GOP cuts in Medicare may be next after dismantling Obamacare – AOL News

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The pledge by President-elect Donald Trump and congressional Republicans to “repeal and replace” the Affordable Care Act beginning early next year has dominated the national policy debate since Trump, and the GOP swept to victory in last week’s election.

With potentially 20 million or more Americans threatened with the disruption or loss of their Obamacare insurance coverage in the coming years, Trump and GOP leaders are coming under mounting pressure to explain precisely how they would replace Obamacare once they pass legislation early next year to dismantle key elements of the program.

Related: Top 2016 issues: Health, Obamacare opinions, Medicare, abortion

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2016 issues: Health, Obamacare opinions, Medicare, Abortion

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Opponents and supporters of Planned Parenthood demonstrate Tuesday, July 28, 2015, in Philadelphia. Anti-abortion activists are calling for an end to government funding for the nonprofit reproductive services organization. (AP Photo/Matt Rourke)

Anti-abortion activists demonstrate near a Planned Parenthood clinic Tuesday, July 28, 2015, in Philadelphia. The protestors are calling for an end to government funding for the nonprofit reproductive services organization. (AP Photo/Matt Rourke)

Kathy Calver listens to a speaker as she and other anti-abortion activists rally on the steps of the Texas Capitol to condemn the use in medical research of tissue samples from aborted fetuses, Tuesday, July 28, 2015, in Austin, Texas. (AP Photo/Eric Gay)

Razor grass and pro-choice signs limit the view of patients entering the Jackson Women’s Health Organization clinic in Jackson, Miss., Tuesday, June 30, 2015. Mississippi’s only abortion clinic will likely remain open at least until the fall, because the U.S. Supreme Court is taking no action until then on a dispute over a state law that could close it. (AP Photo/Rogelio V. Solis)

MANHATTAN, NEW YORK CITY, UNITED STATES – 2015/08/22: Assembly of some 150 anti-abortion protesters behind barricade in front of Planned Parenthood. A coalition of anti-abortion protesters protested on Mott Street in Manhattan in front of Planned Parenthood. (Photo by Andy Katz/Pacific Press/LightRocket via Getty Images)

MANHATTAN, NEW YORK CITY, UNITED STATES – 2015/08/22: Protester with Baby Doe sign in front of Planned Parenthood. A coalition of anti-abortion protesters protested on Mott Street in Manhattan in front of Planned Parenthood. (Photo by Andy Katz/Pacific Press/LightRocket via Getty Images)

WASHINGTON, DC – JULY 28: Republican presidential candidate Dr. Ben Carson speaks at a anti-abortion rally opposing federal funding for Planned Parenthood in front of the U.S. Capitol July 28, 2015 in Washington, DC. Planned Parenthood faces mounting criticism amid the release of videos by a pro-life group and demands to vote in the Senate to stop funding. (Photo by Olivier Douliery/Getty Images)

WASHINGTON, DC – JULY 28: Republican presidential candidate, U.S. Sen. Ted Cruz (R-TX) speaks during a Anti-abortion rally opposing federal funding for Planned Parenthood in front of the U.S. Capitol July 28, 2015 in Washington, DC. Planned Parenthood faces mounting criticism amid the release of videos by a pro-life group and demands to vote in the Senate to stop funding. (Photo by Olivier Douliery/Getty Images)

UNITED STATES – JANUARY 22: Pro-choice protesters chant in front of the Supreme Court on Thursday, Jan. 22, 2015, the anniversary of the Roe v Wade abortion decision. (Photo By Bill Clark/CQ Roll Call)

Republican presidential candidate, Wisconsin Gov. Scott Walker, presents his plan to replace Obamacare, during a visit to Cass Screw Machine Products, Tuesday, Aug. 18, 2015, in Brooklyn Center, Minn. (AP Photo/Jim Mone)

UNITED STATES – FEBRUARY 5: Sen. Marco Rubio, R-Fla., testifies during the House Oversight and Government Reform Committee hearing on ‘ObamaCare: Why the Need for an Insurance Company Bailout?’ on Wednesday, Feb. 5, 2014. (Photo By Bill Clark/CQ Roll Call)

