A friend asked. You might be asking.
But, but His Lordship promised there would be no Medicaid or Medicare cuts on his watch. For some reason people still believe that guy.
The focus on Republican cuts to Medicaid has obscured the fact that cuts to Medicare are a follow-on effect, writes David Dayen, “which will bring the health system to the brink of devastation.”
When is a cut not a cut? Here’s how that works:
Because of a statutory requirement to automatically impose budget cuts when legislation increases the deficit, the Big Beautiful Bill would require automatic sequestration cuts across the board, something that has been confirmed by the Congressional Budget Office (CBO) but has been largely absent from the debate over the bill. Medicare is one of the programs that will face the axe, and the damage sums to $490 billion over the next ten years, starting in the next fiscal year that begins in October. While many of the safety-net cuts in the bill are delayed to help Republicans with their re-election campaigns, the Medicare cuts must begin next year.
The Statutory Pay-As-You-Go (PAYGO) Act of 2010 requires the Office of Management and Budget to keep scorecards that track the cumulative effects of legislation on the budget deficit, based on estimates from the CBO. The Senate version of the Big Beautiful Bill adds roughly $3.3 trillion in debt over the next ten years. That will have to be made up through automatic sequestration cuts.
As CBO confirmed in a letter to the top Democrat on the House Budget Committee, Rep. Brendan Boyle (D-PA), OMB’s calculation is mandatory, and unless Republicans manage to also pass massive deficit-reducing legislation within this fiscal year, something that is incredibly unlikely to happen, the cuts would follow.
Meaning:
… OMB would be required to issue an order reducing spending by $330 billion by January 2026. Many accounts are exempted from sequestration, including Social Security and several programs affecting low-income Americans. But Medicare is not.
There is a limitation on Medicare cuts of 4 percent of the program. In fiscal year 2026, that would come out to $45 billion. These cuts would increase with the growth of the program, hitting $75 billion by 2034 according to CBO. The total ten-year cuts would equal $490 billion.
For those who need reminding, the Director of the Office of Management and Budget (OMB) is Russell Vought.
Republicans who voted for Trump’s bigly bill will swear during their reelection campaigns that they didn’t vote to cut Medicare. But that’s like rear-ending a parked car that crushes a pedestrian standing in front. You didn’t exactly hit the pedestrian, but….
The measure Trump signed on Friday will slash $500 billion from an American health care already under strain. “The Medicare cuts put the system on the fast track to oblivion,” Dayen concludes. Patients will die like crushed pedestrians.
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