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Trump Budget May Break Promise to Protect Social Security, Medicare, and Medicaid

Early word about President Trump’s 2018 budget — which the White House plans to release on May 23 — suggests it will likely break his promise not to cut Social Security, Medicare, and Medicaid.

“I was the first & only potential GOP candidate to state there will be no cuts to Social Security, Medicare & Medicaid,” Trump tweeted during the campaign. But news reports indicate that the budget will propose cuts to Social Security Disability Insurance (SSDI) and more cuts to Medicaid beyond those in the House-passed health bill. That bill, which Trump has endorsed, would also threaten Medicare benefits.

SSDI is an essential part of Social Security, contrary to what budget director Mick Mulvaney has asserted. Social Security is much more than a retirement program. It also provides financial security if a worker becomes disabled before retirement age or if a worker dies, leaving family members to support.

Social Security’s retirement, survivors, and disability benefits are closely integrated, sharing the same benefit formula and similar work-history requirements. Like the rest of Social Security, SSDI largely serves older Americans. About three-fourths of beneficiaries are over 50, and more than one-third are over 60. SSDI beneficiaries seamlessly switch to retirement benefits at age 66. Thus, cutting disability benefits would cut the retirement benefits of the affected workers as well.

The President has already broken his promise not to cut Medicaid. The House-passed health bill, which he has promoted, would cut Medicaid by $839 billion over ten years — or 24 percent in 2026 — the Congressional Budget Office estimates. It would radically restructure Medicaid’s federal financing and effectively end the Affordable Care Act’s Medicaid expansion, reducing enrollment by 14 million people by 2026. The Trump budget will apparently include even deeper Medicaid cuts.

Although the budget may not propose cuts to Medicare, the Trump-endorsed House health bill threatens its benefits by weakening its financing. The bill would repeal a payroll tax increase on high earners that helps fund Medicare and would increase certain Medicare payments to hospitals. These changes would accelerate the Medicare Hospital Insurance trust fund’s depletion by two years (from 2028 to 2026), exposing seniors and people with disabilities to future benefit cuts. House Republican leaders cite the need to “improve Medicare’s fiscal health” to justify their proposal to convert Medicare to a premium support, or voucher, system and raise its eligibility age.

By supporting the House health bill, Trump has endorsed large cuts in Medicaid and paved the way for cuts in Medicare. We’ll be watching to see if his budget adds Social Security to the list of broken promises.