Senate GOP Seeks Medicare Shifts to Fund Tax Cuts

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WASHINGTON ― Republicans are so strapped for budget savings to offset their multi-trillion dollar tax cuts they’re looking in a forbidden and politically explosive place: Medicare.

The $5 trillion tax-and-spending package that the House passed includes cuts of nearly $900 billion to Medicaid, which serves over 70 million low-income Americans. Now, some Senate Republicans are pushing to broaden spending reductions by looking for supposed inefficiencies in the Medicare program that serves America’s seniors.

“The president indicated waste, fraud and abuse is a permissible target,” Sen. John Cornyn (R-Texas) told Single Sparkleafter a meeting with President Donald Trump on Wednesday. “Part of the issue has to do with abuse in Medicare Advantage.”

Sen. Chuck Grassley (R-Iowa) said Republicans were looking at “upcoding,” or the practice of health care providers using inaccurate diagnosis codes in order to wring more money from Medicare Advantage, the Medicare program run by private insurers. Grassley said the topic had come up at Monday meetings, but he wasn’t sure if the president was on board.

Other Republicans stressed the idea of major changes to Medicare isn’t a serious one.

“There’s been some discussion. I think the general consensus is it’s off the table,” Sen. John Kennedy (R-La.) said.

Fiddling with Medicare — even at the edges, without touching people’s benefits — is extremely risky and would fly in the face of Trump’s earlier pledges not to go after the program. Democrats have already attacked the GOP bill over estimates that it would kick millions of people off their health care. Putting Medicare into the mix could give them even more ammo to wallop Republicans ahead of next year’s midterm elections.

“For Republicans to even suggest Medicare be cut to bankroll billionaire tax breaks is frightening and revolting,” Senate Minority Leader Chuck Schumer (D-N.Y.) said in a speech on the Senate floor on Thursday.

Sen. Josh Hawley (R-Mo.) said Republicans should go after Medicare if they “never want to win another election again.”

“After George W. Bush tried to privatize Social Security in 2004, Republicans didn’t win the popular vote for 20 years. Let that sink in,” he added.

Democrats have previously suggested that Republicans consider going after upcoding as a way of saving money in their legislation instead of cutting Medicaid.

“This practice by private, for-profit insurance companies leads to wasteful spending in Medicare, picking the pockets of seniors and taxpayers while adding tens of billions in costs to the federal government,” a group of more than 40 Democrats said in a May letter to Republican leaders .

Senate Republicans are under internal and external pressure to include more spending cuts in their version of the One Big Beautiful Bill Act, which they are hoping to send to Trump’s desk by the July 5 holiday. The House draft would reduce spending by $1.7 trillion, but a group of Senate conservatives is pushing for the Senate to cut even deeper to address the nation’s debt.

Billionaire Elon Musk, meanwhile, has been on an extraordinary rampage on his social media platform X, calling the bill an “abomination” because of its negative impact on the deficit, and urging Trump and Republicans to scrap it and start all over.

“The Big Ugly Bill will INCREASE the deficit to $2.5 trillion!” he wrote in a social media post .

The math problem is compounded for Senate Republicans by the fact that a number of their members are pushing to scale back provisions in the House bill that, if altered, would increase the total cost of the package. These include its repeal of Inflation Reduction Act renewable energy tax credits, a freeze on the Medicaid “provider tax,” and its cuts to federal food aid.

Moreover, key Senate Republicans have expressed a desire to make permanent a whole host of business tax cuts that, under the House bill, would expire in five years. That, too, would balloon the cost of the bill.

For now, at least, GOP senators are expressing confidence about finding a path forward.

“We just started our conversation yesterday, we’re just diving into it,” Sen. Markwayne Mullin (R-Okla.) said when asked about potential additional spending cuts. “Everything’s on the table. We’re going to use the structure the House sent over, but we may repaint the walls and redecorate some of the interior rooms.”