Fact check: Would Trump slash social security and Medicare?

In a new TV ad, former president Donald Trump is being attacked on healthcare, entitlement programs, and taxes by Vice President Kamala Harris, who is launching her final statement for president.

What would a second term for Trump entail? It’s all laid out in his Project 2025 agenda”, the narrator says. “He’d let insurance companies deny coverage for preexisting conditions, cut Social Security and Medicare and give tax cuts to billionaires”.

Harris’ campaign has tied Trump to Project 2025, a 900-page manual of policy recommendations for the incoming Republican administration created by the conservative Heritage Foundation think tank, for months.

The project’s participants and former Trump administration officials share a lot of information. But Project 2025 is not part of Trump’s 2024 agenda, and he has worked to distance himself from it.

With that in mind, the advertisement is a mixed bag of accuracy. It makes up Trump’s earlier claims to repeal the Affordable Care Act (ACA), misleads viewers about “cuts” to entitlement programs that are well-liked by older Americans, and ignores that Americans with average incomes would also benefit from some tax breaks under Trump.

What Trump’s and Project 2025’s plans say about preexisting conditions

Harris’ campaign cited actions and comments made by Trump and his running mate, Senator JD Vance, regarding repealing the ACA to back up its claim that Trump would allow insurance companies to deny people coverage for preexisting conditions. The 2010 health law, signed by former President Barack Obama, requires insurance companies to cover people with pre-existing conditions.

In his 2016 presidential campaign, Trump promised to repeal the ACA, and as president, he supported congressional Republicans ‘ failed repeal-and-replace efforts.

During his 2024 campaign, Trump’s position has gone back and forth. At times, he has said he wants to replace the law with an “alternative”. But in March, he wrote on Truth Social that he is “not running to terminate” the law and instead wants to make it “better” and “less expensive”. Trump said he had “concepts of a plan” to replace the law in the September 10 presidential debate, but that he would “run it as good as it can be run” before putting his plan into action.

On October 17, more than 1,500 doctors wrote a letter to Trump demanding details on how the ACA would be changed, arguing that voters require the explanation to make an informed choice.

In an interview with NBC News’ “Meet the Press” on September 15, Vance claimed their administration would deregulate insurance markets but would still “make sure that pre-existing coverage – conditions – are covered.” He attempted to fill in some of those details. Vance argued the idea of grouping people who had a chronic illness together in insurance pools based on their increased risk later. A group of people who share the costs of healthcare use the term “risk pools.”

A pillar of the healthcare law, which largely ended the practice by requiring insurers to place all individual market enrollees in the same risk pool, would be reversed by placing chronically ill patients in higher-risk pools. According to KFF Health News, this is done to keep premium costs under control by using lower costs for healthy participants to keep up with higher costs for less healthy ones. According to experts, separating sicker people from their own pool could cause higher costs for those who have chronic health conditions, potentially putting coverage out of reach.

Project 2025 does not call for eliminating the ACA or pre-existing coverage protections. It recommends codifying Trump-era rules to expand short-term, limited-coverage healthcare plans. These plans, according to Democrats, “junk insurance,” restrict care, increase the cost of pre-existing conditions, and increase unexpected medical bills.

Project 2025 would not cut Social Security, proposes some changes to Medicare

The advertisements for Harris and Project 2025 mislead about Trump’s and Project 2025’s social security plans. None of the policy document’s ten references to Social Security include any cuts, despite Trump’s pledge to not pursue them.

In his earlier campaigns and before he was a politician, Trump said about a half-dozen times that he was open to major overhauls of Social Security, including cuts and privatisation. More recently, in a March 2024 CNBC interview, Trump said of entitlement programmes such as Social Security: “There’s a lot you can do in terms of entitlements, in terms of cutting”. He quickly responded, and his statement contradicts essentially all of Trump’s statements made during the presidential campaign in 2024.

Trump’s campaign website says not “a single penny” should be cut from Social Security.

Project 2025 proposes changes to Medicare, including making Medicare Advantage, the private insurance offering in Medicare, the “default” enrolment option. The plan has the power to approve or reject particular services, and Medicare Advantage plans have provider networks. Prior authorization requirements are absent from original Medicare plans.

Additionally, the Inflation Reduction Act and other health initiatives that were passed under President Joe Biden are being urged to be repealed. For the first time since the 2022 law, Medicare has been able to bargain with drug manufacturers, and recently, the government has reached a deal with drug manufacturers to lower the cost of 10 expensive prescriptions for Medicare enrollees. In 2026, new prices will be in effect.

Trump has stated his intention to not reduce Medicare throughout his campaign.

Project 2025 and Trump differ on taxes, but ‘ tax cuts to billionaires ‘ are on the table

Most income groups would receive the most of Trump’s tax cuts, while disproportionately wealthy Americans would benefit. Trump’s tax policy and recommendations for Project 2025 differ, but they could change as a result of lower taxes for those who are wealthier.

Under Trump’s 2017 Tax Cuts and Jobs Act, income up to $11, 600 is currently taxed at 10 percent, income from $11, 601 to $47, 150 is taxed at 12 percent and income from $47, 151 to $100, 525 is taxed at 22 percent. People who earn more are taxed between 24 percent and 37 percent.

Project 2025 calls for creating just two income tax brackets: one at 15 percent and one at 30 percent, and eliminating most deductions, credits and exclusions. According to the program, the 30% tax rate should begin “at or close to the Social Security wage base, which will be around $ 188,600 in 2024.”

The standard deduction, which non-itemiser taxpayers may deduct from their income before paying income tax, is not specifically recommended in the Project 2025 plan.

People earning up to $190,000 would receive a higher effective tax rate on their entire income if that were removed, while those earning a lower tax rate would receive a higher effective tax rate.

This is not Trump’s plan. Trump says he would extend the 2017 tax law provisions, which are set to expire at the end of 2025. The law lowered taxes for all income groups, at least initially, wealthier taxpayers benefitted disproportionately. The top one-fifth of the income spectrum’s tax rate was increased by the law, according to the Urban-Brookings Tax Policy Center, over the top quintile grouping’s.

Trump would lower US businesses’ corporate tax rates from 21 percent to 15 percent. (The 2017 law had cut the corporate tax rate from 35 percent to 21 percent.) Trump has also proposed a number of additional tax cuts, including ending the federal government’s taxation of tips, overtime pay, and Social Security benefits.

The effects of the tax proposals of both presidential candidates’ policies on a range of income levels were predicted by the University of Pennsylvania’s Penn Wharton Budget Model in 2026.

It found that Trump’s plan would increase post-tax income for every income group. However, the bottom two-fifths of the income spectrum would have gains smaller than 2 percent, the middle fifth would have a gain of 2.1 percent and the second-highest quintile would gain 2.8 percent. For cuts affecting the top one-fifth of earners, gains would range from 2.7 percent to 3.7 percent.

Source: Aljazeera