Sen. Chris Murphy, D-Conn., second from right, accompanied by Sen. Tammy Baldwin, D-Wisc., left, Sen. Sherrod Brown, D-Ohio, second from left, and Sen. Bob Casey, D-Pa., right, speaks at a press conference on the positive affects of the Affordable Care Act as the Senate convenes for a Sunday session on Capitol Hill in Washington, Sunday, July 26, 2015. On the Senate’s agenda is an effort to repeal President Barack Obama’s health care law. (AP Photo/Andrew Harnik)

President Barack Obama talks to a man in the audience as he takes questions at Taylor Stratton Elementary School in Nashville, Tenn., Wednesday, July 1, 2015, where he spoke about the Affordable Care Act. The president said he wants to refocus on improving health care quality, expanding access and rooting out waste now that the Supreme Court has upheld a key element of his health care law. (AP Photo/Carolyn Kaster)

Jessica Ellis, right, holds a sign that says “yay 4 ACA,” as she and other supporters of the Affordable Care Act react with cheers as the opinion for health care is reported outside of the Supreme Court in Washington, Thursday June 25, 2015, in Washington. (AP Photo/Jacquelyn Martin)

Trent Seubert, left, holds a sign stating that 165,000 people would lose healthcare coverage, as the words “lose healthcare” are covered over with a “still covered” sticker outside the Supreme Court in Washington, Thursday, June 25, 2015, after the court decided that the without the Affordable Care Act (ACA) may provide nationwide tax subsidie. (AP Photo/Jacquelyn Martin)

FILE – In this Nov. 12, 2014 file photo, the HealthCare.gov website, where people can buy health insurance, is displayed on a laptop screen, in Portland, Ore. The Illinois Hospital Association in cash-strapped Illinois says the state might be able to set up a health insurance exchange at a lower cost by “leasing” the federal government’s technology, an option that could appeal to as many as 34 states where subsides could be jeopardized by an unfavorable Supreme Court ruling. . (AP Photo/Don Ryan, File)

UNITED STATES – JUNE 25: Affordable Care Act supporters hold up signs outside the Supreme Court as they wait for the court’s decision on Obamacare on Thursday, June 25, 2015. (Photo By Bill Clark/CQ Roll Call)

FILE– In this Sept. 16, 2013 file photo, Gov. Rick Snyder, center, signs legislation at Oakwood Hospital in Dearborn, Mich. that will make more low-income adults eligible for Medicaid. One year after more low-income adults in Michigan became eligible for Medicaid under the federal health care law, enrollment is skyrocketing near 600,000, well above initial projections. (AP Photo/Carlos Osorio)

IMAGE DISTRIBUTED FOR AIDS HEALTHCARE FOUNDATION – Over 50 AIDS awareness advocates gather to protest in front of the Employment Development Department spearheaded by AIDS Healthcare Foundation (AHF) on Thursday, March 19, 2015, in Sacramento, Calif. The protest was over Cal/OSHA’s five-year delay in amending and tightening California workplace safety regulations regarding condom use in adult film production to better protect adult film workers. (Steve Yeater/AP Images for AIDS Healthcare Foundation)  

University of Maryland medical student Sarah Britz, center, and others, rally outside the Supreme Court in Washington, Wednesday, March 4, 2015 in Washington, as the court was hearing arguments in King v. Burwell, a major test of President Barack Obama’s health overhaul which, if successful, could halt health care premium subsidies in all the states where the federal government runs the insurance marketplaces. (AP Photo/Andrew Harnik)

In this photo taken Feb. 24, 2015, Kimberly Davis holds the medications she now takes to slow the progression of her multiple sclerosis, at her home in Jackson, Miss. The Supreme Court will hear arguments next week over whether millions of people covered by the nation’s health care law can legally continue to get financial help to pay for their insurance. If the court says no, millions of consumers across more than 30 states could lose federal subsidies for their premiums. (AP Photo/Rogelio V. Solis)

