“Fact: Trump announced a budget to cut Social Security and Medicare every single year he was in office.”
— tweet by the Harris-Walz campaign, Aug. 14
“Remember he tried to cut Medicare every year he was president, threatening a program that tens of millions of seniors count on.”
— Vice President Kamala Harris, remarks in Raleigh, N.C., Aug. 16
Expect to hear some version of these claims throughout the Democratic National Convention and for the rest of the election season. Donald Trump has repeatedly said he will not touch Social Security and Medicare if he is reelected, despite a financial crunch in the coming decade, and this attack line is intended to show that his promise cannot be trusted.
Trump has rarely been consistent on policy, so it’s a matter of opinion whether he would keep his promise. But this attack is misleading. His proposed “cuts” to Medicare in the budgets for the fiscal years 2018, 2019, 2020 and 2021 were intended to save money and extend the solvency of the program — and were mostly borrowed from the Obama administration. Trump also did not propose changes to Social Security retirement benefits in those budgets; instead he sought (relatively minor) savings from the Social Security disability program.
Let’s look in more detail.
The Facts
Both political parties make misleading claims about Medicare “cuts,” depending on which party holds the presidency.
The game is played this way: When a president’s budget is released, politicians from the opposing party will claim that any difference over 10 years between anticipated Medicare spending (what is known as the “baseline”) and changes in law intended to reduce spending are devastating “cuts” that will harm seniors who rely on the old-age program.
Politicians (and reporters) usually discuss the numbers —“$350 billion in cuts” — with little context. Medicare is such a huge program — more than $10 trillion over 10 years — that a figure like that amounts to a relatively small percentage.
The overheated rhetoric also ignores this reality: Virtually all of these anticipated savings would be wrung from health providers, not Medicare beneficiaries. Hospitals and doctors object, sometimes vehemently, but often these are good-government reforms intended to make Medicare run more efficiently and with lower costs.
Given the strength of hospital and doctor lobbies, it’s difficult to enact such changes. Barack Obama borrowed a lot of his ideas for squeezing providers from George W. Bush’s budgets. Then Trump borrowed Obama’s unfilled requests — such as charging the same rate for office visits whether a doctor works at a hospital or elsewhere — and put them in his budgets. Trump didn’t have much luck either. In any case, even if provider cuts are enacted, Congress later will sometimes halt or reduce the changes in response to political pressure.
Marc Goldwein, senior vice president at the nonpartisan Committee for a Responsible Federal Budget, which seeks to lower the budget deficit, closely studied the Trump proposals each year.
“The basic argument here is quite ridiculous,” he said of the Harris-Walz campaign tweet. Goldwein noted that the Inflation Reduction Act, in which Harris cast the tiebreaking vote for passage, also reduced health-care costs for Medicare, such as through inflation caps. “By the same logic, you could say Joe Biden cut Medicare.”
The budget group in 2019 estimated that 85 percent of Trump’s proposed Medicare savings came from provider reductions, “many of which closely resemble or build upon proposals made in President Obama’s budgets” and would lower costs for seniors. “Another 5 percent of the savings, by our estimate, would come from policies that reduce overall health care costs and improve Medicare’s finances as a side effect.” The remainder of the savings came from the benefit design for Medicare’s prescription drug program, which the group said would reduce costs for some seniors (especially those using generic drugs) and increase it for others.
The Center for Budget and Policy Priorities, a left-leaning group that studies the impact of budget policies, broadly agreed with that assessment in 2020, noting that some of the ideas to address overpayments to providers were borrowed from the Medicare Payment Advisory Commission, a congressional agency.
“Most of these proposals would have reduced payments to providers and not affected beneficiaries directly. Most are also repeats from prior years, since they were not enacted,” said Paul N. Van de Water, a senior fellow at the center who specializes in Medicare and Social Security, in an email.
Van de Water said he believed that an executive order on Medicare issued by Trump in 2019 would have weakened Medicare and its financing, especially its promotion of private Medicare Advantage plans and a proposal to increase payments to providers. But those proposals were not contained in the budget.
Just over half of Medicare beneficiaries are enrolled in Medicare Advantage, compared to traditional Medicare, which is run by the government and favored by Democrats. The Project 2025 plan issued by the Heritage Foundation — which Trump has sought to distance himself from but which was engineered by many former Trump administration officials, among others — recommends promoting Medicare Advantage plans.
As for Social Security, Trump kept his promise not to touch retirement benefits, bucking longtime efforts by Republicans to raise the retirement age. (In a 2000 book, “The America We Deserve,” published when Trump sought the presidential nomination of the Reform Party, Trump also made an emphatic case for a higher retirement age.)
But Trump did seek, without success, to reduce spending for Social Security Disability Insurance as well as Supplemental Security Income, which is administered by the Social Security Administration. The number of people who receive disability benefits, 8.5 million, is one-seventh the size of the pool who receive retirement and survivor benefits.
Goldwein said that the reductions generally were intended to make the programs more efficient, such as eliminating double payments of both unemployment insurance and disability (also sought by Obama). He also said the proposals were relatively small.
“The President’s budget identifies programmatic changes that would reduce Social Security spending by $25 billion, or less than 0.2 percent over a decade,” the Committee for a Responsible Budget wrote in 2018. “Importantly, most of these changes are meant to reduce overlapping or improper payments and address certain inequities in the program. … Just over half of the savings come from policies also proposed by President Obama in his own budgets.”
The fiscal 2019 budget also claimed it would get another $48 billion in savings from vague pilot programs intended to reduce disability spending, but that was dismissed as a budget gimmick. The Congressional Budget Office concluded no savings would result.
Still, the Center for Budget and Policy Priorities said some of the proposals, never implemented, could have cut in half the retroactive benefits that disabled workers may receive — a potential $7,500 average loss — and would have reduced benefits for families in which more than one member qualifies for SSI.
In response to our findings, Harris-Walz campaign spokesperson Joseph Costello defended the tweet’s phrasing, citing a Washington Post report published during the GOP primary campaign that said each of Trump’s White house budget proposals “included cuts to Social Security and Medicare programs.” (The Post article, which examined various GOP candidates’ past positions, did not explain that those proposed Trump White House program cuts primarily affected providers, not beneficiaries.)
“Donald Trump has repeatedly attempted to cut Social Security and Medicare after repeatedly promising the American people that he won’t cut those exact programs,” Costello said in a statement. “In his 2016 campaign, he pledged, ‘I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare.’ But sure enough, as president, just ‘like every other Republican,’ Donald Trump tried to cut Social Security and Medicare. So no matter how much he lies today, Trump’s own record makes clear that he will gut critical benefits for millions of Americans if he takes power.”
The Pinocchio Test
The Harris-Walz campaign is being disingenuous and misleading. Virtually all of Trump’s proposed Medicare “cuts” were good-government efforts intended to reduce costs and put the program on a sounder financial footing, with some ideas even borrowed from Obama. The campaign has a slightly stronger case for claiming Social Security cuts, as Trump proposed some changes in programs for people on disability. Still, they were relatively minor. Trump kept his promise not to mess with retirement and survivor benefits — the core of Social Security.
This rhetoric is worthy of Three Pinocchios.
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