Great succinct post by Austin Frakt on the history of using Medicare to finance deficit reduction in various bills over the past 15 years...with the notable exception of the Medicare Modernization Act of 2003 (which created part D) which was the opposite, a deficit buster.
The cuts in future Medicare spending in PPACA are fairly large, but nowhere near as large as BBA '97. The arguments against the cuts to Medicare in PPACA being made by Republicans are schizophrenic.
"They are huge and will harm patients" AND (in the same speech) "they will never be made." Which is it?
Congress needs to be out of the weeds of the details of Medicare policy, and the moves in PPACA to develop Independent Medicare Commission and the like are a good step. To make Medicare sustainable will take a great deal of policy making. Congress is incapable of doing this well.