When he began his presidential campaign, Donald Trump promised to “save Medicare, Medicaid and Social Security without cuts.”

This is a promise, however, President Trump would like to break. Trump’s 2018 budget proposal would cut all three programs, which help the most vulnerable in American society, by billions of dollars.

Fox News’s website tells readers that Medicare is spared “as he promised during the 2016 campaign,” but a cursory search of the White House’s own budget document reveals this is not true.

The White House’s position is largely in line with the congressional GOP, which has also tried to pass a budget that would cut $1 trillion from Medicare and almost half a trillion from Medicaid.

Here is what the Trump administration’s budget proposal would do to Medicare, Medicaid, and Social Security.

Cutting Medicare by $266 billion

The Trump budget document, titled “An American Budget: Major Savings and Reforms,” proposed cutting a net $266 billion under the category, “Medicare: Eliminate wasteful federal spending.” Among other things, Trump’s budget proposal changes the way patients are reimbursed for post-acute care, making it harder for physicians to refer patients to other providers, and “limits hospital payments associated with early discharge to hospices.”

Cutting Medicaid by $1.1 trillion

The Trump budget proposes cutting Medicaid, under the simple guise of “reforms,” by $1.1 trillion over 10 years. The goal is to encourage states to transition away from the Medicaid expansion that Obamacare allowed, in part by imposing a “Medicaid per capita cap and block grant with the Consumer Price Index.”

Cutting Social Security by $72 billion

The full budget document proposal lists “Reform disability programs” in line for a $72 billion decrease over the 10-year budget window. This includes explicit cuts to Supplemental Security Income programs and Social Security Disability Insurance programs, both managed by the Social Security Administration.


SSDI recipients are people who have become disabled and who have paid taxes into the Social Security Trust Fund, while SSI is needs-based — both programs have a lengthy waiting period before anyone receives benefits.

The cuts target retroactive SSDI benefits, multi-recipient SSI families, overlapping unemployment and disability payments, and other administration programs.

Last year, when an almost identical proposed cut in 2017’s budget document appeared, a source with knowledge of the budget told ThinkProgress that the cuts were of such a magnitude that it would be like making the program into a block grant.

UPDATE: This story has been updated to include clearer language about, and links to, the full budget proposal documents, following their inclusion on the public White House website.