By Senate Republicans on Wednesday discussed the need to cut out waste, fraud and abuse in Medicare to achieve more deficit reduction in President Trump’s landmark bill to extend the 2017 tax cuts, provide new tax relief, secure the border and boost defense spending.
The House-passed bill would cut more than $800 billion from Medicaid and the Children’s Health Insurance Program, but some GOP lawmakers argue that other mandatory spending programs, such as Medicare, should also be reviewed for “waste” to further reduce the cost of the bill.
Sen. Kevin Cramer (R-N.D.) told reporters after the meeting that there is “a legitimate debate” within the Senate Republican conference about whether bigger cuts can be made to federal Medicaid spending and whether federal Medicare spending needs to be reviewed as well.
“There’s a legitimate debate about, ‘Can we do more with Medicaid? Are we doing too much with Medicaid? How much waste, fraud and abuse is there in Medicare? Why don’t we go after that?’ I think we should,” Cramer said after meeting with colleagues to discuss changes to the House-passed bill to enact Trump’s agenda.
“Some people are afraid of the topics. I’m not,” Cramer said. “In my view, this is our moment as Republicans in control of all three branches and we ought to be going after more fiscal responsibility.”
“Some people are making that case, other people are wringing their hands,” Cramer said of the debate in the GOP conference.
Senate conservatives led by Sens. Ron Johnson (R-Wis.) and Rand Paul (R-Ky.) say they will vote against the bill because it will add trillions of dollars to the national debt. They are pushing for bigger deficit-reduction measures.
Cramer said senators floated the idea of also examining waste, fraud and abuse in Medicare during their Wednesday meeting.
“There was a lot of presentation and then debate, people throwing out other ideas, like, ‘What about waste, fraud and abuse in Medicare?’” he said.
The North Dakota senator said some Republican colleagues also want to do more to crack down on states using health care provider taxes as a budget gimmick to collect more Medicaid funding.
“What can we do about the provider tax, money-laundering scheme by states? What more can we do to bend the cost curve a little bit,” Cramer said of the discussion among GOP senators about how to further reduce how much the bill will add to the debt.
The Congressional Budget Office (CBO) estimates the House-passed bill will add $2.4 trillion to the federal debt over the next decade.
The agency estimated the proposed tax cuts in the plan would decrease revenues by more than $3.6 trillion over that time frame.
And the CBO estimates that the House-passed changes to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) will reduce spending by 1.2 trillion.
The House bill would spend $150 billion to secure the borders and beef up immigration enforcement and $150 billion to increase the Pentagon’s budget.
The federal government is expected to run a $2.2 trillion deficit in 2025 and that could rise to $2.7 trillion in 2035.
Cramer described the Wednesday meeting as “a bunch of policy wonks discussing policy.”
He said he “has no idea” how many Republican lawmakers would agree to delve into Medicare but said “I know I’d like to.”
“And I didn’t bring it up, so I’m not the only one,” he added.
Medicare is the second-largest federal government program. It spent $1 trillion in 2023 and is projected to double to $2 trillion by 2033.
It accounted for 27 percent of the entire 2023 budget deficit, according to the CATO Institute.
Johnson, a member of the Senate Finance Committee, is calling on Republican colleagues to scrap the 1,116-page House-passed bill and start over again.
He wants to fellow Republicans to put a lot more effort into deficit reduction, arguing that federal spending has risen across government programs since the COVID-19 pandemic.