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Donald Trump Is Already Trying to Cut Entitlements

The greatest trick the devil ever pulled was convincing the world that his Medicaid cuts didn’t exist. Photo: Alex Wong/Getty Images

Earlier this week, at the bleeding-heart billionaire class’ annual handwringing exhibition in Davos, Switzerland, Donald Trump suggested that he would “take a look” at cutting entitlement programs “at some point.”

As a candidate in 2016, Trump had promised to oppose any and all cuts to seniors’ welfare benefits, a disavowal of conservative orthodoxy that led many voters to perceive the GOP nominee as a “moderate” (his support for Muslim bans and war crimes notwithstanding). Thus, Democrats wasted little time in publicizing the president’s betrayal of the public’s trust.

“Even as the impeachment trial is underway, Trump is still talking about cutting your Social Security,” Senate Minority Leader Chuck Schumer said at a news conference Thursday, while headlines in the New York Times, the Associated Press, and Washington Post touted the president’s apparent interest in paring back the safety net.

Breitbart’s John Carney took exception to this hysteria, insisting that Trump had displayed no intention of cutting entitlements. Rather, according to Carney, Trump’s remarks indicated that he actually rejects the “corporate media’s” paranoia about debt and deficits. To unthinking mouthpieces of Beltway orthodoxy, Trump’s emphasis on economic growth when answering Joe Kernen’s question about entitlement spending read as a non-sequitur. But to Carney, it is perfectly clear that what Trump is actually saying in the following excerpt is that the United States cannot run out of money because it prints its own currency — and thus, that the “challenge we face is to make sure the economy is producing enough goods and services to provide for all our retirees when their numbers grow dramatically in proportion to the workers.”

CNBC: Entitlements ever be on your plate?

President Trump: At some point they will be. We have tremendous growth. We’re going to have tremendous growth. This next year I — it’ll be toward the end of the year. The growth is going to be incredible. And at the right time, we will take a look at that. You know, that’s actually the easiest of all things, if you look, cause it’s such a —

CNBC: If you’re willing —

President Trump: — big percentage.

CNBC: — to do some of the things that you said you wouldn’t do in the past, though, in terms of Medicare —

President Trump: Well, we’re going — we’re going look. We also have — assets that we’ve never had. I mean we’ve never had growth like this. 

Perhaps I am too blinded by elitist disdain for the war-crime-superfan-in-chief to recognize a cogent endorsement of Modern Monetary Theory when I see one. But to my eyes, this reads like Trump opting to recite blatantly false talking points about the strength of the U.S. economy (we have definitely “had growth like this” in the past) instead of giving a clear answer to the question he was asked, as he does virtually every time he gives an interview to anyone about anything.

But it doesn’t really matter what Trump said, or meant to say. There isn’t any ambiguity about whether this president is willing to seek entitlement cuts. He already has.

I realize that the ever-accelerating news cycle has turned collective amnesia into a pandemic virus, spread through Facebook feeds and Twitter timelines. But it was only three years ago that Donald Trump decided to make a health-care bill that included draconian cuts to Medicaid the first legislative priority of his presidency. And Medicaid is not only an entitlement program, but one of the three entitlement programs that Trump explicitly promised not to cut when campaigning for the White House.

Even if one posits that what everyone really means when they talk about “entitlements” is benefits for seniors — who, after long working lives, are now entitled to state support in their final years — cutting Medicaid funding would still qualify as an entitlement cut. It is Medicaid, not Medicare, that foots the bulk of the bills generated by the 1.4 million Americans in nursing homes. And as the boomer generation ages, and life expectancy for seniors increases, the number of seniors who will be reliant on Medicaid to secure a minimally decent standard of living is poised to rise sharply in the coming years: An American turning 65 today has somewhere between a 50 and 70 percent chance of eventually requiring long-term support by the end of his or her life.

Trump’s proposed cuts to Medicaid during his first year in office would have forced many states to pare back nursing-home admissions, even as demand for long-term care grew. Not only would this have constituted an entitlement cut by any reasonable definition, it would have been a far more devastating one than most of the Social Security “adjustments” entertained by Congress in recent years.

And the Trump administration did not stop pushing for entitlement cuts after Obamacare repeal was taken off life support. The White House’s 2020 budget proposal called for a $1.5 trillion cut in Medicaid spending over a decade, and a $25 billion cut in spending on Social Security, with $10 billion of that sum coming directly out of benefits for the disabled.

Just this week, while Breitbart was scolding the corporate media for absurdly suggesting that Trump is trying to cut entitlements, the Trump administration was finalizing a plan to cut entitlement spending in red states without congressional authorization. As Politico reports:

The Trump administration is finalizing a plan to let states convert a chunk of Medicaid funding to block grants, even as officials remain divided over how to sell the controversial change to the safety net health program.

CMS Administrator Seema Verma plans to issue a letter soon explaining how states could seek waivers to receive defined payments for adults covered by Obamacare’s Medicaid expansion, according to seven people with knowledge of the closely guarded effort…Capping Medicaid spending, even among just Obamacare’s expansion population, would be a major transformation of how the federal government finances the safety net health care program that has grown to cover about 1 in 5 Americans. The plan is guaranteed to enrage critics and invite attacks from Democrats in an election year.

Republicans have long argued that states should receive defined funding for Medicaid, instead of the current open-ended structure in which the federal government matches state spending. Democrats, along with many hospital and physician groups, have fiercely opposed the idea, warning that strict funding constraints would result in cuts to enrollment and health care services.

The cuts in enrollment and health-care services is the point. At present, federal spending on Medicaid rises in tandem with need for the program: All Americans who fall below a certain income or asset level are entitled to Medicaid’s services, even if this means that overall Medicaid spending comes in higher than Congress expected. This is what makes Medicaid an entitlement program. Thus, the Trump administration is trying to help Republican-controlled states cut entitlements in the most literal sense: It is encouraging them to end their residents’ entitlement to the benefits of the Medicaid expansion.

This point isn’t a technical one. When the president and his congressional allies pushed a similar block-granting scheme in 2017, the Congressional Budget Office found the Republican proposal would constitute a “35 percent reduction” in Medicaid spending by 2036. The reason for this was simple: Medicaid’s per-beneficiary spending is rising at a faster rate than consumer price inflation, and the GOP’s proposal would eventually tie growth in overall Medicaid spending to the latter. The administration’s current initiative aims to advance the same type of covert benefit cut at a smaller scale.

The president knows this. He understands that his administration is working to cut entitlement benefits. In fact, according to Politico, he is concerned that voters will catch on, and is hoping to keep the effort quiet:

[T]here is internal debate on how broadly to publicize the effort. Verma, who two sources said sees the plan as a legacy-defining achievement, is pushing for an in-person event to announce the policy. Other officials, however, argue a high-profile rollout is unnecessary and could bring more scrutiny on a controversial proposal … President Donald Trump, who last week lashed out as HHS Secretary Alex Azar over negative health-care polling, recently voiced concerns about fueling perceptions that he’s cutting Medicaid and other health-care services during an election year, said two officials with knowledge of the president’s comments.

Trump’s support for entitlement cuts is a matter of fact, not “perception.” To the extent that the “corporate media” failed to accurately convey Trump’s position on entitlements this week, it did not not do so by unfairly interpreting his remarks on the subject, but by obscuring his administration’s past and present actions on the issue.

Donald Trump Is Already Trying to Cut Entitlements