Senate Republicans are proposing to cut billions from Medicare and $1 trillion from Medicaid, in addition to big federal spending cuts that would likely decimate federal housing and education programs, Sen. Bernie Sanders (I-VT) said in a blistering report released Wednesday.

Sanders’s analysis is based on Sen. Mike Enzi’s (R-WY) proposed fiscal 2018 budget resolution — a nonbinding partisan proposal that sets top-line numbers for committees creating their spending bills. Enzi gave members of the Senate Budget Committee the proposal; the committees that will wind up writing the final spending bills have not yet signaled they intend to move forward with that plan.

The vision faces practical problems in the Senate, where it would need Democrats to sign onto normal spending bills to pass them. And it is a major break from President Donald Trump, who repeatedly promised his voters that programs like Medicare would not be cut at all.

Still, liberals in Congress legitimately worry that the outline is opening up the possibility that Republicans could make a real dent in the social safety net. If Republicans combine spending cuts with their tax plan that is in the works, Republicans might be able to use a procedural maneuver that would let them pass their plans without any Democrats through reconciliation.

“It’s one of those things that everyone can agree — that Medicare is in need of reform,” a top Republican Senate aide told Vox last week when asked why the GOP plan violates President Trump’s promise not to cut Medicare.

Sanders received Enzi’s proposals because he is the ranking member of the Senate Budget Committee; these details have not yet been unveiled in a public proposal.

"The Republican budget is a massive transfer of wealth from working families, the elderly, children, the sick, and the poor to the top 1 percent," Sanders’ report argues.

If Republicans want to balance the budget they would have to make deep cuts

Sanders has already argued that the GOP plan breaks Trump’s promise on Medicare. The report emphasizes that it would cut spending for Medicaid, which provides care for low-income and disabled Americans, by more than $1 trillion over the next 10 years.

Sanders also notes that Enzi calls for $5 trillion in “unspecified non-defense” cuts over the next 10 years. Assuming that these cuts are “applied proportionately” to existing federal outlays, Sanders writes, that would mean:

Cutting affordable housing spending by $37 billion over 10 years, eliminating housing assistance for 1 million families.

Cutting Pell Grant funding by more than $100 billion over 10 years, which Sanders says would affect 8 million students;

Cutting enough funding from the WIC Program to end it immediately, meaning 1.25 million women, infants, and children would lose access to nutrition assistance;

Cutting Head Start funding by $3 billion, which Sanders says would eliminate services for 25,000 children annually.

Together, the numbers suggest that the Republican Party is eager to slash spending on key programs, which will be a difficult to sell in the Senate where they’ll need at least eight Democratic votes to pass it under regular order — but not impossible if Republicans pursue it with their tax plan. It’s also a clean break from the president, who has vowed not to touch Medicare.

The budget resolution is a guide

The GOP budget proposal represents what Senate Republicans would do to the federal budget if given the chance, not necessarily what they will do.

The Senate Budget Committee’s budget resolution is a nonbinding guideline for committees that are creating their own spending bills. The proposal itself doesn’t mandate actual policy changes, but proposes a Republican vision for a balanced budget.

In this case, that vision would virtually gut the social safety net and key health programs that serve elderly, disabled, and low-income Americans. Proposing the cuts in the Senate’s budget is ultimately up to the Senate committees. And even if the committees do propose them, they would likely need to garner support from eight Democrats to pass the 60-vote threshold in the Senate.

But the budget resolution also sets up “reconciliation instructions” for a bill that can impact spending, revenue, or the debt ceiling, with only a party line vote in the Senate. This year, Republicans are using “budget reconciliation” to pass tax reform with a simple majority in the Senate. These “instructions” could mandate committees to deliver spending cuts.

Right now the Senate proposal only requires $1 billion in “savings” from the Natural Resources Committee. But in the House, which also proposed changes to Medicare in its version of the budget, the budget proposal mandates committees to cut a total of $203 billion from federal spending, likely forcing major cuts to food stamps, cash assistance programs, and Medicaid.

Eventually the House and Senate will have to come to an agreement on a budget — and how many cuts they want to require. That could put some of these safety net programs on the chopping block.

Trump promised again and again to protect Medicare — but GOP deficit hawks keep defying him

The proposals represent a clear break from President Donald Trump, who has repeatedly insisted that his Republican-led administration would not make changes to Medicare or Medicaid. The House also proposed changes to Medicare in its version of the budget over the summer that would similarly be dead on arrival in the Senate.

This isn’t the first time congressional Republicans have tried to break away from Trump’s promise not to touch Medicare. House Republicans and Speaker Paul Ryan have for years drawn up plans that would allow them to make deep cuts the program.

It’s a priority the GOP hasn’t been eager to surrender. In June, Rep. Tom Cole (R-OK), who sits on the House Budget Committee and is the chair of the appropriations subcommittee that manages health spending, called Trump’s promise to leave Medicare and Social Security and balance the budget a “fantasy.” Yet on the campaign trail, Trump promised the American people over and over again that his administration would not touch Social Security and Medicare funding. (Trump’s own budget proposal to Congress included cuts to Social Security Disability Insurance.)

“We have been talking about Medicare and Medicaid reform all the way through,” Cole told Vox then. “I’m not asking the president to abandon his principles. He is the president of the United States. He doesn’t have to sign something. But we shouldn’t abandon ours either.”

Cole continued:

Just because they have a political construct that they ran on — with all due respect, if you are not willing to tackle Social Security, Medicaid, and Medicare, you are not ever getting a balanced budget, and to pretend otherwise is a fantasy. ... People have cast those votes [on Medicare] before. I wouldn’t give up any of the places where we have been aggressive in the past.

Republicans, who in the coming months are looking to pass what is shaping up to be a massive tax cut — in addition to increasing defense spending and nondefense spending — are having a difficult time finding ways to taper the deficit.

Trump only tied their hands further when he said Social Security and Medicare were off limits.