Budget watchers are growing increasingly frustrated about the politicization of tackling cost-saving measures in entitlement programs, particularly Medicare.
Democrats seized on the proposal, characterizing it as Trump slashing Medicare benefits, even though the president largely hewed to his State of the Union promise to leave Medicare untouched. He instead proposed some $500 billion worth of measures that would reduce costs to providers without eating into benefits.
“If you’re sitting at home at your kitchen table and you’re a senior or there is a senior in your family on Medicare, you’re getting cut,” she said.
But experts say the Medicare proposals should be relatively uncontroversial, leaving budget watchers wondering if reforms to any of the nation’s largest deficit drivers is politically possible, or if the issue has simply become a non-starter in Washington.
“There is literally nothing that would cut benefits from Medicare recipients,” said Marc Goldwein, the head of policy for the Committee for a Responsible Federal Budget, a fiscal watchdog group. “The policies would actually help them because they’d reduce the amount they’d pay in premiums and out-of-pocket costs.”
Among them is a proposal requiring that the site of a procedure — a doctor’s office or a hospital — doesn’t affect the cost.
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Another would affect the level of payments Medicare pays to providers for what’s called post-acute care, such as physical therapy or rehab.
Both aim to reduce payments to the providers but don’t directly scale back benefits or cut off access for recipients.
But it is possible for such cost-cutting measures to ultimately affect benefits, according to Juliette Cubanski, an associate director of the Kaiser Family Foundation’s Medicare Program.
“When it comes to Medicare, I don’t think it makes sense to hold up this budget as something that Medicare beneficiaries need to lose any sleep over,” she said. “But if you cut provider payments and they scale back on benefits, there could be a spillover effect there, or a connection between the two.”
But the exact implications aren’t clear, says Goldwein, who said studies of similar cost-cutting measures in the past have found minor changes in benefits.
Those policies are in contrast to the various restrictions Trump proposed for Medicaid, food stamps, welfare and housing assistance, which would deny some beneficiaries access and in some cases scale back the level of benefits.
For those concerned about reducing the deficit, conflating cost-saving measures with cutting benefits muddies the waters, analysts say.
“I think it’s very frustrating to lump them together, because people have a point on Medicaid. But when it comes to Social Security and Medicare, they’re Obama-era policies to increase program integrity and reduce costs,” Goldwein said.
Since Trump took office, the deficit has increased by roughly two-thirds and is expected to reach $1 trillion. Democrats blame the $1.9 trillion GOP tax law from 2017 and a Republican effort to boost defense spending. Republicans, meanwhile, point to the higher domestic spending favored by Democrats.
But analysts argue that an aging population is stretching spending from mandatory programs such as Social Security and Medicare, which are major drivers of the debt.
Russ Vought, acting director of the White House Office of Management and Budget, said the problem stemmed from politicians using a program’s cost as shorthand for its value.
“Washington, D.C., far too often wants to just say what’s the dollar amount and makes that the sacrosanct value for how you’re doing with regard to your commitment,” he said at a House Budget Committee hearing this past week. He also insisted that the Trump budget would leave programs such as Medicaid untouched.
Democrats, for their part, said they welcomed reforms but needed proof that they worked before slashing budgets.
“I have to be a little bit miffed, I guess is the best word, because you talk about savings and waste and fraud, and that you’re going to be doing different types of approaches, but has the administration offered any legislation in any of these areas?” Yarmuth asked Vought at the hearing. “The administration has not offered legislation to deal with health care.”
Indeed, Goldwein noted, some $750 billion of savings in the president’s budget would come from an unspecified health plan that has yet to be unveiled.
Election year politics is in many ways playing a role in the debate, with experts noting that it’s easier to tout more benefits and lower taxes than the alternative.
“It’s very difficult to talk about cutting Social Security or Medicare benefits. At the same time, there aren’t a lot of people who want to say we need to increase taxes or revenues to pay for these programs,” Cubanski said. “We’re not having a conversation about, ‘How much are we willing to pay for these programs?’ and ‘How much should we pay moving forward?’”
OTTAWA – Prime Minister Justin Trudeau says the NDP is caving to political pressure from Conservative Leader Pierre Poilievre when it comes to their stance on the consumer carbon price.
Trudeau says he believes Jagmeet Singh and the NDP care about the environment, but it’s “increasingly obvious” that they have “no idea” what to do about climate change.
On Thursday, Singh said the NDP is working on a plan that wouldn’t put the burden of fighting climate change on the backs of workers, but wouldn’t say if that plan would include a consumer carbon price.
Singh’s noncommittal position comes as the NDP tries to frame itself as a credible alternative to the Conservatives in the next federal election.
Poilievre responded to that by releasing a video, pointing out that the NDP has voted time and again in favour of the Liberals’ carbon price.
British Columbia Premier David Eby also changed his tune on Thursday, promising that a re-elected NDP government would scrap the long-standing carbon tax and shift the burden to “big polluters,” if the federal government dropped its requirements.
This report by The Canadian Press was first published Sept. 13, 2024.
Simon Jolin-Barrette, minister responsible for consumer protection, has tabled a bill to force merchants to calculate tips based on the price before tax.
That means on a restaurant bill of $100, suggested tips would be calculated based on $100, not on $114.98 after provincial and federal sales taxes are added.
The bill would also increase the rebate offered to consumers when the price of an item at the cash register is higher than the shelf price, to $15 from $10.
And it would force grocery stores offering a discounted price for several items to clearly list the unit price as well.
Businesses would also have to indicate whether taxes will be added to the price of food products.
This report by The Canadian Press was first published Sept. 12, 2024.
Quebec legislature member Youri Chassin has announced he’s leaving the Coalition Avenir Québec government to sit as an Independent.
He announced the decision shortly after writing an open letter criticizing Premier François Legault’s government for abandoning its principles of smaller government.
In the letter published in Le Journal de Montréal and Le Journal de Québec, Chassin accused the party of falling back on what he called the old formula of throwing money at problems instead of looking to do things differently.
Chassin says public services are more fragile than ever, despite rising spending that pushed the province to a record $11-billion deficit projected in the last budget.
He is the second CAQ member to leave the party in a little more than one week, after economy and energy minister Pierre Fitzgibbon announced Sept. 4 he would leave because he lost motivation to do his job.
Chassin says he has no intention of joining another party and will instead sit as an Independent until the end of his term.
He has represented the Saint-Jérôme riding since the CAQ rose to power in 2018, but has not served in cabinet.
This report by The Canadian Press was first published Sept. 12, 2024.
