Throughout his campaign, President-elect Donald Trump repeatedly promised he would not cut Medicare or Medicaid (or Social Security, for that matter). But with Trump’s pick to head the Department of Health and Human Services (HHS), he seems prepared to violate that promise.
Rep. Tom Price (R-GA), who will go before a Senate committee on Wednesday to begin hearings on his nomination, has spent his career trying to dismantle Medicare and Medicaid —all while fighting for massive tax cutsfor the wealthy and corporations. Back in 2009, Price claimed, “Nothing has had a greater negative effect on the delivery of health care than the federal government’s intrusion into medicine through Medicare.”
Here are three ways the President-elect’s choice for Secretary of HHS plans to weaken Medicare and Medicaid:
1. Privatize Medicare and convert it into a voucher.
Price has long been a supporter of privatizing Medicare. In addition to his own proposals as House Budget Chair, Price was a vocal supporter of a 2012 Medicare privatization proposal championed by now-Speaker Ryan.
Many in the GOP have referred to this as “premium support.” But what they’re really proposing is eliminating Medicare’s guarantee of health coverage. Instead, seniors will be handed a voucher with a fixed value that may or may not cover the cost of a decent plan — either from traditional Medicare or a private insurer — that includes the coverage and services they need. And because the GOP is trying to shift costs to seniors, the value of that voucher will likely go down over time, leaving seniors to foot more and more of the bill themselves as they get older.
A Center for American Progress analysis found that Ryan’s 2012 Medicare privatization plan would result in the average senior who reaches age 65 in 2023 paying an extra $59,500 in Medicare costs over her lifetime. And because the voucher loses value over time, seniors who qualify for Medicare coverage in 2050 would lose a whopping $331,200 over their lifetime.
2. Raise the Medicare eligibility age.
Price has also long supported raising the Medicare eligibility age from 65 to 67. Under this scenario, seniors in need of coverage at 65 would have to buy a health plan on the private market or go without coverage.
Having to wait an extra two years may not sound like a long time. But for seniors who need coverage because of chronic health conditions, serious illnesses, or as a way to access life-saving treatment, a two-year delay could be a death sentence. The nonpartisan Congressional Budget Office estimated that 185,000 people would become uninsured over ten years if the Medicare eligibility age were increased. What’s worse, this estimate assumed that these seniors would have the option of seeking coverage on the Affordable Care Act’s exchanges and Medicaid. Combined with Price’s proposals to slash Medicaid and repeal the Affordable Care Act, raising the retirement age would leave even more low-income seniors without health insurance at all.
3. Slash Medicaid and convert it into a block grant.
Gutting Medicaid has also long been on Price’s wish list, including by turning the program into a “block grant.” In short, this would make deep cuts to the federal funding that states receive to implement Medicaid, forcing them either to pony up more from their own coffers, or (much more likely) to make big cutbacks in the coverage they provide to their residents. Faced with inadequate resources, states could have little choice but to institute waiting lists for coverage or to cap enrollment — leaving millions of seniors and people with disabilities without the care they need.
In fact, an Urban Institute analysis of a past proposal of Speaker Ryan’s that Price vocally supported estimates that an additional 14–20 million Americans would lose coverage under a Medicaid block grant — on top of the 30 million who are set to lose coverage under ACA repeal and elimination of Medicaid expansion.
Price and his GOP colleagues may claim these proposals are about “saving Medicare.” But if Price were serious about improving the program’s fiscal health, he would not support repealing the ACA (which has already begun to slow the growth of health care costs) and slashing Medicaid, which will make people sicker by the time they reach retirement age. Instead, he’d call for common sense cost-cutting policies like letting Medicare negotiate drug prices to rein in skyrocketing costs. Considering that prescription drugs costs account for $1 of every $6 of the program’s spending, allowing Medicare to negotiate drug prices could save the U.S. up to $16 billion per year.
President-elect Trump has famously promised that he wouldn’t make policy decisions that “let people die in the streets.” But taking away critically needed health insurance from vulnerable seniors and people with disabilities is a recipe for doing just that. With 11.2 million seniors pushed into poverty by out of pocket health expenses in 2015, and retirement security moving further out of reach for millions of families, Price’s prescriptions for our health care system are a recipe for making us all sick.
Rebecca Vallas is the Managing Director of the Poverty to Prosperity Program at Center for American Progress Action Fund (CAPAF), and Jeremy Slevin is the Associate Director of Advocacy for the same program.
ThinkProgress is an editorially independent site housed at CAPAF.