Senate Republicans are eyeing possible Medicare provisions to help offset the cost of their megabill as they try to appease budget hawks who want more spending cuts embedded in the legislation.
Making changes to Medicare, the federal health insurance program primarily serving seniors, would be a political longshot: It would face fierce backlash from some corners of the Senate GOP, not to mention across the Capitol, where Medicare proposals were floated but didn’t gain traction.
But Senate Republicans are now seriously considering it as they race to pass their party-line tax and spending package before a self-imposed July 4 deadline. The idea came up in closed-door meetings this week and, crucially, some Republicans believe President Donald Trump is on board with touching the program as long as it’s limited to “waste, fraud and abuse.”
“I think anything that is waste, fraud and abuse are obviously open to discussions,” Senate Majority Leader John Thune (R-S.D.) said Thursday when asked about Medicare.
Cracking down on some smaller areas of the vast program could net significant savings for Senate Republicans. The other main area they’re planning to tap is ratcheting down the House-negotiated state-and-local-tax-deduction cap – as Thune first acknowledged to POLITICO Tuesday. Both are politically explosive areas that will trigger serious blowback in the House.
“I think the focus, as you know, has been on addressing waste, fraud and abuse in Medicaid,” Thune added when pressed on Medicare. “But right now we’re open to suggestions if people have them about other areas where there is clearly waste, fraud and abuse that can be rooted out in any government program.”
Sen. Ron Johnson (R-Wis.), who was among the Republicans on the Senate Finance Committee who went to the White House Wednesday to meet with Trump about the tax portion of their megabill, told reporters he believed the president was more amenable to making Medicare changes than he might have previously let on.
“I think the president is actually open to any elimination of any waste, fraud and abuse … wherever,” he said, though added that Trump “doesn’t want to cut benefits.”
Finance Committee Republicans wanted to use their audience with Trump to press their case for making certain business tax incentives permanent, but a significant chunk of the conversation instead focused on senators pitching their individual ideas for how to inject more savings into their version of the House-passed bill.
A band of House moderates is deeply uncomfortable with the idea of touching Medicare in the megabill, even if it is in the name of “waste, fraud and abuse.” Speaker Mike Johnson said in a brief interview Thursday that he wouldn’t “address hypotheticals.”
But he reiterated he doesn’t want to inject any more major political fights into the already fractious talks. Johnson said the House GOP’s “work reflects more than a year of very careful and deliberate discussion and ideas and so, you know, we’re very satisfied with the product we’ve sent over there, and I hope they’ll change it as little as possible.”
Some House lawmakers briefly floated the idea of overhauling Medicare Advantage — which enables older Americans to buy private plans offering health coverage — to garner savings. Critics have accused Medicare Advantage plans of using financial gamesmanship to increase federal payments, but targeting the program would likely draw the ire of the insurance industry.
The search for more cuts comes as GOP senators look for areas where they can go beyond the House’s $1.6 trillion in cuts. But the push is being complicated because some Senate committees, including the Agriculture panel, are likely to scale back the savings found by their House counterparts.
Leadership is pushing the Agriculture Committee to net $150 billion in cuts as they work to scale down a controversial House plan to shift billions in food aid costs to states, according to four Republicans with direct knowledge of the matter. That’s half of the $300 billion in agriculture cuts from the House bill, and GOP senators are still trying to fit in a $70 billion farm bill package.
As part of an effort to generate more savings, Republicans have floated several ideas related to Medicaid, including tightening the House’s work requirements and trying to roll back — not just freeze — the use of state provider taxes. Both of those ideas would face their own block of opposition within the Senate GOP.
But they also raised Medicare as part of a lengthy debate Senate Republicans had among themselves Wednesday, when they met first with CMS Administrator Mehmet Oz and subsequently got briefed by the chairs of the Armed Services, Banking and Commerce Committees on their pieces of the megabill.
“There was legitimate debate about: Can we do more with Medicaid? Are we doing too much with Medicaid? How much waste, fraud, abuse is there in Medicare — why don’t we go after that? I think we should,” Sen. Kevin Cramer (R-N.D.) said about the discussion Wednesday.
Asked if there was any consideration of including Medicare as part of the megabill, Sen. Roger Marshall (R-Kansas) said, “There is on the Senate Republican side.”
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