Yes, They’re Going After Medicare Too
Jonathan Cohn The Bulwark
A rally to defend Medicare and Medicaid. (photo: John Tlumacki/Boston Globe/Getty Images)
A wonky change in Trump’s Big Beautiful Bill would hammer some of the very people Republicans insist they are protecting.
That is not true.
One reason is the bill’s projected fiscal effects. Thanks to all the tax cuts, the legislation would likely increase deficits enough to trigger automatic spending reductions that, under the terms of a 2010 law, would include cuts to Medicare.1
But the claim is also not true for another reason: One of the more important health care cuts in the legislation would affect Medicare beneficiaries.
And not just any Medicare beneficiaries. I’m talking about some of the most vulnerable seniors and people with disabilities who are on Medicare—the ones who can least afford to deal with punishing medical bills.
The reason these people will feel the impact of this cut is a bit hard to explain. Like so many other provisions in the GOP legislation, it’s not a straight-up reduction in benefits or restriction in eligibility. Rather, it’s a change in the enrollment process for a particular program within Medicaid called the “Medicare Savings Program.”
Yes, you read that right: It’s a program within Medicaid with the word “Medicare” in its title. That’s one of the things that makes it so confusing!
But the short of it is that the program (along with a related initiative) plays a critical role in helping vulnerable Medicare beneficiaries cover their medical costs. And thanks to the Republican bill, roughly 1.3 million people who qualify for the assistance wouldn’t get the benefits, according to official estimates.
Many would respond by not getting medical care they need, and their health would deteriorate as a result. Thousands could die prematurely every year, according to one estimate that a group of health researchers put together last month.2
That might seem shocking or hard to believe. But it makes perfect sense to those who understand the program, and to those who work with the Medicare beneficiaries who depend on it.
If you speak with some of them—as I did these past two weeks—you can see why they are so worried.