UNITED STATES – JUNE 25 – Supporters of the Affordable Care Act celebrate as the opinion for health care is reported outside of the Supreme Court in Washington,Thursday June 25, 2015. The Supreme Court on Thursday upheld the nationwide tax subsidies under President Barack Obama’s health care overhaul, in a ruling that preserves health insurance for millions of Americans. (Photo By Al Drago/CQ Roll Call)

RICHMOND, CA – MARCH 31: Posters about Obamacare are posted on a window during a healthcare enrollment fair at the Bay Area Rescue Mission on March 31, 2014 in Richmond, California. SEIU-United Healthcare Workers West (SEIU-UHW) held the fair to help people sign up for free and low-cost health coverage through Medi-Cal or Covered California on the final day before the sign-up deadline. (Photo by Justin Sullivan/Getty Images)




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More from The Fiscal Times: Congress Gives Trump a Chance to Recast the Federal Budget

However, practically overnight the Republicans have substantially raised the stakes in their drive to reform the government health care system and cut costs. House Budget Committee Chair Tom Price (R-GA) told reporters on Thursday that the House GOP will likely push next year for major changes and cuts in Medicare, the premier health care program for 57 million seniors that has been the bedrock of retirees’ health coverage since the mid-1960s.

Price, who reportedly is being considered by Trump to head the Department of Health and Human Services, said that Republicans would likely move “within the first six to eight months” of Trump’s administration to begin implementing their plan. Key elements include raising the age of eligibility from 65 to 67 and gradually privatizing the system with government-issued vouchers or “premium supports” to defray the cost of insurance policies purchased on the open market.

Trump repeatedly promised during the presidential campaign that he would not cut Social Security or Medicare to control government spending and address long-term deficit problems. “So, you’ve been paying into Social Security and Medicare…but we are not going to cut your Social Security, and we’re not cutting your Medicare,” Trump said at a rally in Iowa in December 2015.

However, privatization of Medicare has long been a central feature of House Speaker Paul Ryan’s highly controversial budget proposals that enjoyed substantial GOP support in the House but never made it past the Senate. Now Ryan and other Republican House leaders believe that the election results are a mandate to push a bold agenda including Medicare reform – much to the dismay of advocates of the program.

More from The Fiscal Times:Five Things Trump Wants to Do That Liberals Would Love

“This is one case where there just seems to be a gross contradiction between something that Trump clearly stated and what the congressional Republicans are now talking quite openly about doing next year,” said Paul N. Van de Water, a senior fellow at the liberal Center for Budget and Policy Priorities. “I didn’t follow Trump’s promises verbatim over the campaign, but everybody certainly seems to have picked up the notion that he promised not to cut Social Security and Medicare.”

Related: Trump’s transition team

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Donald Trump’s transition team

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U.S. President-elect Donald Trump and Chairman of the Republican National Committee Reince Priebus address supporters during his election night rally in Manhattan, New York, U.S., November 9, 2016. REUTERS/Mike Segar

Republican vice presidential nominee Mike Pence attends a campaign rally in Manchester, New Hampshire, U.S. November 7, 2016. REUTERS/Carlo Allegri

Campaign CEO Stephen Bannon departs the offices of Republican president-elect Donald Trump at Trump Tower in New York, New York, U.S. November 11, 2016. REUTERS/Carlo Allegri

U.S. Republican presidential candidate Governor Chris Christie speaks to supporters in West Des Moines, Iowa, U.S. January 31, 2016. REUTERS/Brian C. Frank/File Photo

Former candidate Ben Carson arrives to attend the third and final 2016 presidential campaign debate between Republican U.S. presidential nominee Donald Trump and Democratic nominee Hillary Clinton at UNLV in Las Vegas, Nevada, U.S., October 19, 2016. REUTERS/Mike Blake

Former New York Mayor Rudy Giuliani leaves the offices of Republican President-elect Donald Trump at Trump Tower in New York, New York, U.S., November 11, 2016. REUTERS/Carlo Allegri

Former House Speaker Newt Gingrich speaks at the Republican National Convention in Cleveland, Ohio, U.S. July 20, 2016. REUTERS/Mark Kauzlarich

