We may lump Medicare, Medicaid, and Social Security together as “entitlement programs”, but they really are quite different. Medicaid serves poor children, seniors, working families, and people with disabilities.
Tom Price, Trump’s nominee for HHS Secretary, wants to get rid of all of it. Paul Ryan wants to privatize the services all three provide, through much reduced block grants to the states. Medicare and Social Security have strong and politically aware voting constituencies behind them: Medicaid serves poor people who are less likely to organize, less likely to vote, less likely to donate big bucks to Congress in return for a demand to protect their interests.
What’s on the table for the incoming Trump administration?
“Of the two battles, the Republican effort to dismantle Medicaid is more certain. Neither Mr. Trump nor Senate Republicans may have the stomach to fully own the political risks of Medicare privatization. But not only have Speaker Paul D. Ryan and Tom Price, Mr. Trump’s choice for secretary of health and human services, made proposals to deeply cut Medicaid through arbitrary block grants or “per capita caps,” during the campaign, Mr. Trump has also proposed block grants.
If Mr. Trump chooses to oppose his party’s Medicare proposals while pushing unprecedented cuts to older people and working families in other vital safety-net programs, it would play into what seems to be an emerging strategy of his: to publicly fight a few select or symbolic populist battles in order to mask an overall economic and fiscal strategy that showers benefits on the most well-off at the expense of tens of millions of Americans.”
Here’s the irony for me: I will benefit from a Trump tax cut, and I can afford to pay for my own health care if I have too — that is, absent a catastrophic health care crisis like Alzheimer’s or a debilitating accident or something else that leaves me medically dependent for the remainder of my life. Do I take my own goodies and turn a blind eye to the savage cuts in benefits for people who need them most? Lots of those people were, apparently, Trump voters who thought he’d go after Muslims but not them.
What a sorry state of affairs.