Health Care

GOP divisions over Social Security, Medicare cuts forecast tough fights ahead

House Republicans are divided over cuts to Medicare and Social Security, setting up what could be a fierce internal clash over the future of the nation’s top safety net programs when Congress delves into budget fights later in the year.  

Entitlements have long been a political third rail, but some in the GOP say everything is on the table and are eager to use upcoming debt ceiling negotiations to extract promises to reduce government spending, including entitlement funding.

That could pit the GOP’s staunchest deficit hawks against other conservatives who insist Medicare and Social Security will be left alone and the cuts will come from elsewhere. 

With a narrow GOP majority, Speaker Kevin McCarthy (R-Calif.) can lose only four votes on any bill, and will have to find a way to placate the lawmakers calling for hard cuts.

Rep. Chip Roy (R-Texas), one of the conservative leaders who extracted a promise from McCarthy to limit new discretionary spending, insisted entitlements are safe.

“It took approximately .2 seconds for everybody to be saying, ‘You’re gonna slaughter defense … You’re gonna hurt Social Security and Medicare.’ Everybody calm down,” Roy said in an interview with conservative radio host Jesse Kelly. 

What we have been very clear about is, we’re not going to touch the benefits that are going to people relying on the benefits under Social Security and Medicare,” he said Sunday on CNN’s ‘State of the Union.’

The official rules package Republicans passed earlier this week calls for equal or greater cuts in mandatory spending to offset any new spending, but it did not specify where those cuts needed to come from. 

Yet other Republicans are concerned that excluding the entitlements from the debate creates a greater threat to defense programs, which conservatives are vowing to protect. 

“I’m all for a balanced budget, but we’re not going to do it on the backs of our troops and our military,” Rep. Michael Waltz (R-Fla.) told Fox Business this week. “If we really want to talk about the debt and spending, it’s the entitlement programs.”

The GOP divisions are sure to be a headache for McCarthy and other Republican leaders later in the year when both chambers are expected to consider an increase in the debt ceiling — a routine procedural move allowing the federal government to borrow money to fund obligations Congress has already approved.

Republicans are eyeing the debt ceiling vote and possible government default as a way to force Democrats into concessions.

McCarthy has not weighed in on the issue since Republicans won the House majority in November’s midterms. But he’d indicated heading into the elections that Republicans would use their new power to prioritize cuts in federal spending, and that entitlement cuts were not necessarily off the table. 

The Republicans’ cautious approach to entitlement programs this year represents a sharp contrast to the party’s position over recent decades, when GOP leaders have hammered Social Security, Medicare and Medicaid as socialist initiatives — inefficient and anti-American — that threaten individual freedoms.

Ronald Reagan, even before Medicare’s creation in 1965, warned of the existential dangers of “socialized medicine.” Former Speaker Newt Gingrich (R-Ga.) wanted Medicare “to wither on the vine.” Former president George W. Bush privatized parts of Medicare, and sought to extend that push to Social Security. And former Speaker Paul Ryan (R-Wis.), who had built his wonky reputation as chair of the Budget Committee, used that perch to propose annual budgets that ended traditional Medicare, turning it into a voucher program, and privatized Social Security.

The arrival of President Trump marked a stark recalibration of those long-held positions, beginning on the very first day of his candidacy in 2015 when he vowed to “save Medicare, Medicaid and Social Security — without cuts.”

That promise was a head-snapping reversal for the GOP, but it helped the populist Trump build support from working-class voters — who benefit disproportionately from the entitlement programs, and tend to support them as a result — who ultimately ushered him into the White House.

Now, as Republican leaders are facing pressure from their right flank to slash federal spending and rein in deficits, entitlements have emerged as ground zero in that debate. Members are walking a fine line by calling for reforms in the name of keeping entitlement programs solvent, without actually labeling them “cuts.”

Rep. Buddy Carter (R-Ga.) said Republicans should “absolutely” make entitlement changes a condition of raising the debt ceiling later in the year. But the goal should be to “secure” those programs, he said, not get rid of them.

“Do you realize that Medicaid and Medicare will be insolvent by 2026? That Social Security will be insolvent by 2033? That’s why we’ve got to act,” he said Wednesday. “But our goal, our charge, should be to save and stabilize, not to cut.”

Democrats and progressive groups, meanwhile, are itching for the opportunity to defend Medicare and Social Security, echoing the final days of the 2022 mid-term election. The White House has warned that they will accept nothing but a “clean” debt-ceiling hike — free of add-ons — and congressional Democrats are already piling on in the first days of the new Congress. 

“The debt ceiling shouldn’t be held hostage to this sort of conversation, particularly when you participated in increased spending,” said Rep. Richard Neal (Mass.), senior Democrat on the Ways and Means Committee, which has jurisdiction over Medicare and Social Security. “Better to have the discussion right now. Let’s set the table. Let’s get to the debate over Social Security and Medicare — happy to engage.”

Rep. Drew Ferguson (R-Ga.), another Ways and Means member, acknowledged the political pitfalls surrounding any effort to reform the popular entitlement programs. But he warned that inaction is not an option — and the only solution will require cooperation from both parties. 

“To simply put our heads in the sand is not going to work,” he said. “But what we cannot do — what we cannot do — is weaponize the issue to take down the other party.”