Presidents Health Reform Vision
The budget anticipates $844 billion in health-care savings over the next 10 years from the presidents health reform vision, a vague plan for replacing the Affordable Care Act. About $744 billion of that would come from changes to Medicaid that would end what the administration describes as the financial bias that currently favors able-bodied working-age adults over the truly vulnerable.
Under the ACA, millions of uninsured low-income people gained coverage for the first time as part of the laws Medicaid expansion. Trumps plan would end federal dollars which dwarf the states contributions possibly making some 13 million people again uninsured, if states are unable to maintain expanded eligibility, according to the Center on Budget and Policy Priorities, a Washington think tank.
The administration also suggested its health reform vision could save money through instituting greater price transparency, lowering prescription-drug prices, and ending surprise bills but the budget does not offer a plan for accomplishing those initiatives or indicate exactly how much money each could save.
According to the budget, the plan would protect the most vulnerable, especially those with preexisting conditions.” Yet at the same time, the Trump administration is supporting a Texas lawsuit seeking to do away with the ACA entirely including its popular coverage guarantee for people with preexisting conditions.
Creating Fear That Will Discourage Enrollment In Health Coverage Programs
The Department of Homeland Security and the Department of State issued immigration rules in 2019 that will make it much more difficult for people with low or modest means to immigrate to the United States or for people already here to gain permanent resident status or extend or modify their temporary status. These complicated rules, along with other Trump Administration policies, have led many families that include immigrants to forgo Medicaid and other assistance programs for which theyre eligible despite the fact that most people who qualify for the programs identified in the rules will not undergo the public charge assessment that the rules radically changed. Beginning February 24, 2020, DHS immigration officials will be able to reject immigration applicants if they have received, or are judged likely to receive in the future, any of an array of benefits, including Medicaid. Timing for the DoS implementation of the policy has not yet been announced.
A Vote For The Gop Tax Bill Is A Vote To Cut Medicare
Communications Director, Social Security Works
Do you trust Paul Ryan to protect your Medicare benefits? How about White House budget director Mick Mulvaney, a former member of the House Freedom Caucus and, like Ryan, a longstanding foe of Medicare? If the just-passed House tax bill, its Senate counterpart, or some compromise of the two is signed into law, the enactment will put Medicares future in the hands of Ryan and Mulvaney.
According to the Congressional Budget Office, the GOP tax bill will instantly trigger $400 billion in automatic cuts to Medicare in the next ten years, including $25 billion in the first year after enactment alone.
These cuts are the result of a law known as Statutory PAYGO. That law requires an automatic cut in spending when Congress increases the deficit. The tax bill is, in Donald Trumps words, a big, beautiful Christmas present for Trumps family and other billionaires. If the Republicans are successful in passing a tax bill that increases the deficit by $1.5 trillion, as they intend, the provisions of PAYGO will be activated.
To be clear: If the tax bill passes the Senate and is signed into law by Donald Trump, nothing more needs to be done to cut Medicare. If the House and Senate do nothing, the cuts take effect immediately after the end of the Congressional session and get bigger with every passing year. A vote for this tax bill is a vote to cut Medicare.
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Making It Harder For States To Finance Their Medicaid Programs
The Trump Administration proposed a rule in November 2019 that would make it harder for states to pay for their share of Medicaid costs. If finalized, the rule could require many states to change how they finance their Medicaid programs eliminating some financing options that have long been available to states. These changes would dramatically affect state budgets and could lead to significant cuts to benefits, coverage, and provider payments.
No Service Cuts But The Trust Fund Took A Hit
Protecting Medicare was was one of Trump’s earliest campaign pledges. “Save Medicare, Medicaid and Social Security without cuts. Have to do it,” he said in his presidential campaign announcement speech.
So far, the promise of Medicare remains in force. There have been no cuts in services or a change in the government’s responsibility to fund the program.
That said, Medicare’s resources to pay for those services has shrunk, and both Trump and House Republicans have proposed ways to trim Medicare spending over the next decade.
On the resources side, a side effect of the Republican 2017 Tax Cut and Jobs Act was a loss of tax dollars flowing into Medicare’s Hospital Insurance Trust Fund. That’s the main pot of Medicare money, and the Medicare Trustees forecast in their 2018 report that the fund would run out of money in 2026. A year earlier, they said it would last until 2029.
