While proposing huge increases to spending on what we euphemistically call “defense,” Trump also wants deep cuts in spending on health care for the poor and elderly. These include cuts to Medicaid and Medicare, which he repeatedly swore he wouldn’t touch during the campaign.
Republicans love to talk about all the “waste, fraud and abuse” in programs like Medicaid, but studies show that the amount wasted is pretty small. And rooting it out is quite difficult and expensive in and of itself. Every four years we hear about how we can save so much money by fighting it, but it never actually happens. Changing payments to doctors and hospitals invariably means paying them less for the work they do for those with Medicaid, which only limits the number of doctors and hospitals who will take Medicaid and further reduces access to health care. Trump’s budget would also cut the budget for the National Institutes of Health by $4.5 billion, with most of those cuts coming from the National Cancer Institute.
The Trump administration is proposing a sharp slowdown in Medicaid spending as part of a broad reduction in the government’s investment in health care, calling for the public insurance for the poor to morph from an entitlement program to state block grants even after a Republican Congress rejected the idea.
The budget released by the White House on Monday also calls for a sizable reduction for Medicare, the federal insurance for older Americans that President Trump has consistently promised to protect. Most of the trims relate to changing payments to doctors and hospitals and renewing efforts to ferret out fraud and wasteful billing — oft-cited targets by presidents of both parties.
This is nothing more than institutionalized cruelty. People are going to die because of this. When you combine these kinds of budget cuts with the Republican obsession with eliminating Obamacare, it becomes quite clear that they simply don’t care who they hurt. The poorest and most vulnerable are the first victims of their policies. The only victims, really. And that is not an accident or coincidence.