Medicare, Medicaid concerns arise in Montana as tax reform takes off

by Billings Gazette, Tom Lutey

As Republicans race ahead with plans to pass tax reform by Christmas, Montana groups fearing deep cuts to Medicare and Medicaid are suggesting Congress tap on the brakes.

The concern is that future Medicare spending could be cut as much as $478 billion and Medicaid could see a $1 trillion cut to its growth. The estimated cuts come not from the scant-on-detail congressional Republican tax reform package, but rather the federal budget approved last week.

The budget called for slowing the growth of Medicare over a decade, but not cutting spending below current levels. Nonetheless, with an aging baby boomer population, cuts to services for seniors raises concerns for AARP Montana.

“Our national staff is evaluating the proposal, along with the budget and of course we’re very concerned about how any of this will affect Medicare and Social Security,” said Claudia Clifford, of AARP Montana.

There’s a vulnerable class of seniors younger than 65 who can’t turn to Medicare to pay for medical costs. For those seniors, Medicaid can be important for paying medical bills. If Medicaid is cut and seniors younger than 65 have to cover medical debts out of pocket, they might enter retirement in debt.

“The dangerous thing about medical debt is you don’t have the years to pay it off and you should be saving for retirement,” Clifford said.

Montana’s congressional Republicans have cautioned not to read too much into the budget projections for Medicare and Medicaid, asserting that any tax reform passed will be offset by economic growth.

“We’re going to continue to protect our senior citizens. I have not seen that proposal,” said Republican Sen. Steve Daines when asked in October about Medicare cuts.

Monday, Daines told constituents in a teleconference that businesses were waiting on tax reform to invest in the economy.

“Since Election Day, the Dow, the stock market, is up about 28 percent and that’s created over $5 trillion of value in this economy and that is in part due to the anticipation, the confidence, the optimism the nation has behind the change that occurred during the election,” Daines said.

Rep. Greg Gianforte has also said the reductions to the growth in Medicare and Medicaid spelled out in the newly passed budget should not be construed as cuts intended to prevent deficit spending after tax cuts.

Democratic Sen. Jon Tester said earlier in the month that he was concerned that the newly passed budget allowed for deficit cuts of $1.5 trillion and that Medicare and Social Security could be in the crosshairs of the Senate Finance Committee if future cuts were needed.

Tester this week described the current tax reform proposal as having no meat on its bones, or in other words lacking specific details. He promised to post the tax bill to his website as soon as it was published so constituents could read it and make comments.

The problem with the state of tax reform currently is that there are no specifics, said Bob Olsen, Montana Hospital Association vice president. MHA was fresh off a battle to prevent a proposed Affordable Care Act repeal bill from harming federal Medicaid support in Montana. The state expanded Medicaid under ACA, and more than 70,000 working poor Montanans acquired health care as a result. Plans to cut federal support for Medicaid would have harmed thousands of Montanans, MHA argued.

The tax reform efforts raise similar issues, Olsen said.

“We’re concerned about this lack of detail, number one,” Olsen said of the tax reform proposal. MHA is concerned that as the federal commitment to health care changes, states will be given less federal support – while at the same time being asked to make tough cuts for subsidized health care programs.

Medical professionals in Montana are asking questions about the future of Medicaid and Medicare in relation to tax reform, Olsen said. They deserve answers.