On Trump’s watch, it lost three years of solvency.
In a presentation at the American Enterprise Institute, a market-oriented think tank, the chief actuary at the Centers for Medicare and Medicaid Services, Paul Spitalnic, said two of the lost years were due to lower than expected wage growth.
But the other lost year came from the Republican tax cuts.
“The Tax Cuts and Jobs Act of 2017 decreased individual tax rates and as a result, there is somewhat less income coming into the trust fund,” Spitalnic said. “That does have an effect of making depletion of the trust fund a year earlier.”
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Trumps Plan To Defund Social Security
Permanently terminating the employee payroll tax along the lines President Trump has proposed would empty Social Securitys trust fund by 2026 or earlier.
On August 8, at his golf club in Bedminster, New Jersey, President Donald Trump announced that his administration is seeking to delay much of the payroll tax that funds Social Security1 of 4 unilateral actions he took in lieu of negotiating with Congress on meaningful economic relief legislation. The president also said that if he is reelected, he wants not only to turn the delay into a tax cut that would result in significant revenue losses for Social Security, but also to eliminate employee payroll taxes for good. As our analysis based on the Social Security trustees projections shows, eliminating employee payroll taxes along the lines that the president has proposed would, absent additional action, completely exhaust the Social Security trust fund by 2026 or earlier and result in steep benefit cuts.
people receive Social Security.
This would drain about $350$450 billion in payroll tax revenue in 2021 and more in later years.
The percentage of promised benefits recipients would receive in Social Security if the trust fund is exhausted
Based on the latest Social Security trustees projections, we estimate:
Seth Hanlon and Christian E. Weller are senior fellows at the Center for American Progress.
Democrats Say Latest Trump Budget Cuts Medicare But Its Not That Simple
Democrats didn’t wait long after President Donald Trump unveiled his budget for 2020 to call him out for cutting Medicare, a program he promised to leave untouched.
“The Trump administration wants to cut hundreds of billions of dollars from the #Medicare budget, all while giving billionaires and giant corporations huge tax breaks with the #GOPTaxScam,” tweeted Democratic presidential candidate Elizabeth Warren, D-Mass., on .
Democratic Hawaii Sen. Brian Schatz talked of $845 billion in cuts over the next 10 years.
‘It’s right there in the budget that the president released this week,” Schatz said.
Reading the summary table in the budget, Schatz has a point.
The administration projects Medicare spending that is $846 billion less than what the government would have spent if everything stayed on the same path it’s on today.
Whether that’s a cut is a more difficult question. While Democrats criticize Trump for cutting Medicare, President Barack Obama regularly offered his own version of steps to rein in the growth of Medicare. In his last budget, Obama proposed trimming spending by about $420 billion over 10 years.
The reality is, spending rises every year in Trump’s budget, except for the last one in 2029 .
Adding those dollars back reduces the total reduction to $595 billion for Medicare.
But is that actually a cut?
Most of the proposed changes target payments to hospitals and other providers and that might not affect Medicare patients.
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Is President Trump Really Proposing To Cut Medicare By $845 Billion
Copies of U.S. President Donald Trump’s fiscal year 2020 budget sit at the U.S. Government… Publishing Office. Photographer: Anna Moneymaker/Bloomberg
If you add up the proposed Medicare changes in President Trumps 2020 budget, it looks like he would cut the program by $845 billion over the next decade. Thats generated outrage from Democrats, but a closer look suggests that the reductions are much smaller, most would affect providers rather than beneficiaries, and many recycle old ideas that have little chance of ever being adopted.
Make no mistake, the Trump budget is hardly senior-friendly. Hed freeze or reduce spending for many federal senior service programscontinuing a trend that has gone on for more than a decade. And his proposed cuts to Medicaid could hurt family caregivers of parents or younger relatives with disabilities. But the Medicare cuts? There is much less there than meets the eye.
The Committee for a Responsible Federal Budget does a nice job walking through the math, and concludes that the net reduction in Medicare spending would be between $515 billion and $575 billion, not $845 billion. The White House projects that total Medicare spending over the next decade will top $10 trillion.
