President Trump ran his 2016 presidential campaign on a few huge promises to voters, including a vow to leave Medicaid, Medicare, and Social Security untouched, but now an outline for the 2020 budget shows cuts to all three.
Back in 2015, Trump told the conservative Daily Signal, “I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid” but Trump’s long term plan shows spending to be $1.5 trillion LESS on Medicaid over the next 10 years, $25 billion LESS on Social Security, and $845 billion LESS on Medicare. Sounds a lot like those cuts he promised not to make.
The Trump administration has tried to ease the public into these cuts by conveniently dropping the “Medicaid” portion of Trump’s promise, suggesting, for example, in a statement from the Office of Management and Budget Deputy Director Russ Vought, that the president is “keeping his commitment to Americans by not making changes to Medicare and Social Security.” But it’s simply not true. While Trump made the direct claims that he would not be like “every other Republican” in making cuts to those programs, it’s clear to see he has and will continue to cut them as he sees fit.
Vought said, “He’s not cutting Medicare in this budget,” and continued, “What we are doing is putting forward reforms that lower drug prices. Because Medicare pays a very large [share] of drug prices in this country, [that] has the impact of finding savings. We are also finding waste, fraud, and abuse.”
But let’s be clear, the 2020 budget wants to somehow find $845 billion from Medicare over the next decade, but $269 billion of that is going to be listed under the Department of Health and Human Services so it looks like there are only $575 billion in cuts to Medicare. Now, the administration claims it will eliminate excess spending and provider payments as well as cut costs to Rx drugs to achieve this figure.
The Committee for a Responsible Federal Budget thinks that changes to provider payments, medical malpractice, and drug costs will be the way to achieve the proposed budget number. They also estimate that Medicare Part D drug costs to some patients will increase even as it lowers for others. It’s no surprise that many organizations are going to speak out against these cuts. The Federation of American Hospitals says this specific part of Trump’s plan is “devastating for seniors.”
Trump has made lots of threats to repeal Obama’s Affordable Care Act and the 2020 budget as he is proposing it would, indeed, repeal one of the ACA’s most successful parts, the Medicaid expansion. The ACA’s Medicaid expansion led to a drop in the number of uninsured people in states that adopted the policy, and shows promise in even conservative states.
Moreover, Trump would like to adopt something called a “Market-Based Health Care Grant”, a $1.2 trillion program, which would take the current pay-as-needed system and change it into a system that sees states given a lump sum block grant- one that doesn’t fluctuate based on need or changing costs.
The proposed budget also sees $25 billion in cuts to Social Security benefits, including cuts to a programs that help Americans with disabilities who cannot work.
Despite his campaign promises, the Trump administration’s budgets and policies have shown his true colors, particularly reflected in the appointment of Trump’s budget chief Mick Mulvaney, who has a long history of supporting cuts to Medicare, Medicaid, and Social Security. Mulvaney is on record saying that he tricked Trump into proposing Social Security cuts just by calling Social Security a different name- welfare- and getting the President on board with that.
Furthermore, Trump has supported every repeal and replace idea Republicans have offered, even hosting a party for House Republicans in the White House Rose Garden when a proposal passed that would cut more than $800 billion from Medicaid over the next decade.
but sincTrump rolled out the red tape around the federal programs of Medicare, Medicaid, and Social Security during his 2016 presidential campaign because they are enormously popular and proposed cuts to them would have potentially alienated a large portion of voters. Now, however, it seems he’s willing to break any and all promises as he attempts to secure 4 more years in office.