accounts for 15% of the federal budget -- behind only Social Security and defense spending. And that share is expected to rise as healthcare costs continue their upward spiral and more baby boomers retire, threatening the long-run solvency of Medicare. Yet several of the most prominent solutions under discussion largely derive their savings by shifting a greater share of the cost onto beneficiaries.