While even $515 billion is a lot of money, very little would directly affect beneficiaries. CRFB figures about 85 percent of the cuts would come from hospitals, doctors, skilled nursing facilities, and other providers.
Little chance of becoming law
The Payroll Tax Funds Medicare And Social Security
The federal government imposes a 15.3% levy on wages known as the payroll tax. It’s evenly divided between employers and workers, and most of it goes to fund Social Security. It also helps to finance Medicare, the federal health insurance program for people over the age of 65 and for younger Americans with disabilities.
In an , 58% of retirees said they relied on Social Security for a “major source” of their income.
Trump’s unexpected comments on Saturday came as he signed an array of executive actions aimed at providing relief to Americans during the pandemic. Among them was a deferral in the collection of payroll taxes, which he is waiving from September through the end of the year for workers earning below $104,000 a year.
But it doesn’t forgive workers’ payments outright since the power to eliminate taxes or change the tax code rests with Congress. As workers and employers are still legally on the hook to make those payments next year, experts say it’s unlikely that workers will see a bump in their wages anytime soon. Companies are more likely to continue withholding the money from paychecks.
Plus, lawmakers from both parties roundly rejected including a payroll tax cut in their stimulus proposals. Many economists say it would not benefit the 31 million unemployed Americans, either.
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Have Medicare Benefits Already Decreased Under Trump
According to the Centers for Medicare and Medicaid Services , Medicare spending has actually increased in the Trump presidency, not just in terms of dollars, which are subject to inflation, but in terms of percentages.
Some Medicare premiums also may be slightly lower now. According to CMS, the average Medicare Advantage premium 2019 is estimated to be $28 in 2019, down from $29.81 in 2018.
In terms of dollars, Medicare benefits totaled $702 billion in 2017, according to the Kaiser Family Foundation.
Press Releasetrump Administration Announces Historically Low Medicare Advantage Premiums And New Payment Model To Make Insulin Affordable Again For Seniors
Ahead of the annual Medicare Open Enrollment, the Centers for Medicare & Medicaid Services , under the leadership of President Trump, announced today that average 2021 premiums for Medicare Advantage plans are expected to decline 34.2 percent from 2017 while plan choice, benefits, and enrollment continue to increase. The Medicare Advantage average monthly premium will be the lowest in 14 years for the over 26 million Medicare beneficiaries projected to enroll in a Medicare Advantage plan for 2021. Additionally, for the first time, seniors who use insulin will have over 1,600 Medicare Advantage and Part D prescription drug plans to choose from that will offer insulin at no more than a $35 monthly copay beginning in January.
This news comes as the agency releases the benefit and cost-sharing information for Medicare Advantage and Part D prescription drug plans for the 2021 calendar year. Medicare Advantage plans are private health plans that cover all Medicare benefits plus provide additional benefits, while Part D plans are private health plans that provide prescription drug coverage for seniors. Specific highlights include:
View this chart on the Medicare Advantage premium change between 2017 and 2020 on a state-by-state basis at: .
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Extreme Cuts To Snap And Other Benefits For Struggling Families Threaten Veterans Economic Security
While veterans are a diverse group, many face challenges making ends meet and depend on various programs that help struggling families. The federal government provides guidance for veterans transitioning to civilian employment and encourages them to turn to programs like SNAP, the Women, Infants and Children program, free and reducedprice school meals, and Temporary Assistance for Needy Families if they need assistance supporting their families. Approximately 1.2 million veterans, or nearly 7 percent of the veteran population, had incomes below the federal poverty level in 2018, and many of them relied on these critical programs.
Nearly 1.3 million veterans live in households that participate in SNAP The Presidents budget cuts $292 billion over 10 years from mandatory programs that support working and vulnerable families, including $182 billion from SNAP. The cuts to SNAP are in addition to the Administrations new and proposed rules that will make more than 3 million people food insecure and make it harder for vulnerable Americans to put food on the table. A study from Feeding America highlights that approximately 20 percent of households receiving help from the charitable food assistance network include a veteran. For low-income veterans, who may be unemployed, working in low-wage jobs, or face physical and mental health challenges, SNAP and other programs provide essential support to help them meet basic needs and support their families.