It's June 16, 2015, and candidate Donald Trump distinguishes himself from the rest of the Republican field with the promise to "save Medicare, Medicaid, and Social Security, without cuts. Have to do it. Get rid of the fraud, get rid of the waste and abuse, but save it."
Now it's May 23, 2017, and while popular vote loser Donald Trump is overseas, his budget director Mick Mulvaney releases a budget that cuts Medicaid funding nearly in half by 2027 when combined with the proposed cuts in Trumpcare.
That's $610 billion in Medicaid cuts on top of an $880 billion cut in Trumpcare. Here's the reality of what that means for nearly every American, because just about everybody will be touched by Medicaid, either themselves or through a loved one. Nearly one in four Americans is covered by Medicaid. Half of all births are covered by Medicaid. In Louisiana, it's about two-thirds of births. Just about $1 out of every $6 spent on health care in the U.S. is spent by Medicaid. That's 74 million Americans directly covered by Medicaid.
And here's where it's really going to hit home.
The elderly and disabled account for around 60% of Medicaid's expenditures, with the disabled, including the mentally ill, accounting for a full 42% of spending.
The program is the country's largest funder of long-term care expenses, covering 40% of the costs, as well as more than 60% of all nursing home residents. For Baby Boomers nearing or past retirement age, these funds are crucial: As MONEY has previously reported, nursing homes for the elderly cost an average of $80,000 annually, and those expenditures aren't covered under Medicare, the health program for seniors over 65. In fact, because Medicaid absorbs high healthcare costs of people with expensive conditions like dementia, it has kept private insurance around 7% lower than they would be.
To demonstrate how disastrous that will be, look at what's looming ahead for us.
The reality is there are no charity organizations who can step in to take care of birthing babies in lieu of doctors. There are no charities that can provide either nursing homes or the round-the-clock skilled nursing necessary for residents. Not to mention all the other services Medicaid provides, from substance abuse treatment to support for the disabled in their own homes, allowing them to attend school and to work and to have regular lives and to allow their family members that same freedom.
Candidate Donald Trump knew how politically devastating cutting all this would be and how much support he would get by declaring them off limits. President Trump no longer cares.