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The political split screen on Medicare solvency

May 7, 2024
Illustration of a venn diagram with a hospital bench and clasped hands on one side and money and a health insurance card on the other

Illustration: Natalie Peeples/Axios

Lawmakers on both sides of the aisle are busily spinning Monday's Medicare trustees' report, in what's likely a preview of how the program's future will play into this year's campaigns.

Driving the news: The report projects the benchmark hospital insurance trust fund will run out of money to pay full benefits beginning in 2036 — five years later than projected last year.

  • Whether that's good news or bad, depends on party affiliation.

Democrats cite it as further evidence they've saved the program while accusing congressional Republicans and former President Trump of laying plans to cut or privatize the program.

  • Republicans say President Biden and his allies are ducking a looming crisis.

Between the lines: The truth is the safety-net program has been buoyed by a strong economy and labor market. But it's unclear whether lawmakers are willing to address long-term challenges like rising premiums and cost-sharing that are eating into retirees' savings.

  • Trust fund expenditures are projected to be lower than previous estimates because of a policy change on medical education expenses in Medicare Advantage, and because inpatient hospital and home health agency services was lower than estimated.

What they're saying: "We're always going to fix Medicare and always going to fix Social Security," House Ways and Means Ranking Member Richard Neal told Axios.

  • "It's been in far worse shape in previous years ... but you're still going to see now the group that's gonna start talking about the dark cloud that hovers over Medicare and Social Security. That'll be the same group that enthusiastically voted for the Bush tax cuts and voted for the Trump tax cuts."
  • Ways and Means Chair Jason Smith offered a different view, saying the report "didn't look good."
  • "It doesn't change anything," said Republican Study Committee Chair Kevin Hern. "We need to sit down and look at the underlying problem ... Now's a good time to do it, take a little pressure off with the extension."

House Budget Chair Jodey Arrington said the report reinforces the need for a bipartisan fiscal commission to reduce the national debt.

  • A commission of lawmakers and outside experts could highlight tough choices ahead, including raising taxes, cutting benefits or cutting payments to health providers.
  • "I don't know where the leadership is on it, I know it was an important initiative for the speaker ... but we're not giving up on it," Arrington said.
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