As the fight over the Republicans’ so-called One Big Beautiful Bill Act unfolded, much of the focus turned to Medicaid, and for good reason. Despite Donald Trump’s promise not to cut the health care program, the GOP legislation would cut roughly $700 billion from Medicaid in the coming years, and with just hours remaining before the bill reached the floor, party leaders added new and punitive Medicaid provisions to shore up support from far-right members.
But as important as the future of Medicaid is, the legislation’s impact on Medicare matters, too.
If people were to dig into the 1,000-page bill to look for the provisions related to Medicare cuts, they won’t find them. But there’s a difference between the literal text of the legislation and the practical effects of the legislation.
In fact, as The Washington Post reported, the Congressional Budget Office found that the Republicans’ megabill would add so many trillions of dollars to the national debt, “it could force nearly $500 billion in cuts to Medicare” — with some cuts taking effect as early as next year. As the Post noted, the higher deficits would force budget officials “to mandate across-the-board spending cuts over that window that would hit the federal health insurance program for seniors and people with disabilities.”
When legislation significantly adds to the national debt, which already exceeds $36.2 trillion, it triggers ‘sequestration,’ or compulsory budgetary reductions. In that scenario, Medicare cuts would be capped at 4 percent annually, or $490 billion over 10 years, the CBO reported in response to a request from Rep. Brendan Boyle (Pennsylvania), the top Democrat on the Budget Committee.
Referencing Congress’ Pay-As-You-Go (“PAYGO”) Act, Boyle said in a written statement, “This Republican budget bill is one of the most expensive — and dangerous — bills Congress has seen in decades. The nonpartisan CBO makes it clear: The deficit will explode so badly it will trigger automatic cuts, including over half a trillion dollars from Medicare.”
The Pennsylvania Democrat added, “This is what Republicans do — pay for massive tax breaks for billionaires by going after programs families rely on the most: Medicaid, food assistance, and now Medicare. It’s reckless, dishonest, and deeply harmful to the middle class.”
Though it’s unlikely that congressional Republicans read it, the CBO published a relatively brief three-page summary of its Medicare findings on Tuesday night, ahead of Thursday morning’s vote.
In fairness, Congress would have opportunities to pass separate legislation to mitigate the damage created by the Republicans’ agenda. Given that GOP members wouldn’t want to be responsible for massive Medicare cuts, such action would be likely.
But that doesn’t change the bottom line: The CBO told the House that the Republicans’ reconciliation package would lead to $500 billion in cuts to Medicare, and two days later, 215 House Republicans voted for it anyway.