Ironically, however, Republicans may also seek to upend some of the reforms aimed at reducing wasteful spending put in place by Democrats. Republicans have decried the Independent Payment Advisory Board, which is tasked with identifying opportunities for cost-cutting. They have also demanded the end of pilot programs that are geared toward replacing the fee-for-service reimbursement model with one that pays providers based on the outcomes of entire episodes of care, such as knee replacements.

Ryan's long-time hope to turn Medicare partially or entirely into a voucher program has earned plaudits in conservative policy circles but fierce opposition from Democrats, the AARP and unions.

However, if the rhetoric of the president-elect throughout the campaign to be taken at face value, he does not support any Medicare privatization plan. In fact, Trump lashed out at primary opponents who entertained support for getting rid of Medicare as we know it and he repeatedly promised supporters that he would not back any cuts in Medicare or Social Security benefits.

Some suggest, however, that Trump is shifting his position on the issue, pointing to his transition website, which now says he supports "modernizing Medicare." That could theoretically mean any number of things, but the terminology aligns with what Ryan has been saying for years.