Donald Trump promised Americans, over and over again, in writing and in public remarks, that he would never cut Medicaid. And yet, the president is now an enthusiastic proponent for a Republican health care plan that makes brutal cuts to Medicaid.
I've been curious as to how the White House and its allies would defend this. Now we know: they're defending it by lying.
The first real indication of the GOP's rhetorical direction came on Friday, when White House Press Secretary Sean Spicer had this exchange during the official briefing:
Q: When you look at the House bill and the Senate legislation, is the Senate legislation the preferred vehicle for this going forward?SPICER: I think the President is very supportive of the Senate bill. There's a lot of ideas in there. He's talked about having heart, and he likes a lot of the reforms that have been in there. He's committed to making sure that no one who currently is in the Medicaid program is affected in any way, which is reflected in the Senate bill, and he's pleased with that.
For anyone with even a rudimentary understanding of the Republican plan, the idea that Medicaid beneficiaries won't be "affected in any way" is hopelessly bonkers.
And yet, Spicer isn't alone in pushing this outlandish line. Asked yesterday about the GOP plan's Medicaid cuts, Kellyanne Conway said with a straight face, "These are not cuts to Medicaid." HHS Secretary Tom Price made the same argument.
The nonsense isn't limited to Trump administration officials. Sen. Pat Toomey (R-Pa.), for example, argued yesterday that "no one" would lose coverage through Medicaid from his party's plan. (The Congressional Budget Office estimated that 14 million Americans who rely on Medicaid would lose coverage under the House bill, and the Senate bill cuts deeper.)
Around the same time, Sen. John Barrasso (R-Wyo.) bragged about his party's proposal to increase Medicaid spending.
We're stuck in a very strange conversation, but no one should be confused about reality.
One of the key purposes of the Republican plan is cutting Medicaid. For far-right lawmakers, this is a feature, not a bug. Republicans have wanted to change the nature of the program for many years, and they see this week as a unique opportunity to fulfill an ideological dream.
The New York Times reported the other day:
Since its founding, Medicaid has operated as a partnership between the federal government and the states. Each pays a share of patients’ medical bills, with no overall limit on spending. The [Republican plan] would try to slim down the federal share of that spending, by limiting how much the federal government would pay for each person enrolled in the program. [...]The results, according to independent analyses, would be major reductions in federal spending on Medicaid over time. States would be left deciding whether to raise more money to make up the difference, or to cut back on medical coverage for people using the program. The Congressional Budget Office estimates that the changes would lead to a reduction in spending on Medicaid of more than $800 billion over a decade.
For Republicans, reducing spending on Medicaid by more than $800 billion is not a "cut" and wouldn't adversely affect any of the program's beneficiaries.
What's more, they apparently expect Americans to believe this.