No Cuts To Medicare Enacted Yet
As a presidential candidate, Donald Trump pledged that he wouldn’t cut Medicare, the federal health-care program that mainly serves Americans 65 and older.
So far, nothing has been enacted on Trump’s watch that cuts Medicare benefits, said Erin A. Taylor, a policy researcher at the RAND Corp. “To my knowledge there has been no actual policy enacted yet during the Trump administration that would cut Medicare funding in such a way as to have significant impact on beneficiaries,” she said.
However, Trump did offer a number of ideas for overhauling pieces of Medicare in his fiscal year 2019 budget proposal. Some, Taylor said, could leave Medicare beneficiaries better off, while some might not it is hard to say at this time whether the gains for beneficiaries would outweigh the losses.
Over 10 years, Trump’s 2019 budget proposal says it would cut Medicare spending by a cumulative $236 billion, including by reductions in “waste” and “fraud” and by changing the way drugs are priced and paid for in the program.
The largest cuts, Taylor said, would come from reducing Medicare’s payments for uncompensated care in hospitals and from changing payments for graduate medical education. But “the effects of these changes may trickle down to beneficiaries in terms of changes in sites of service or effects on incentives on the parts of hospitals to provide care, but those effects may not be negative,” Taylor said.
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President Trump’s proposed $4.8 trillion budget slashes billions of dollars from Medicaid, food stamps and other safety net programs in an attempt to shrink the federal deficit.
Medicaid and the Affordable Care Act see about $1 trillion in cuts over the next decade, according to The Hill. The budget eliminates the enhanced federal match for Medicaid expansion enrollees. An additional $150 billion is expected to be shaved off of Medicaid from the implementation of work requirements, which is expected to result in people losing their healthcare coverage.
The “President’s health reform vision” to ax the Affordable Care Act takes $844 billion over 10 years from the ACA, the report said.
The decrease in federal spending on Medicare would total about $750 billion over 10 years, but that includes shifting two programs out of the budget. After accounting for those changes, the reduction is just over $500 billion, according to CNN. Much of that cut comes from reducing payments to providers.
The budget needs Congressional approval and is not expected to get past a Democratic-controlled House without changes.
House Speaker Nancy Pelosi tweeted: “The budget is a statement of values. Once again, the #TrumpBudget makes it painfully clear how little the President values the good health, financial security and well-being of America’s hard-working families.”
WHY THIS MATTERS
THE LARGER TREND
Trump Promises To Cut Medicare And Social Security If He Wins A Second Term
Trump was asked at Davos if cutting entitlements will ever be on his plate, and he said they would be if he wins a second term.
In an interview with CNBC, Trump said, At some point, they will be. We have tremendous growth, were going to have tremendous growth. Next year, it will be towards the end of the year, the growth is going to be incredible, and at the right time, we will take a look at that. You know, thats actually the easiest of all things, because its such a big percentage.
Trump was lying about the projected growth. Economic growth is projected to slow in 2020 to 1.9% according to projections by the Chicago Federal Reserve.
Trump is saying that if he wins a second term, he is going to cut Social Security and Medicare.
The president wants to cut Social Security and Medicare to pay for another round of tax cuts for the wealthy.
Frank Clemente, executive director of Americans for Tax Fairness said in a statement provided to PoliticusUSA, President Trump and the GOP cant seem to help themselves: their core goal is to cut taxes for the rich and corporations, then turn around and try to pay for those cuts by slashing vital public services working families depend on and have spent years paying into. But this time the American people are wise to the trick and wont put up with it.
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Other proposals would cut down on reimbursement rates to healthcare providers, reducing how much doctors, hospitals, and hospices are paid for providing healthcare. Cutting Medicare reimbursement rates is a controversial strategy in the past, its received both support and criticism from Democrats and Republican alike. Some say cutting reimbursement rates saves taxpayers money by cutting into medical industry profits. And the Trump administrations budgets highlights specific instances where they believe reimbursement rates for doctors are excessive: for example, they cite the fact that doctors offices owned by hospitals are often paid more for performing the same procedures than independent physicians.
But cutting reimbursement rates also means that some seniors could lose access to their favorite doctors. Dan Adcock, director of government relations at the National Committee to Preserve Social Security and Medicare, said of the cuts to Medicare, he was most worried about the lower reimbursement rates. When reimbursement rates decrease, “you start to affect access, because doctors decide they can’t make a decent living,” said Adcock.
The Budget Takes Aim At Social Security Disability Insurance
Trumps proposed budget contains a number of changes to Social Security Disability Insurance . SSDI is a federal program that protects workers who develop a life-changing disability after having paid into the fund by earning work credits.
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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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Taking Scissors To Safety Net
That sinking feeling youll get if Donald Trump is elected to a second term will be caused by plummeting through the hole in your safety net. The one he plans on cutting.
Social Security snip, snip.
Medicare snip, snip.
Medicaid snip, snip.
In his most recent town hall among some friendly hosts from FOX News the president was asked about plans for his next term, should he be reelected. He spoke of how he believes the economic growth will be tremendous. One of the hosts cut in, saying, But if you dont cut something in entitlements
And Trump interrupted, saying, Oh, well be cutting.
