Senate Democrats Press Trump on Protecting Medicare, Medicaid

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By Victoria Pelham

Dec. 7 — President-elect Donald Trump should stand by campaign promises to protect the Medicare and Medicaid programs, a group of mostly Democratic senators said Dec. 7.

The 21 senators expressed concerns that Trump seems to have “reversed course” in the days following the election. In their letter, senators including Elizabeth Warren (D-Mass.), Ron Wyden (D-Ore.) and Bernie Sanders (I-Vt.) said Trump’s tone has changed to seem to support policies that would “gut” and “endanger” the health-care coverage for seniors and low-income Americans.

Also, Trump’s choice of Rep. Tom Price (R-Ga.) to lead the Department of Health and Human Services adds to these fears, the letter said. Price has backed the idea of health-savings accounts, fixed-dollar tax credits for health insurance and privatizing Medicare.

During the primaries, the Democrats noted, Trump stood out among Republicans for taking a different stance on cutting these benefits which support more than 100 million people. But once elected, his transition website “eliminated… earlier assurances” and backed an overhaul of both Medicare and Medicaid that includes “benign-sounding cliches” echoing proposals by Price and House Speaker Paul Ryan (R-Wis.), the senators said.

And the union of interests between a Republican-led Congress and a Trump administration could have serious effects on entitlement programs such as privatizing Medicare, raising the eligibility age and block-granting Medicaid. The website currently touts Trump’s intentions to repeal the Affordable Care Act, “modernize Medicare, so that it will be ready for the challenges with the coming retirement of the Baby Boom generation—and beyond” and “maximize flexibility for States in administering Medicaid” that would allow for innovation.

Trump’s transition team could not be reached Dec. 7 for comment on the senators’ letter.

The letter asks President-elect Trump to “rapidly and publicly clarify” his commitment to not dismantling any parts of the health-care benefits.

Pressing for Details

The allegation of a Trump administration going back on its promises with policies that would curb the entitlement programs is valid, health-care analysts told Bloomberg BNA.

“There are substantial differences between various statements candidate and nominee Trump made and statements and positions that Republican members of Congress have not just taken but reiterated for a very long period of time,” Henry Aaron of the Brookings Institution told Bloomberg BNA. “There’s a tension there.”

“The real question is how he and they will resolve the discrepancy,” said Aaron, the Bruce and Virginia MacLaury Senior Fellow in the Economic Studies program at Brookings and a former official with the Department of Health and Human Services’ predecessor agency in the 1970s.

That conversation will largely occur within the Republican Party, but that doesn’t mean the Democratic Party won’t have a role to play, especially if Republicans wind up being divided.

This letter, almost entirely from Senate Democrats, aims to show a robust opposition to any of the proposed Medicare and Medicaid reforms, those familiar with it said. The unified front in the face of a Republican White House and congressional majority will be critical to pushing their favored health-care policies.

“It’s the first signs of an effort within the Democratic party to embrace a common theme and stick together,” Aaron said Dec. 7.

John Feore, a director with consulting firm Avalere Health, agreed, noting that the members’ assertions are trying to drive home the message that they won’t let cuts to these entitlement programs “go through without a fight.”

“It could also start the debate a little bit earlier to enable a potential opposition to start mobilizing now,” Feore told Bloomberg BNA.

Further, pointing out contradictions in President-elect Trump’s policy plans early on might put some additional pressure on the administration by guiding what exactly Republicans think they would be able to carry out and could “force Republicans’ hands” to release more specific policy details, Feore said.

And the Dec. 7 letter likely won’t be the last of its kind, Feore said.

To contact the reporter on this story: Victoria Pelham in Washington at vpelham@bna.com

To contact the editor responsible for this story: Brian Broderick at bbroderick@bna.com

For More Information

Text of the letter is at http://src.bna.com/kAS.

Copyright © 2016 The Bureau of National Affairs, Inc. All Rights Reserved.

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