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"If there are a lot of details still to be filled in," wrote one analyst, "the theme of the GOP's healthcare agenda is clear: cuts."
Having secured control of both chambers of the U.S. Congress and the White House starting in January, Republicans are making no secret of their intention to pursue sweeping healthcare cuts that would raise costs and imperil insurance coverage for millions of people across the country.
Rep. Jodey Arrington (R-Texas), chairman of the House Budget Committee, told reporters earlier this week that the GOP is looking to use the filibuster-evading reconciliation process to pursue cuts to "mandatory programs"—a category that includes Medicare, Medicaid, and Social Security.
Bobby Kogan, senior director of federal budget policy at the Center for American Progress, noted in response to Arrington's comments that Republicans attempted to cut both Medicaid and Affordable Care Act (ACA) tax credits that help enrollees afford health insurance.
The Republican Study Committee, of which Arrington is a member, proposed eliminating the ACA tax credits in its 2025 budget proposal—a move that could result in around 4 million people losing insurance.
The tax credits are set to expire next year, meaning Republicans could just do nothing and allow them to lapse.
Last time Republicans had a federal trifecta, they tried and failed to fully repeal the ACA—an effort that sparked a
wave of civil disobedience on Capitol Hill.
Both President-elect Donald Trump and House Speaker Mike Johnson (R-La.) said on the campaign trail that they're looking to try again.
"We're going to replace it," Trump said during his lone debate with Vice President Kamala Harris in September—while admitting that he did not have a fully formed alternative plan.
Johnson, for his part, said during a campaign stop in Pennsylvania last month that "healthcare reform's going to be a big part of the agenda." When a voter posed the question, "No Obamacare?" Johnson replied in the affirmative, "No Obamacare."
"The ACA is so deeply ingrained, we need massive reform to make this work," he added, "and we've got a lot of ideas on how to do that."
Sarah Lueck and Allison Orris of the Center on Budget and Policy Priorities
wrote Wednesday that Trump's return to the White House and the GOP's capture of both chambers of Congress poses "big risks to people's ability to access and afford health coverage in Medicaid and the marketplaces."
"While Republicans have moved away from talking about their plans for changing health coverage in the U.S. as 'repeal,'" Lueck and Orris added, "Trump's first term and Republicans' recently released policy agendas suggest they may pursue policies that would have much the same result: higher costs for people, reduced access to care for vulnerable groups, and more people who are uninsured."
"Just as a grassroots movement of Americans around the country succeeded in saving the Affordable Care Act during Trump's first term, we can save Social Security and Medicare."
Even if Republicans don't succeed at enacting major legislative changes to the nation's healthcare system, Trump will still have the power to do significant damage unilaterally. Lueck and Orris noted that the first Trump administration "took numerous administrative steps that made it harder for eligible people to get coverage" and weakened consumer protections, from adding new paperwork requirements to the Medicaid enrollment process to expanding so-called "junk" insurance plans.
Vice President-elect JD Vance also suggested during the 2024 campaign that a second Trump administration could seek to roll back protections for people with preexisting conditions.
"If there are a lot of details still to be filled in, the theme of the GOP's healthcare agenda is clear: cuts," Vox's Dylan Scott wrote days before the November 5 election. "Cutting regulations. Cutting spending."
Stephanie Armour of KFF Health Newswrote following Trump's victory that his second term "will likely bring changes that scale back the nation's public health insurance programs—increasing the uninsured rate, while imposing new barriers to abortion and other reproductive care."
Medicaid is particularly vulnerable, Armour noted, with Trump and the Republican Party potentially set to pursue "the imposition of work requirements on beneficiaries in some states" and changes to how the program is funded.
"Now, the federal government pays states a variable percentage of program costs," Armour explained. "Conservatives have long sought to cap the federal allotments to states, which critics say would lead to draconian cuts."
As for Medicare, the Project 2025 agenda authored by many former members of Trump's first administration calls for making privatized Medicare Advantage plans the default enrollment option for the nation's seniors—a change that advocates say would pose an existential threat to traditional Medicare.
"Trump and Republicans will try to cut our earned benefits," Alex Lawson, executive director of the progressive advocacy group Social Security Works, warned in an op-ed for Common Dreams on Wednesday. "But just as a grassroots movement of Americans around the country succeeded in saving the Affordable Care Act during Trump's first term, we can save Social Security and Medicare."
Let there be no doubt: Trump and the Republicans will try to cut our earned benefits. But just as a grassroots movement around the country succeeded in saving the Affordable Care Act during Trump’s first term, we can save Social Security and Medicare.
No one voted to cut Social Security. No one voted to cut Medicare. And no one voted for higher drug prices.
Donald Trump ran on a promise to protect Social Security and Medicare. Based on Trump’s long record of working to cut and undermine our earned benefits, we don’t trust that promise for one second. But we plan to make him keep it.
There’s a good reason Trump didn’t campaign on cutting Social Security: Ninety-two percent of Americans think that’s a terrible idea.
What will Trump do once he’s actually in the White House? During his first term, he tried to cut Social Security every single year. He appointed an unqualified crony, Andrew Saul, to head the Social Security Administration. And he surrounded himself with advisors who had long records of working to cut and privatize Social Security.
