Trump Medicare promise causes heartburn for GOP

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Time and again on the campaign trail, Donald Trump pledged to his supporters that he wouldn’t gut Medicare as president.

Trump’s incoming chief of staff, Reince Priebus, doubled down on that position over the weekend, insisting that his boss wouldn’t “meddle” with Medicare or Social Security.

But a week before Trump’s inauguration, that campaign promise is already encountering fierce resistance from Republicans on Capitol Hill. For years, GOP lawmakers — led by Speaker Paul Ryan (Wis.) — have been sounding the alarm that a major overhaul to Medicare and other entitlements are needed to ensure they don’t go bankrupt.

That the Trump team is insisting it won’t tackle these reforms is troubling to some fiscal hawks on the Hill, including members of the conservative House Freedom Caucus.

{mosads}“Math and demographics dictate that we deal with Medicare. What you can’t say is, ‘We’re going to address the nation’s budget. We’re going to get our financial house in order,’ and then not address entitlements,” GOP Rep. Mark Sanford, a Freedom Caucus member and former South Carolina governor, told The Hill. “The longer we wait, the harder the problems become … I hope that [Trump] takes a look at the compelling math.”

Lacking any significant entitlement reforms, the GOP’s fiscal 2017 budget will add $10 trillion to the nation’s debt over the next decade, Sanford explained — a situation he called “catastrophic for the American taxpayer and for those who care about the national debt.”

Across the Capitol, Sen. Rand Paul (R-Ky.), a onetime presidential rival to Trump, called it “inexcusable” that his own party would push through a budget that didn’t rein in entitlement spending. He offered his own budget blueprint that targets entitlements and balances in five years, though it was rejected by the Senate.

It’s not just those on the far right of the Republican Party pushing for Medicare reforms. A central tenet of Ryan’s perennial budgets when he was writing them was a move toward privatizing Medicare, resulting in steep benefit cuts.

“We intend to try to save Medicare from insolvency, and we’ll be working to that end,” said Rep. Lynn Jenkins (R-Kan.), who previously served on Ryan’s GOP leadership team and is a member of the Ways and Means Committee, which has jurisdiction over Medicare.  

“If we don’t do anything, then those two [entitlement] programs fail,” added another senior House Republican who didn’t want to be identified criticizing Trump. “And when they fail, I wouldn’t want to be around here when that happens.”

A central Medicare trust fund is projected to run out of money by 2028, Obama administration officials warned last year. Some payment reforms in ObamaCare have helped slow down Medicare spending, but the threat of insolvency could be accelerated after Republicans repeal the healthcare law.

Small Business Chairman Steve Chabot (R-Ohio) said he didn’t know if the president-elect fully understood the scale and scope of the Medicare problem. But the only way to make structural reforms to fix entitlement programs is if Trump gets on board, the chairman argued.

“We can’t do that without Trump being with us. There is not a way we can do it on our own,” Chabot said in an interview. “The Democrats will be obstructionists, so if you don’t have the White House, you can’t make those changes.”

Chabot and other Hill Republicans said they plan to make the case to the new administration that ignoring the problem could cause the program to collapse, resulting in a far worse situation for senior recipients.

And they’re encouraged by what some of Trump’s key Cabinet picks could mean for future entitlement reform. Ryan’s successor as Budget chairman, Rep. Tom Price (R-Ga.), sought to overhaul those entitlement programs with the same gusto as the Speaker; Price is now Trump’s pick for Health and Human Services secretary.

Meanwhile, Trump tapped Rep. Mick Mulvaney (R-S.C.), a fiscal hawk and Freedom Caucus co-founder, to lead his White House budget office.

“Mick Mulvaney knows these numbers well, and it will be very interesting to see his ability to push policy within the Trump administration, because I think he is knowledgeable on this subject,” said Sanford, who serves with Mulvaney in the South Carolina delegation. “He recognizes the absolute mathematic need and demographic need for change.

“And how the administration responds will be an early indicator of how Trump listens to his own Cabinet members and to his own White House.”

So far, however, Trump has signaled he has no plans to renege on his repeated campaign promise to leave Medicare untouched.

“I don’t think President-elect Trump wants to meddle with Medicare or Social Security,” Priebus said Sunday on CBS’s “Face The Nation.” “He made a promise in the campaign that that was something that he didn’t want to do.”

In fact, the Washington Post compiled a video of the countless times Trump vowed to “save” Medicare, Medicaid and Social Security “without cuts,” while getting rid of any fraud, waste and abuse.

“Every Republican wants to do a big number on Social Security. They want to do it on Medicare. They want to do it on Medicaid. And we can’t do that,” Trump said in 2015. “And it’s not fair to the people who’ve been paying in for years.”

Rep. Chris Collins (R-N.Y.), Trump’s liaison to Capitol Hill, acknowledged that “ultimately” the new president will have to do something to shore up the Medicare and Social Security trust funds, saying they soon will be “empty.”

But Collins doesn’t expect Trump to tackle longer-term entitlement reforms during his first year in office given the already busy congressional calendar.

“Right now, ObamaCare is the topic of the day,” Collins told The Hill. “With what we need to do with ObamaCare repeal, replace, fundamental tax reform, infrastructure, I don’t see that as this year’s priority to tackle the decades-long problem of actually fixing and shoring up the looming deficits in Medicare and Social Security.”

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