When he was running for president, Donald Trump strenuously objected to the idea of cutting Medicare and Social Security. As president-elect, Trump may need to fight members of his own party in order to keep that promise — or else be exposed as a liar to the very working-class Americans whose support elected him in the first place.
As Bloomberg reported on Wednesday, although Republican leaders are united in their determination to repeal the Affordable Care Act (colloquially known as Obamacare), they are divided over whether to apply that same approach to Medicare. In an interview with Fox News on Nov. 10, House Speaker Paul Ryan argued that “Medicare has got some serious problems because of Obamacare, so those things are part of our plan to replace Obamacare.” Similarly, Rep. Tom Price — the Georgia representative Trump nominated to be his secretary of health and human services on Monday — told Talking Points Memo on Nov. 17 that he viewed a Medicare overhaul as a feasible goal "probably in the second phase of reconciliation, which would have to be in the FY [Fiscal Year] 18 budget resolution in the first 6-8 months."
The problem with the statements by Ryan and Price, of course, is that they contradict Trump's own campaign rhetoric.
"People have been paying in for years," Trump told "Fox & Friends" during an April interview in which he attempted to distinguish himself from the other Republican presidential candidates. "They're gonna cut Social Security. They're gonna cut Medicare. They're gonna cut Medicaid. I'm the one saying that's saying I'm not gonna do that! I'm gonna make us so rich you don't have to do those things."
Clearly there are Republicans in Congress who heeded Trump's message.
“That falls under the rule of not biting off more than you can chew,” said Senator Lamar Alexander of Tennessee, who chairs the Health, Education, Labor and Pensions Committee, in an interview with Bloomberg about the future of Medicare. “The problems about the solvency of Medicare should be left for another debate, another discussion," instead of being tied into the movement to repeal Obamacare.
If Trump does decide to sell out his ostensible beliefs and work with congressional Republicans on reforming or repealing Medicare, he will have several options available to him, Bloomberg reported earlier in the month.
"There are some Republican proposals to combine Medicare Part A, which covers treatments at hospitals and several post-acute care providers, with Part B, which largely reimburses doctors for their services," Bloomberg reported.
Bloomberg also noted that combining Parts A and B of our current Medicare system would likely prove quite complicated and could result in a number of thorny legal issues, from determining how a federal anti-kickback statute would apply to the new system to determining whether some of Ryan's and Price's more ambitious proposals could even be implemented using budget reconciliation.