GOP’s Medicare Raid Proposal Stems From Spending Addiction

Even as the Trump administration focuses on making government efficient in ways it has not been in decades, lawmakers still can’t stop their spending habits. That’s the unfortunate takeaway from spending legislation House Republican leaders released over the weekend.

The legislation may pass with Republican votes and President Trump’s support. It represents a better fiscal vision than a bill crafted with more Democrat input. But when “better” in this case equates to “slightly less irresponsible,” it speaks to the chasm between Congress’s spendaholic ways and fiscal reality.

Latest Raid on Medicare, Explained

The 99-page continuing resolution released Saturday morning has many positive policies. It doesn’t just freeze spending at current-year levels; it slightly reduces spending, and it reallocates funds from nondefense spending toward our military to improve the nation’s security.

But the second half of the “Full-Year Continuing Appropriations and Extensions Act” includes more questionable policies. On one hand, it contains an extension of Covid lockdown-era flexibilities that allow Medicare to see more patients via telehealth — a positive policy. And the legislation pays for that change via a further extension of the Medicare sequester first applied as part of the Budget Control Act of 2010.

On the other hand, Section 2101 of the bill extends “community health centers” by amending “the Patient Protection and Affordable Care Act” in part by adding “$2,135,835,616 for the period beginning on April 1, 2025, and ending on September 30, 2025.”

There’s another term for the “Patient Protection and Affordable Care Act”: Obamacare. To convert the continuing resolution’s arcane language into plain English, House Republican leaders took it upon themselves to provide an extra $2.1 billion in funding for a community health center program created by Obamacare. 

As best anyone can tell, they did so by raiding Medicare. As of this writing, the Congressional Budget Office hasn’t released an analysis of the bill’s budgetary effects. However, the extension of the Medicare sequester is the only “pay-for” included in the extensions section of the bill, suggesting that the spending reductions from the Medicare sequester will fund both the community health center spending and the Medicare-related provisions such as the telehealth extension.

Complicated Vote Dynamics

At this point, House Republican leaders and other Beltway types might ask me politely, or not so politely, to stop taking potshots at their bill. Don’t you realize that, if conservatives tank this bill, we will have to negotiate with congressional Democrats, and you’ll get something far worse?

Actually, I do understand. I recognize that last December’s 1,547-page monstrosity of a continuing resolution stemmed from Speaker Mike Johnson’s, R-La., need to capture Democrat votes for the legislation. The more provisions he added to win Democrats, the more he alienated conservative Republicans, such that the final bill looked about 70 percent Democrat and (if it had ever received a floor vote) probably would have passed with more support from Democrats than Republicans.

Stop Overspending!

On the other hand, Johnson and others in Republican leadership wrongly continue to believe that this $2.1 billion in community health center spending between April and September represents “must-pass” legislation. That same belief prompted House leaders under then-Speaker Kevin McCarthy, R-Calif., to try to advance legislation in the fall of 2023 that similarly “raided” Medicare to fund health center spending.

Apart from the fact that it shouldn’t be Republicans’ job to fund continuations of Obamacare programs, the federal government faces serious financial problems. For every $5 the federal government will take in this fiscal year, Washington will spend nearly $7. That’s not sustainable for an ordinary family’s budget, and it isn’t sustainable for the federal government either.

The efforts of the Department of Government Efficiency to pare back unnecessary contracts and streamline the federal workforce will help restore fiscal sanity. But you can’t just balance the budget, let alone get the deficit down to manageable levels, simply by cutting out “diversity, equity, and inclusion” efforts or even zeroing out foreign aid. You must tackle mandatory spending, which includes the community health center funding created by Obamacare — and, yes, even Medicare and Social Security.

The fact that Johnson et al. wouldn’t even halt the community health center funding from now through September — and were willing to “raid” Medicare to ensure it continues — demonstrates that Republicans have yet to grasp the extent of the spending problem or have the political will to act accordingly. Unfortunately, this continued denial also means that whenever the crisis finally hits, American families will face more drastic fiscal changes because their lawmakers lacked the courage to act sooner.