LENOX — “Entitlement reform” is the catchphrase you’ll encounter more frequently from the Trump/Musk White House in the months ahead.
Beware of what’s looming for the roughly 72 million low-income and disabled Americans who rely on Medicaid health insurance (including about 2.1 million Massachusetts residents on MassHealth, 30 percent of the state’s population).
Equally worrisome are the potential cuts facing the mostly elderly 69 million Social Security recipients nationwide who receive monthly benefits, plus 4 million people with disabilities.
A budget resolution approved 217-215 along party lines in the U.S. House last month requires nearly $900 billion in spending cuts by the Energy and Commerce Committee over the next 10 years.
Much of the fallout would descend on Medicaid and Medicare, according to the Massachusetts Health and Hospital Association.
The Blue Crpss Blue Shield of Massachusetts Foundation study points out that MassHealth (the state’s Medicaid program heavily reliant on federal funding) pays for 37 percent of births statewide, 48 percent of the state’s children covered by the program and 59 percent of people with disabilities, as well as 70 percent of residents in nursing homes.
One more statistic worth noting: 20 percent of the state’s hospital revenue comes from MassHealth. That soars to 65 percent when Medicare is included — and that coverage is not entitlement but funded by benefits paid for by employers and workers through paycheck deductions, also known as safety net taxes.
The potential impact of the devastating Medicaid cutbacks supported by Republicans who control Congress, and by Elon Musk’s Department of Government Efficiency (DOGE) staff slashers, is only now coming into clear focus.
Medicare, insuring at least 66 million Americans who are 65 and older or disabled, already penalizes physicians and hospitals with absurdly low payment formulas. The U.S. House budget plan imposes a further cut of 2.8 percent for payments to doctors who treat elderly patients, as Forbes reported this week.
No wonder so many physicians, especially in primary care, are fleeing the system, leading to acute shortages in many areas, including Berkshire County.
As for Social Security, it would be foolish to rely on President Donald Trump’s repeated claims that benefits will not be touched. Instead, pay heed to warnings from former agency Commissioner Martin O’Malley. He cites extensive staffing cuts engineered by DOGE and imposed on the Social Security Administration.
“Everything they’re doing is driving this agency to system collapse,” O’Malley said. “It will lead to interruptions in service, and that will ultimately cascade into more frequent system interruptions for the processing of claims, ultimately leading to system collapse and eventually the interruption of benefits.”
He foresees “a meltdown” within the next three months. Remember, it was Musk who called Social Security “the biggest Ponzi scheme of all time,” alleging it is riddled with fraud and exploited by Democrats as a “gigantic magnet to attract illegal immigrants and have them stay in the country.”
What’s a Ponzi scheme, you might ask? A fraudulent investment program that pays existing investors with funds collected from new investors lured by promises of high returns and little or no risk.
Musk, who apparently considers himself an unelected co-president, detailed that conspiracy theory during an interview with Fox business commentator Larry Kudlow. Musk also cited a related “great replacement” canard postulating that white Americans are being pushed out by noncitizens.
Reality check: Undocumented immigrants pay more than $25 billion into the Social Security system each year through payroll taxes, but they cannot collect benefits, according to a study by the nonpartisan Institute on Taxation and Economic Policy.
Already built into the fragile Social Security program: a 20 percent cut in monthly benefits starting in about eight years unless Congress acts to increase or remove the cap on earnings subject to deduction, currently $176,100.
Right now, if you make more than that, those higher earnings are free of Social Security taxes. Remove the escape hatch for high earners, and Social Security benefits are preserved far longer.
It’s not pleasant to come bearing bad tidings of woe. But anyone who prefers a head-in-the-sand denial of a tidal wave heading our way to swamp already fraying safety nets is bound to risk drowning in despair.