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?’”
WINNIPEG – The federal New Democrats have kept a longtime stronghold in the Elmwood-Transcona riding in Winnipeg.
The NDP’s Leila Dance won a close battle over Conservative candidate Colin Reynolds, and says the community has spoken in favour of priorities such as health care and the cost of living.
Elmwood-Transcona has elected a New Democrat in every election except one since the riding was formed in 1988.
The seat became open after three-term member of Parliament Daniel Blaikie resigned in March to take a job with the Manitoba government.
A political analyst the NDP is likely relieved to have kept the seat in what has been one of their strongest urban areas.
Christopher Adams, an adjunct professor of political studies at the University of Manitoba, says NDP Leader Jagmeet Singh worked hard to keep the seat in a tight race.
“He made a number of visits to Winnipeg, so if they had lost this riding it would have been disastrous for the NDP,” Adams said.
The strong Conservative showing should put wind in that party’s sails, Adams added, as their percentage of the popular vote in Elmwood-Transcona jumped sharply from the 2021 election.
“Even though the Conservatives lost this (byelection), they should walk away from it feeling pretty good.”
Dance told reporters Monday night she wants to focus on issues such as the cost of living while working in Ottawa.
“We used to be able to buy a cart of groceries for a hundred dollars and now it’s two small bags. That is something that will affect everyone in this riding,” Dance said.
Liberal candidate Ian MacIntyre placed a distant third,
This report by The Canadian Press was first published Sept. 16, 2024
OTTAWA – Prime Minister Justin Trudeau say the Liberals have “all sorts of reflections” to make after losing a second stronghold in a byelection in Montreal Monday night.
His comments come as the Liberal cabinet gathers for its first regularly scheduled meeting of the fall sitting of Parliament, which began Monday.
Trudeau’s Liberals were hopeful they could retain the Montreal riding of LaSalle—Émard—Verdun, but those hopes were dashed after the Bloc Québécois won it in an extremely tight three-way race with the NDP.
Louis-Philippe Sauvé, an administrator at the Institute for Research in Contemporary Economics, beat Liberal candidate Laura Palestini by less than 250 votes. The NDP finished about 600 votes back of the winner.
It is the second time in three months that Trudeau’s party lost a stronghold in a byelection. In June, the Conservatives defeated the Liberals narrowly in Toronto-St. Paul’s.
The Liberals won every seat in Toronto and almost every seat on the Island of Montreal in the last election, and losing a seat in both places has laid bare just how low the party has fallen in the polls.
“Obviously, it would have been nicer to be able to win and hold (the Montreal riding), but there’s more work to do and we’re going to stay focused on doing it,” Trudeau told reporters ahead of this morning’s cabinet meeting.
When asked what went wrong for his party, Trudeau responded “I think there’s all sorts of reflections to take on that.”
In French, he would not say if this result puts his leadership in question, instead saying his team has lots of work to do.
Bloc leader Yves-François Blanchet will hold a press conference this morning, but has already said the results are significant for his party.
“The victory is historic and all of Quebec will speak with a stronger voice in Ottawa,” Blanchet wrote on X, shortly after the winner was declared.
NDP Leader Jagmeet Singh and his party had hoped to ride to a win in Montreal on the popularity of their candidate, city councillor Craig Sauvé, and use it to further their goal of replacing the Liberals as the chief alternative to the Conservatives.
The NDP did hold on to a seat in Winnipeg in a tight race with the Conservatives, but the results in Elmwood-Transcona Monday were far tighter than in the last several elections. NDP candidate Leila Dance defeated Conservative Colin Reynolds by about 1,200 votes.
Singh called it a “big victory.”
“Our movement is growing — and we’re going to keep working for Canadians and building that movement to stop Conservative cuts before they start,” he said on social media.
“Big corporations have had their governments. It’s the people’s time.”
New Democrats recently pulled out of their political pact with the government in a bid to distance themselves from the Liberals, making the prospects of a snap election far more likely.
Trudeau attempted to calm his caucus at their fall retreat in Nanaimo, B.C, last week, and brought former Bank of Canada governor Mark Carney on as an economic adviser in a bid to shore up some credibility with voters.
The latest byelection loss will put more pressure on him as leader, with many polls suggesting voter anger is more directed at Trudeau himself than at Liberal policies.
This report by The Canadian Press was first published Sept. 17, 2024.
The New Democrats have declared a federal byelection victory in their Winnipeg stronghold riding of Elmwood—Transcona.
The NDP candidate Leila Dance told supporters in a tearful speech that even though the final results weren’t in, she expected she would see them in Ottawa.
With several polls still to be counted, Conservative candidate Colin Reynolds conceded defeat and told his volunteers that they should be proud of what the Conservatives accomplished in the campaign.
Political watchers had a keen eye on the results to see if the Tories could sway traditionally NDP voters on issues related to labour and affordability.
Meanwhile in the byelection race in the Montreal riding of LaSalle—Émard—Verdun the NDP, Liberals and Bloc Québécois remained locked in an extremely tight three-way race as the results trickled in slowly.
The Liberal stronghold riding had a record 91 names on the ballot, and the results aren’t expected until the early hours of the morning.
This report by The Canadian Press was first published Sept. 16, 2024.
