Maybe you thought that when Donald Trump was running for president and promised not to cut Social Security, Medicare, and Medicaid, he meant he’d refuse to reduce the benefits Americans are entitled to under the three programs.
It looks more and more like that wasn’t true at all.
Trump stood out from the rest of the Republican pack for his explicit, repeated pledges not to cut entitlements. Here’s what he tweeted in May 2015 before he was officially a candidate:
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 (@realDonaldTrump) May 7, 2015
Likewise, in his campaign kickoff speech the next month at Trump Tower, Trump proclaimed that he would “save Medicare, Medicaid and Social Security without cuts.”
But what was Trump actually saying?
Most Trump voters, and most Americans, surely assumed that he meant that he would refuse to cut the promised benefits under all three programs.
For instance, someone born in 1970, who made an average of $60,000 per year, and retires in 2037 at age 67 is scheduled to receive a bit under $2,000 in Social Security benefits per month.
During the campaign it seemed clear Trump meant he wouldn’t cut those $2,000 in benefits. As he put it, “I’m not going to cut [Social Security] at all; I’m going to bring money in, and we’re going to save it.” (This was not a reckless claim by any means; increasing Social Security revenue to meet promised benefits would be simple and relatively painless.)
But that was then, and this is now.
Recent statements by both Trump and his White House have made clear that he only considers a program to have been “cut” if the overall, absolute level of spending on the program goes down.
Here’s how Trump explained it on Twitter, talking about the fate of Medicaid under the Senate GOP’s Better Care Reconciliation Act:
Meanwhile, a White House blog post made the same case at greater length. We need to “break the beltway mentality,” it said, because “only in Washington would anyone have the nerve to claim an 18 percent increase in government spending on top of inflation is a ‘cut.’”
It is true that under the GOP’s Senate bill that federal spending on Medicaid would go up from $393 billion this year to $458 billion in 2026.
The problem is that it’s projected to require $616 billion in 2026 to pay for current promised Medicaid benefits (including nursing home care, for which Medicaid is the primary source of funding). So spending just $458 billion that year would require cutting those promised benefits by about 26 percent.
The reason Medicaid spending is set to increase so much isn’t because it’s a profligate program that blows wads of cash on solid-gold ventilators. In fact, Medicaid is notoriously frugal. The projected increase in costs is driven by the aging of the U.S. population and an anticipated expansion of Medicaid in additional states.
And logically, Trump’s definition of what it means to “cut” Medicaid applies in exactly the same way to Social Security and Medicare.
The Congressional Budget Office currently projects that spending on Social Security’s Old Age and Survivors Insurance will increase from $762 billion in 2016 to $1,371 billion in 2026. This will happen, again, not because Social Security is so incredibly generous but because there will be many more Americans eligible to receive it. But if Trump signed a bill cutting Social Security benefits by the same amount as the Senate wants to cut Medicaid by 2026 — 26 percent — we would still be spending over $1 trillion on Social Security in 2026, far more than today.
The same goes for Medicare. The federal government spent $588 billion on it in 2016, but projects that it will need $1,079 billion to cover it in 2026. This will be due both to the aging of the U.S. population and increasing healthcare costs. That could be cut by 26 percent in 2026 and still be far more than it costs now.
According to Trump the candidate, cuts of these magnitude would be catastrophic. The people on the other end of those cuts would undoubtedly agree.
The White House did not respond to a request for clarification about whether Trump’s perspective on cutting entitlement programs does in fact apply beyond Medicaid.
However, Max Richtman, president of the National Committee to Preserve Social Security and Medicare, was willing to address the issue. “The reality for Social Security beneficiaries receiving a smaller social security check,” says Richtman, “or seniors paying more for Medicare than under current law, is a painfully obvious cut and would be contrary to President Trump’s repeated campaign promises.”
The quickest way to unveil the gimmick at work here is to look at how Trump has talked about Social Security from a different angle. The CBO projects that the program’s reserve fund will only last until 2029, after which it could only pay out what it took in in taxes — now estimated to be about 71 percent of benefits owed. (Of course, any Congress that allowed that to happen would be thrown out of office en masse.) Trump in his first official speech, had a word for what the program would look like if that 71 percent were delivered: “destroyed.”
But even at 71 percent, total, absolute benefits paid out in 2037 would be higher nominally than they are now in 2017. The new Trump would look at that same destruction and see a generous boost.