Now, Trump has a new advisor, Elon Musk. He just put Musk in charge of a commission to slash $2 trillion of federal spending. That is essentially impossible without cutting Social Security, Medicare, and/or Medicaid. Indeed, incoming Vice President JD Vance has specifically said that Musk will target Social Security.
We are never going to stop fighting to protect and expand Social Security.
Musk is the wealthiest man in the world. It’s no surprise that Musk and his fellow billionaires want to cut our earned benefits rather than pay their fair share in taxes.
Trump’s top priority is to extend the tax cuts he gave the ultra-wealthy in his first term. Then, Republicans will turn around and claim that we “can’t afford” Social Security and Medicare.
Republicans in Congress have already telegraphed what those cuts could look like. The Republican Study Committee (RSC), a caucus that counts over 80 percent of House Republicans as members, released a budget proposal earlier this year that makes massive cuts to Social Security. That includes raising the retirement age to 69, and decimating benefits for the middle class.
The RSC budget would also repeal Medicare’s power to negotiate lower drug prices. That means seniors and people with disabilities would have to turn over more of their hard-earned Social Security checks to Big Pharma.
In case anyone doubted that Republicans are serious about passing these cuts into law, House Budget Chairman Jodey Arrington (who angrily chased me down the street last year after I confronted him about his support for Social Security cuts) just pledged to cut health care benefits through reconciliation—meaning that Republicans would only need 50 votes in the Senate.
Trump and Republicans will try to cut our earned benefits. But just as a grassroots movement of Americans around the country succeeded in saving the Affordable Care Act during Trump’s first term, we can save Social Security and Medicare.
Musk is the wealthiest man in the world. It’s no surprise that Musk and his fellow billionaires want to cut our earned benefits rather than pay their fair share in taxes.
Here’s how:
We are never going to stop fighting to protect and expand Social Security. Social Security has stood strong for nearly a century. It has survived wars, depressions, and pandemics. And with your help, it will survive Donald Trump.
Sen. John Thune "has called for taking the debt limit hostage to force cuts to Social Security," warned one defender of the nation's most effective anti-poverty program.
Senate Republicans on Wednesday elected Sen. John Thune of South Dakota—a former corporate lobbyist and close ally of Sen. Mitch McConnell—as the leader of their conference for the upcoming term, when the GOP will have a 53-seat majority.
Republican lawmakers chose Thune over Sens. John Cornyn (R-Texas) and Rick Scott (R-Fla.), who was favored by allies of President-elect Donald Trump.
"Senators have received angry phone calls from constituents demanding to know how their representatives plan to vote, following MAGA world's embrace of Scott," The Washington Postreported. The leadership election was conducted via secret ballot.
In a statement Wednesday, Thune said he is "extremely honored to have earned the support" of the Senate GOP conference and stressed that "this Republican team is united behind President Trump's agenda."
"Our work starts today," Thune added.
"It's a new day in the United States Senate."
After being elected Senate Republican Leader, Sen. John Thune says, “We are excited to reclaim the majority and to get to work with our colleagues in the House to enact President Trump’s agenda.” https://t.co/sMMVVx2PxT pic.twitter.com/GylMysaA3V
— ABC News (@ABC) November 13, 2024
Before winning election to the Senate in 2004, Thune worked as a lobbyist for several sectors including the railroad industry. The Leverreported last year that as part of his lobbying work for the Dakota, Minnesota, and Eastern (DM&E) Railroad, Thune "helped the company procure a $230 million loan from the Federal Railroad Administration."
"In 2015, Thune reprised his advocacy for the rail industry, leading an effort to repeal an Obama administration regulation requiring improved, electronic braking systems on some hazmat trains," the outlet added. "The following year, he received the first-ever 'Railroad Achievement Award' presented by the Association of American Railroads, the industry's main lobbying group."
Thune is also "one of the biggest recipients of oil and gas money in Congress," the youth-led Sunrise Movementnoted Wednesday following his election as leader of the incoming GOP Senate.
Over the course of his Senate career, Thune has received more than $1.16 million in campaign donations from the fossil fuel industry, according to the campaign finance watchdog OpenSecrets.
Thune's top contributor between 2019 and 2024 was the American Israel Public Affairs Committee (AIPAC), the right-wing pro-Israel lobbying group.
"Thune has called for taking the debt limit hostage to force cuts to Social Security."
Thune will take the reins of the Senate GOP conference as the party readies another round of tax cuts for the rich and large corporations—one of Trump's top priorities. Thune is a leading advocate of repealing the estate tax, a move that would benefit a small number of wealthy Americans.
Congress is also barreling toward another potentially damaging fight over the debt ceiling, which is set to be reinstated on January 2, 2025.
Thune has previously expressed support for leveraging the debt limit—and the threat of a catastrophic default—to secure steep cuts to federal spending and possible changes to Social Security such as raising the retirement age, which would slash benefits across the board.
Social Security Works, a progressive advocacy group, voiced alarm over Thune's debt ceiling stance following his election as Senate Republican leader on Wednesday.
"Thune has called for taking the debt limit hostage to force cuts to Social Security," Nancy Altman, the group's president, said in a statement.