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WASHINGTON — The presidential debate in early September included just one mention of Social Security and three references to Medicare, making the safety net programs a minuscule part of the policy discussion, despite their importance to tens of millions of Americans.
Democratic nominee Kamala Harris and Republican candidate Donald Trump have both mentioned the programs numerous times during appearances, though neither campaign has sought to elevate the financial stability of the two programs as a core issue.
More often than not, Harris and Trump rebuke their opponent, while committing to “save” Social Security and Medicare — skipping over the details or the role Congress must play in the discussion.
How to address projected shortfalls for both the Social Security and Medicare trust funds will become an increasingly important topic for the president and Congress during the next decade.
The latest Social Security trustees report expects the Old-Age and Survivors Insurance and the Disability Insurance trust funds will be able to pay full benefits until 2035, after which, without action by lawmakers, benefits would drop to about 83%.
The trustee report for Medicare shows the funding stream for the hospital insurance trust fund can cover all of its bills through 2036 before it would only be able to cover 89% of costs.
There are currently 67.5 million people enrolled in Medicare, which provides health insurance and prescription drug coverage for people over the age of 65 as well as younger people who have certain severe illnesses or disabilities.
Nearly 68 million people receive some level of benefit from Social Security each month, accounting for about $1.5 trillion in spending by the federal government annually, according to a fact sheet.
While the issue is somewhat less pressing for Trump, who would be term limited to another four years, Harris could theoretically spend the next eight years in the Oval Office, making the solvency of the trust funds an issue she would likely need to address with Congress.
Protecting seniors
During the September debate, Harris brought up Social Security and Medicare following a question about how her policy beliefs on fracking, assault weapons and border security have changed over time.
“My work that is about protecting Social Security and Medicare is based on long-standing work that I have done. Protecting seniors from scams,” Harris said as part of a longer answer. “My values have not changed. And what is important is that there is a president who actually brings values and a perspective that is about lifting people up and not beating people down and name-calling.”
Harris later brought up Medicare again, noting that legislation Congress approved during Biden’s term in office allowed program administrators to negotiate certain prescription drug prices for the first time. That law, known as the Inflation Reduction Act, also capped the cost of insulin for Medicare enrollees at $35 per month.
Trump didn’t broach the subject of Social Security or Medicare during the September debate with Harris, but he did speak about the two programs during an earlier summer debate with President Joe Biden, before he stepped aside as the Democratic nominee.
During that debate, Trump claimed the Biden administration was going to “destroy” the two programs by allowing noncitizens to draw down benefits.
FactCheck notes on its website that comments and viral posts about noncitizens receiving Social Security benefits don’t always represent reality and sometimes confuse different programs.
“Immigrants who are lawfully living or authorized to work in the U.S. are eligible for a Social Security number and, in some cases, Social Security benefits. But viral posts make the false claim that ‘illegal immigrants’ can receive Social Security numbers and retirement benefits, and they confuse two programs managed by the Social Security Administration.”
KFF writes on its website that whether legal immigrants are eligible for Medicare depends on several factors, including how long they’ve paid into the system.
“New immigrants are not eligible for Medicare regardless of their age. Once immigrants meet the residency requirements, eligibility and enrollment work the same as they do for others.”
Trump on entitlement programs
Trump’s comments on entitlement programs haven’t always been consistent or entirely clear, but his campaign and he both maintain they will “save” the program.
During an interview with CNBC in March, Trump said that there are numerous things lawmakers could do to address solvency.
“There is a lot you can do in terms of entitlements, in terms of cutting and in terms of also the theft and the bad management of entitlements,” Trump said, declining to list any of those policy proposals.
Trump’s campaign website posted a video of him back in January 2023, saying Republicans “should not cut a penny” from Medicare or Social Security to pay for other legislation.
The problems facing Social Security and Medicare aren’t related to Congress reducing the amount of tax dollars flowing into the programs. Rather it is the structure for the programs lawmakers set up previously.
Without action by Congress, the trust funds won’t be able to account for benefit payments in the long term.
So the challenge for the next president won’t be preventing lawmakers from taking action related to Social Security and Medicare, but helping find a bipartisan path forward on legislation to change revenue, spending, or both.
Trump does want to end taxes on Social Security benefits, writing on social media in July that “SENIORS SHOULD NOT PAY TAX ON SOCIAL SECURITY!”
Henry Aaron, the Bruce and Virginia MacLaury Chair and senior fellow in the Economic Studies Program at the Brookings Institution, wrote in a detailed analysis of the platform that Trump’s proposal to end income tax on Social Security benefits “would accelerate trust fund depletion by about two years and deepen the long-run funding gap by more than 7%.”
Harris policies
Harris’ campaign website says she would “protect Social Security and Medicare against relentless attacks from Donald Trump and his extreme allies.”
“She will strengthen Social Security and Medicare for the long haul by making millionaires and billionaires pay their fair share in taxes,” the policy page states. “She will always fight to ensure that Americans can count on getting the benefits they earned.”
Harris announced in early October during an appearance on “The View” that if elected she would work toward including long-term home care for seniors enrolled in Medicare.
“There are so many people in our country who are right in the middle: They’re taking care of their kids and they’re taking care of their aging parents, and it’s just almost impossible to do it all, especially if they work,” Harris said during the live interview. “We’re finding that so many are then having to leave their job, which means losing a source of income, not to mention the emotional stress.”
The proposals would likely need partial, if not complete, buy-in from Congress to move forward and could come with a $40 billion annual price tag, though the campaign noted in a fact sheet that there are pay-fors.
“These new benefits will be fully paid for and extend the life of the Medicare Trust Fund by expanding Medicare drug price negotiations, increasing the discounts drug manufacturers cover for certain brand-name drugs in Medicare and addressing Medicare fraud,” it states.
A Harris administration would also “crack down on pharmaceutical benefit managers (PBMs) to increase transparency, disclose more information on cost, and regulate other practices that raise prices” and “implement international tax reform” to pay for the changes.