The presidents mostly silent press secretary, Arizonas own Stephanie Grisham, tried to soften the blow by asking people not to hear what they actually heard, tweeting, Fake news POTUS was taking about cutting deficits, NOT entitlements.
He was talking about cutting entitlements.
And it isnt the first time hes said this.
Trumps New Budget Proposal Slashes Medicaid Medicare Pesky Cdc Funding
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On Monday, Donald Trump unveiled his budget proposal for 2021, a submission that is less an order than it is a window into the presidents fantasies, given that it must be approved by Congress, which has historically rejected the White Houses budgets. Still, its a great opportunity for Americans, particularly those who may run against the president for office this fall, to see what sort of cuts he would put in place if there were nothing to stop him from acting on his basest instincts. And if you guessed that when left entirely to his own devices, the president would gut spending for the most vulnerable members of the nation, you guessed right!
During the last year President Barack Obama was in office, the deficit was less than $600 billion, but it has grown significantly since then.The 2017 GOP tax cuts and new domestic spending approved by bipartisan majorities in Congress have widened this gap markedly. However, the Trump administrations new budget summary contains the line: All administration policies will pay for themselves, including extending tax cut provisions expiring in 2025. Without action by Congress and the administration, tax cuts for families and individuals would expire at the end of 2025. Budget experts have projected that extending those tax cuts would reduce revenue by roughly $1 trillion.
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Recurring Theme: Cut The Safety Net
Then, theres Trumps own budget, as explained by a conservative Wall Street Journal article:
“The White House proposes to cut spending by $4.4 trillion over a decade. Of that, it targets $2 trillion in savings from mandatory spending programs, including $130 billion from changes to Medicare prescription-drug pricing, $292 billion from safety-net cuts such as work requirements for Medicaid and food stamps and $70 billion from tightening eligibility access to federal disability benefits.”
The president has said this stuff again and again.
Believe him and know this:
While youre hanging by a thread, hes oiling up the scissors.
Democrats Have Already Signaled Trumps Budget Is Going Nowhere
While Trump tries to have it both ways by proposing entitlement cuts while claiming hes not really doing that, Treasury Department spokesperson Monica Crowley was somewhat more straightforward during a Monday morning appearance on Fox Business.
Asked by host Stuart Varney if she agrees that the new budget hits the safety net, Crowley said the president understands that Washingtons habit of out of control spending without consequence has to be stopped.
Treasury Secretary Assistant Sec. Monica Crowley defends cuts to entitlements in Trump’s new 2021 budget proposal: “The president also understands that Washington’s habit of out of control spending without consequence has to be stopped.”
But for Trump, not all spending is bad. While his budget cuts non-defense spending by 5 percent, he actually slates defense spending for an increase to $740.5 billion for fiscal year 2021.
Budget proposals are just that proposals. And while Trump insists that Republicans are the ones trying to save entitlements from destruction, the irony is that the truth is exactly the opposite: Entitlement cuts are dead on arrival as long as Democrats control a chamber of Congress.
House Budget Committee Chair John Yarmuth alluded to this reality in a statement he released on Sunday blasting Trump for proposing deep cuts to critical programs that help American families.
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Despite Promises Trump Takes Aim At Social Security Medicare
“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Donald Trump in 2015. “Every other Republican’s going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do. I do.”
As regular readers may recall, this became a staple of his entire national candidacy: no matter what, Americans could count on him to champion these social-insurance programs. Ahead of the 2016 race, Trump wanted everyone to know that entitlement cuts, as far as he was concerned, are off the table.
A few weeks ago, however, the Republican started hedging. Over the weekend, referring to the new White House budget, Trump’s promise not to cut Social Security, Medicare, or Medicaid quietly lost one of its three pillars. He tweeted, “We will not be touching your Social Security or Medicare in Fiscal 2021 Budget.”
Part of the problem is that the president quietly scrapped a prong from his three-pronged promise. The other part of the problem is that Trump’s newest boast isn’t true, either. As the Washington Postreported:
According to Republican rhetoric from the last decade, removing nearly a half-trillion dollars from Medicare through cuts to providers necessarily counts as “cutting” Medicare.
Don’t be surprised if Democrats exploit this opportunity for the next several months.
Trump Broke This Promise From The Beginning
This is Trump on the campaign trail in 2015:
I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid. Huckabee copied me.
Donald J. Trump May 7, 2015
Trumps budgets and the policies he has supported around health care and government spending in Congress reflect the opposite. Some of this can be attributed to Trumps appointed budget chief Mick Mulvaney the former Congress member who was part of the ultraconservative Freedom Caucus has long rallied for cutting Medicare, Social Security, and Medicaid.
In fact, Mulvaney once bragged to a Politico reporter that he tricked Trump into accepting a proposal to cut Social Security by calling SSDI just disability insurance spinning it to the president as general welfare reform. The idea has been in every single one of Trumps budget proposals to Congress since the president came to office.
Then there was the Republican Obamacare repeal push every bill proposed massive cuts to Medicaid in order to pay for tax cuts elsewhere. Trump supported every iteration of Republicans Obamacare repeal-and-replace bills. He even held a party for House Republicans in the White House Rose Garden when the lower chamber of Congress narrowly passed a proposal that slashed more than $800 billion from Medicaid over 10 years.
Now his policy positions around those programs break from that promise.
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