How Medicaid Reform Could Fund Trump's Ambitious Agenda, Reverse Bidenflation, and Restore American Greatness

Where Republicans view the responsibility of financing President Obama's initiatives through cost reduction measures as their duty, Donald Trump "s 's vision of a single comprehensive, magnificent bill' to broaden his hallmark tax reduction policy, genuine conservatives view this as an unparalleled chance within their congressional tenure to drastically reduce federal expenditures.

By curbing the most severe instances of waste, fraud, and systematic misuse. Medicaid By targeting the states—particularly those that have used funds from federal taxpayers to support services for unauthorized immigrants—Congress could mitigate inflation by completely financing the indefinite continuation of the 2017 Tax Cuts and Jobs Act. Additionally, Republican members of Congress could enhance Medicaid and secure healthcare coverage for the nation’s most at-risk populations indefinitely.

Although there isn’t a finalized structure for extending the tax laws passed under President Trump’s initial term, we can provide an approximate financial assessment. Adding onto the estimated $4 trillion price tag over ten years from maintaining the Tax Cuts and Jobs Act (TCJA) in its entirety, additional provisions expected to be included would add further costs. These include exempting Social Security from taxation, which could amount to roughly $1.5 trillion over the coming decade; eliminating taxes on tips, adding about $200 billion more; and boosting expenditures for defense and border control by at least another $300 billion. This brings the potential total expense close to $6 trillion across the same timeframe.

Furthermore, five Republican representatives who claim affiliation with the party but represent some of the nation’s richest Democratic-dominated areas are calling for the House Ways and Means Committee to eliminate the $10,000 limit on the state and local tax deductions. Should these so-called SALT Republicans unite, their opposition would be sufficient to block the approval of the tax cut extension legislation, as the current GOP-controlled House has a narrow margin of just 220-213 votes. Additionally,Democrats are expected to secure victory in two pending special elections, thereby increasing their representation by fall.

Nevertheless, these Republican supporters of SALT restrictions will not provide House Ways and Means Committee Chair Jason Smith (R-MO) with the specific figure they want to boost the deduction and secure his support. Doubling the limit to $20,000 for joint filers would add approximately $230 billion to the ten-year budget shortfall. However, increasing this threshold to $40,000 for individuals and $80,000 for couples filing together could result in almost one trillion dollars added to the national debt over a decade. The overall price tag of what’s being called “the grand, impressive package” ranges from $6 trillion to $7 trillion.

Exploring alternative areas for reducing expenses, we find that discretionary spending accounts for roughly one-fourth of our yearly $6 trillion in federal expenditures. Additionally, Trump has consistently declined over the past decade to make changes to Social Security or Medicare.

This brings us to Medicaid, the federal healthcare initiative designed for low-income Americans, which has evolved so much since its inception in 1965 that even the architects of the original Great Society programs wouldn’t recognize it today.

Designed as an equal financial collaboration between federal and state governments, Medicaid initially catered solely to individuals enrolled in either Aid to Families with Dependent Children—meant specifically for extremely low-income families headed by single mothers—or Aid to the Aged, Blind, or Disabled. Although Congress gradually expanded the eligibility requirements over time for low-income children and expectant women, Medicaid retained stringent conditions such that around 12 percent of the U.S. population participated in the program at the start of the 21st century.

The Affordable Care Act introduced during former President Barack Obama’s tenure significantly altered the Medicaid program. Enacted in 2010, this legislation theoretically mandates that every participating state extend eligibility to all U.S. citizens irrespective of their age or capability, allowing them to be covered if their income falls within 138% of the federal poverty level or less. Although the Supreme Court curtailed Obama's power to withhold funds from states not fully expanding eligibility, the financial inducement—whereby Obamacare originally committed to covering 100% of expenses related to the ACA expansion at first, decreasing gradually until states were responsible for just 10% starting in 2020—proved effective. As things stand today, merely ten states remain steadfast against expansion, leaving over one-quarter of America’s populace reliant on Medicaid.

When combined with the approximately 20% of baby boomers enrolled in Medicare and an additional 20 million individuals participating in various smaller government-funded health care initiatives, nearly half of all Americans rely on some form of socialized medicine. The outcomes align closely with what might be anticipated. Discounting interest expenses, around 40% of our federal budget is earmarked for Medicare and Medicaid expenditures this fiscal year; without reforms, these costs could exceed 50% within three decades. Since 2008, funding allocated specifically to Medicaid has surged by over two-fold, increasing another 50% just from 2019 onwards. This year’s projected expenditure for Medicare stands at close to $900 billion, with projections indicating that under present regulations, the total liability for Medicare over the coming ten-year span may balloon to roughly $8.2 trillion.

Therefore, Congress has the ability to modify the legislation that permits the federal government to support 21 million capable adults, with 60% of them being unemployed, as indicated by data compiled from state Medicaid agencies by the Foundation for Government Accountability.

The clearest target for elimination is President Obama’s unreasonable mandate that requires federal taxpayers to allocate double the funds for able-bodied adults included under the Affordable Care Act (ACA) expansion compared to what is provided for impoverished children or individuals with disabilities. According to projections from the nonpartisan Congressional Budget Office, adjusting the Federal Medical Assistance Percentage Matching rate so that Medicaid expansion recipients receive funding equivalent to the original intended beneficiaries of Medicaid could reduce the deficit by approximately $710 billion over the coming ten years.

THE FOUR GROUPS THE SPEAKER OF THE HOUSE, JOHNSON, NEEDS TO SATISFY IN ORDER TO GET TRUMPS GIANT BILL APPROVED

Requiring work for capable individuals is an additional measure supported by 62% of Americans, according to a Kaiser Family Foundation survey, which includes backing from 60% of independents and 82% of Republicans. According to estimates from the Committee for a Responsible Federal Budget, implementing such measures could result in savings of around $140 billion over ten years. Furthermore, the CRFB projects that prohibiting states from exploiting the “Medicaid provider tax” loophole would lead to approximately $720 billion in savings between 2026 and 2035.

These and various other alterations related to Medicaid would result in over $4 trillion in savings. Such modifications would reduce the scale of the federal government, compel capable individuals to leave welfare programs, and address inflation as part of an effort to finance growth-inducing tax reductions aimed at revitalizing the nation with the slogan “Making America Great Again.” In 2010, Democrats got their chance to substantially transform the American economic landscape, which they did. Now, after fifteen years under policies deemed unsuccessful by this perspective, it’s time for Republicans to reverse these measures.