3 things to know about Trump’s budget plan for Medicare, Medicaid

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President Donald Trump has said he won’t touch Medicare until he introduces a budget plan that does just that, along with deep cuts to Medicaid. Democrats call it ‘savage’ and ‘heartless’, while administration officials insist they are only slowing explosive growth in the years to come and current Medicare benefits will remain intact .

Here are three things to know about the election-year fight over health care spending:

Trump has proposed spending $1.6 trillion less on future health care spending, including $451 billion less on Medicare.

On Twitter, two days before releasing his budget, the president declared: “we will not touch your social security or your health insurance”. This is a promise he also made in his State of the Union address.

Whether he broke that promise depends on how you look at it.

President Donald Trump delivers his State of the Union Address during a joint session of Congress in the House Chamber on Capitol Hill in Washington, Tuesday, Feb. 4, 2020, as the Vice President looks on Mike Pence and President Nancy Pelosi.

Leah Millis/Pool via AP

There is no doubt that the President’s budget plan would reduce federal health care spending over the next 10 years, with an estimated reduction of $1.6 trillion, including $451 billion less spent on Medicare and 920 billion dollars less for Medicaid.

The Trump administration is loath to call it a “reduction” because it only applies to future spending plans and budgets would not shrink from current spending. When asked for specifics, the Department of Health and Human Services declined to speak in terms of numbers for Medicare and Medicaid, offering only that the plan “slows the average growth rate” of Medicare by a small amount. percentage over the 10-year period.

Overall, HHS said “funding levels will not be lower each year than they are today.”

PHOTO: Health and Human Services Secretary Alex Azar speaks during a press conference at the Department of Health and Human Services on the coordinated public health response to the 2019 coronavirus, February 7, 2020 , in Washington, D.C.

Health and Human Services Secretary Alex Azar speaks during a press conference at the Department of Health and Human Services on the coordinated public health response to the 2019 coronavirus, February 7, 2020, in Washington, D.C.

Olivier Douliery/AFP/Getty Images

(The dollar figures were provided by a senior administration official who spoke to ABC News on condition of anonymity; the estimates were also confirmed by independent budget analysts.)

The Democrats remained indifferent.

PHOTO: Speaker of the House Nancy Pelosi and Senate Minority Leader Chuck Schumer speak during a press conference, on Capitol Hill, February 11, 2020 in Washington, DC

Speaker of the House Nancy Pelosi and Senate Minority Leader Chuck Schumer speak during a press conference, on Capitol Hill, February 11, 2020 in Washington, DC

Alex Brandon/AP

“Don’t come in front of an audience and say I’m here to protect Medicare and Social Security…and present a budget like this,” Pelosi told reporters Tuesday.

The plan will not impact Medicare benefits

Trump health policy experts also say Medicare’s slower “growth” plan won’t impact benefits, but rather how providers like hospitals are paid.

Tricia Neuman, a policy expert at the nonpartisan Kaiser Family Foundation, said the administration was correct that the plan reduced Medicare spending growth without actually cutting benefits for current enrollees. But she also notes that it includes a proposal that would make it harder for some seniors to qualify for long-term care services, for about $34 billion in Medicaid savings.

Separately, the plan also proposes $135 billion in savings from drug price reforms “with few details,” she notes.

But those details aside, there’s another reason Trump’s budget plan is unlikely to have an impact on Medicare beneficiaries — it has almost no chance of coming to fruition. The Democrats control the House and an election is on the horizon.

What the budget provides is a blueprint of what Trump would try to accomplish given the chance. It’s essentially a starting point for budget discussions – and the campaign debate. But lawmakers on either side of the aisle are unlikely to be eager — especially in an election year — to cut health care spending.

If re-elected, Trump clearly has Medicaid cuts in his sights

Medicaid is government-run health insurance for low-income and disabled people and covers one in five Americans. And according to the Kaiser Family Foundation, it funds almost half of all births in the United States.

Under Trump’s 10-year plan, $920 billion in future spending would be cut, according to the senior administration official and analysts.

Like Medicare’s numbers, HHS declined to confirm that figure, saying only that the plan “slows average annual growth” from 5.4% to 3.1% “to ensure a more sustainable program for the truly needy.” and gives the state the flexibility to reform and innovate”.

The plan accounts for savings by imposing work requirements as a condition of accepting Medicaid coverage for people who are not exempt.

Democrats clearly planned to use the proposal as a talking point before the election, with Senate Minority Leader Chuck Schumer, DN.Y., calling it a “plan to destroy America” ​​on Tuesday.

“Now the American people can clearly see that he is an impostor not fighting for them,” he said.

ABC News’ Benjamin Siegel contributed to this report.

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