Defense Intelligence Agency director U.S. Army Lt. General Michael Flynn testifies before the House Intelligence Committee on “Worldwide Threats” in Washington February 4, 2014. REUTERS/Gary Cameron/File photo TPX IMAGES OF THE DAY

U.S. Senator Jeff Sessions (R-Al) speaks at the Republican National Convention in Cleveland, Ohio, U.S. July 18, 2016. REUTERS/Mike Segar

Republican President-elect Donald Trump’s daughter Ivanka Trump arrives at Trump Tower in New York, New York, U.S., November 11, 2016. REUTERS/Carlo Allegri

Son of Republican President-elect Donald Trump Eric Trump gives the thumbs up as he arrives at Trump Tower in New York, New York, U.S., November 11, 2016. REUTERS/Carlo Allegri

Donald Trump Jr. sits between his wife Vanessa (L) and his brother Eric Trump (R) during the third and final debate between Republican U.S. presidential nominee Donald Trump and Democratic nominee Hillary Clinton at UNLV in Las Vegas, Nevada, U.S., October 19, 2016. REUTERS/Rick Wilking

Jared Kushner (L) and Stephen Bannon stand by as Republican presidential nominee Donald Trump holds a campaign rally in Canton, Ohio, U.S., September 14, 2016. REUTERS/Mike Segar

PayPal co-founder and Facebook board member Peter Thiel delivers his speech on the U.S. presidential election at the National Press Club in Washington, U.S., October 31, 2016. REUTERS/Gary Cameron

Steven Mnuchin, Chairman and Co-CEO of Dune Capital Management LP and Chairman and CEO of OneWest Bank Group LLC
speaks at a panel discussion “Jump-Starting the Housing Market” at the 2009 Milken Institute Global Conference in Beverly Hills,California April 28, 2009. REUTERS/Fred Prouser (UNITED STATES BUSINESS)

Anthony Scaramucci, co-managing partner and founder of Skybridge Capital speaks at the opening of the annual Skybridge Alternatives Conference (SALT) in Las Vegas May 6, 2015. REUTERS/Rick Wilking

Newly elected Congressmen Lou Barletta (R-PA) (R) and Tim Scott (R-SC) (C) arrive on Capitol Hill in Washington, November 17, 2010. The new members of the upcoming 112th Congress are going through orientation. REUTERS/Jim Young (UNITED STATES – Tags: POLITICS)

Florida Attorney General Pam Bondi speaks at the Republican National Convention in Cleveland, Ohio, U.S. July 20, 2016. REUTERS/Mike Segar

Representative Marsha Blackburn (R-TN) speaks during the final day of the Republican National Convention in Cleveland, Ohio, U.S. July 21, 2016. REUTERS/Mike Segar

U.S. Representative Chris Collins (R-NY) flashes a thumbs-up before delivering his nomination speech at the Republican National Convention in Cleveland, Ohio, U.S. July 19, 2016. REUTERS/Jim Young

U.S. Representative Devin Nunes (R-CA) talks to reporters as he walks from the offices of House Speaker John Boehner (R-OH) (not pictured) at the U.S. Capitol in Washington, October 15, 2013. Republicans in the House of Representatives failed to reach internal consensus on Tuesday on how to break an impasse on the federal budget that could soon result in an economically damaging default on the country’s debt. REUTERS/Jonathan Ernst (UNITED STATES – Tags: POLITICS BUSINESS MEDIA)

Campaign Communications Director Hope Hicks departs the offices of Republican president-elect Donald Trump at Trump Tower in New York, New York, U.S. November 11, 2016. REUTERS/Carlo Allegri




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“It’s hard to see how one could square that with either premium support for example or certainly raising the Medicare age,” he added in an interview Friday. “Both of those are either reducing benefits or requiring people to pay more for the same benefits, which is essentially the same thing.”

For years dating back to the administration of President George W. Bush, Republicans have been advancing proposals for replacing traditional Medicare with some private system, but those proposals have never gotten very far. The latest iteration of that plan – to preserve traditional Medicare for those currently in the system but to pressure younger Americans to gradually shift to a voucher plan – was included in a major health care policy paper Ryan released June 22 called “A Better Way– Our Vision for a Confident America.”

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