Social Safety Net Attacks: Proposed Medicaid Cuts, Social Security Reductions

Overview

Trump told voters in 2015 and 2016 that he would not cut Social Security, Medicare, or Medicaid. Every annual budget he submitted proposed cuts to all three.

The budgets were largely dead on arrival in Congress. The campaign promise was clear and repeated.

The Promise

"I'm not going to cut Social Security like every other Republican and I'm not going to cut Medicare or Medicaid."

This statement, made at a 2015 campaign event, was Trump's explicit break with Republican orthodoxy on entitlements. It was repeated throughout the 2016 campaign. It was central to his pitch to older voters and working-class voters who depended on these programs.

The Budgets

Every annual budget proposal Trump submitted cut Medicaid. The 2017 proposal cut it by $610 billion through block grant conversion — a mechanism that would have reduced federal funding and forced states to choose between cutting enrollment and cutting benefits.

The 2020 proposal cut Social Security disability by $70 billion, Medicare by $756 billion, and Medicaid by $920 billion.

The Medicaid Work Requirements

While the budgets weren't enacted, the administration implemented one piece of the agenda through regulatory action: Medicaid work requirements. The administration approved waivers allowing states to require Medicaid recipients to work a minimum number of hours. Courts blocked the implementation in several states; the Biden administration rescinded the waivers.

The work requirements were part of a consistent ideological direction that the budget proposals reflected: reduce the size of means-tested programs through eligibility restrictions rather than explicit benefit cuts.