Photo illustration: Sarah Grillo/Axios. Photo: Brendan Smialowski/AFP via Getty Images
President Trump appeared to extend his pledge not to cut Social Security and Medicare benefits to Medicaid on Friday — a change that could complicate Republicans' plans for a reconciliation package.
Why it matters: House Republicans are discussing significant cuts to the safety net program to pay for an extension of tax cuts. But Trump, in his remarks, left enough wiggle room to keep the option alive in some form.
What they're saying: "We're going to love and cherish Social Security, Medicare, Medicaid," Trump told reporters Friday in wide-ranging remarks.
- "We're not going to do anything with that other than if we can find some abuse or waste, we'll do something, but the people won't be affected," he added. "It'll only be more effective and better."
Between the lines: A lot obviously depends on the definition of "abuse or waste."
- But it would be hard for Republicans to make hundreds of billions of dollars in proposed Medicaid cuts under discussion through policies like per capita caps and not have beneficiaries be "affected," as Trump put it.
- Larry Levitt, executive vice president for health policy at KFF, wrote on X that if House Republicans followed through with the full scale of Medicaid cuts they've floated, "it's hard to imagine that could be all fraud or waste and not affect beneficiaries."
Yes, but: Much will still come down to how much of the roughly $4 trillion tax cut package Republicans look to offset.
- House Budget Committee members are already pushing for deeper cuts, which puts a focus on Medicaid.
- On the other hand, more moderate House Republicans are likely to be uneasy with substantial Medicaid cuts.
The bottom line: Raymond James analyst Chris Meekins wrote in a note that the definition of "abuse" and "waste" is "really in the eye of the beholder."
- He cited actions around state-directed payments with exponential growth as one action that some could consider "abuse."
- "Our view remains that Medicaid will be a topic of sizable cuts from Republicans in Congress," he wrote.
- "The amount of those cuts likely largely will come down to how much money they feel they need to offset for the tax cuts and other spending they want to do."
