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?’”
New Brunswick voters have elected a Liberal majority government, tossing out the incumbent Progressive Conservatives after six years in power and handing the reins to the first woman ever to lead the province. Liberal Leader Susan Holt spent much of the campaign rolling out proposed fixes for a health-care system racked by a doctor shortage, overcrowded emergency rooms and long wait-times. She promised to open 30 community health clinics across the province by 2028. (Oct. 22, 2024)
Susan Holt has made history in New Brunswick by becoming the first woman to serve as the leader of the province’s Liberal Party, a significant milestone in the province’s political landscape. Holt’s leadership victory signals a new era of representation, gender equality, and change in the region, which has long been dominated by male politicians.
Holt’s journey to the top has been one of perseverance and dedication. Before entering politics, she built a distinguished career in the private sector, where she held numerous leadership positions. Her experience in business development and public policy has equipped her with the skills needed to navigate the complex world of politics.
In a province where women have historically been underrepresented in politics, Holt’s election represents a watershed moment. Women’s involvement in leadership roles has been steadily increasing nationwide, but New Brunswick, like many parts of Canada, has seen slower progress in achieving gender parity. Holt’s rise to the top of the Liberal Party not only shatters a glass ceiling but also serves as an inspiration for future generations of women aiming for political leadership.
As the leader of the New Brunswick Liberal Party, Holt has laid out a vision of inclusivity and progress. Her policies focus on economic development, healthcare reform, environmental sustainability, and addressing social issues that have plagued the province. She has also emphasized the importance of transparent governance and creating opportunities for underrepresented communities, making her platform both modern and forward-thinking.
Holt’s leadership arrives at a time when many voters are calling for change, especially in the face of challenges like economic uncertainty and the need for healthcare improvements. She aims to bring fresh ideas to tackle these issues while ensuring that all citizens, regardless of their background, have a voice in government decisions.
Susan Holt joins the ranks of other trailblazing women across Canada who have led provincial parties and governments. Women like former Alberta Premier Rachel Notley and Ontario’s Kathleen Wynne have paved the way, and now Holt is contributing to this growing legacy of female political leadership in Canada.
Her achievement highlights not only the growing number of women entering politics but also the demand for leaders who can bring diverse perspectives to the table. In a field often dominated by entrenched traditions, Holt’s election is a step toward a more inclusive and representative political landscape in New Brunswick.
Holt’s leadership signals a broader shift in Canadian politics, where more women and diverse voices are gaining prominence. For young women across the country, her rise serves as a powerful reminder that leadership roles are within reach, even in traditionally male-dominated spheres.
With her election, Susan Holt has proven that perseverance, skill, and a vision for change can break even the toughest barriers. Her leadership will not only reshape New Brunswick’s political future but also inspire others across Canada to pursue leadership positions and continue to challenge the status quo.
NDP Leader Carla Beck has two planned campaign events today, starting the day with an availability in Moose Jaw and then later this evening attending an event in the capital with the Regina Medical Staff Association.
Saskatchewan Party Leader Scott Moe, meanwhile, will speak in Prince Albert at the start of Voting Week in the province.
Saskatchewan residents can vote for five days starting today in the lead-up to next week’s provincial election, although polls won’t be open Sunday.
The NDP and the Saskatchewan Party are urging voters to cast their ballots early.
Voters can find their polling stations on their information cards or by visiting the Elections Saskatchewan website.
Chief electoral officer Michael Boda says there are about 810,000 registered voters in Saskatchewan.
This report by The Canadian Press was first published Oct. 22, 2024.
