Yet within days of Trump’s historic election, the guaranteed health coverage provided by Medicare was cast in doubt. House Speaker Paul Ryan (R-Wis.) revived his plan to replace it with a fixed-dollar subsidy that beneficiaries would use to buy private health insurance. Meanwhile, Congress is expected to move quickly to repeal the Affordable Care Act (ACA), which could have the effect of erasing the consumer-friendly Medicare benefits that the law created.

Stirring Fears and Uncertainty

As news of Ryan’s proposed Medicare overhaul spread, it stirred fears among the 57 million beneficiaries who rely on it to cover prescription drugs, doctor visits and hospitalizations. Democrats lined up to pledge their opposition. It also prompted an outcry from consumer groups, including AARP.

What remains to be seen in January, as Congress reconvenes and the president-elect takes office, is how Trump’s campaign assurances to protect Medicare will hold up against House lawmakers intent on revamping the popular health program.

Trump contributed to the uncertainty by announcing House Budget Committee Chairman Tom Price (R-Ga.) as his pick to run the Department of Health and Human Services. Price has been an advocate of Ryan’s Medicare approach, which supporters call “premium support” and critics decry as a “voucher system.” Trump’s website further raised questions about his plans for Medicare. It says he wants to “modernize Medicare,” which is often seen as Washington code for the type of changes Ryan wishes to make.

Since the election, Trump has not made any comments about Medicare. But in an interview with ABC News on Dec. 4, Vice President-elect Mike Pence said Trump “made it very clear in the course of the campaign that we’re going to keep our promises in Social Security and Medicare.”

