We always knew Trump wasn’t sincere about protecting Medicare and Medicaid. But he just betrayed his own lie by saying that the two programs – which provide 140 million people with health coverage – should NOT EXIST on the federal level. Why? Because defense should be the federal government’s only priority.
Trump didn’t run as a libertarian. But his (poorly worded) declaration would make the Cato Institute blush:
“It’s not possible for us to take care of… Medicare, Medicaid. They have to do it on a state basis. All these little scams… you have to let states take care of them. We have to take care of one thing: military protection.” – President Donald Trump, April 1, 2026
Trump clearly is using his undeclared war on Iran to justify cutting health care for older and lower income Americans. In other words: we apparently can afford $200 billion for a senseless war in the Middle East, but not for our country’s social safety net programs.
Trump’s remarks — specifically that these landmark programs can be solely administered at the state level — are ludicrous. (So what else is new?) Medicare is by definition a federal program available to all Americans equally. The states could not possibly run Medicare — let alone afford it.
As our senior health policy expert Anne Montgomery explains:
“Sending Medicare to the states is a terrible idea that will never happen. The program doesn’t work that way. It’s a federal guarantee that ensures seniors everywhere receive the same care and protections, no matter where they live.” -Anne Montgomery, NCPSSM
As for Medicaid, it already is a federal-state partnership. But Medicaid depends on the federal government for about 70% of its funding. The states are already scrambling to mitigate the damage from Trump’s “Big, Ugly Bill,” which cut nearly $1 trillion from Medicaid to fund a tax cut for the wealthy and big corporations.
Advocates worry that Trump and Congressional Republicans are laying the groundwork for another ugly bill using the same budget reconciliation process as last time.Anne Montgomery fears that such a bill would take a scalpel to even more critical health care funding:
“A second reconciliation bill would do a lot more damage — programs like Medicaid, SNAP, and possibly even Medicare are certainly at risk. What we’re seeing is a clear assault on the nation’s major health care programs.” – Anne Montgomery, NCPSSM
This all amounts to what Montgomery calls “a war on seniors and their earned benefits.” In 2024, a majority of voters 65+ backed Trump at the ballot box. Today, only 14 months after his inauguration, 57% of that group disapproves of his performance in office.
In the face of this, why should any senior (other than the wealthy) support Trump-aligned GOP candidates in the upcoming 2026 elections?
Trump and his minions claim that our crucial social insurance programs are rife with ‘fraud,’ in order to justify gutting them. But Montgomery, who previously worked at the Government Accountability Office (GAO) analyzing waste, fraud, and abuse, calls BS on that:
“If this administration were serious about fiscal responsibility, they’d target real cost drivers like defense spending — not vital health programs.” – Anne Montgomery, NCPSSM
After DOGE inflicted trauma and chaos on the Social Security Administration, a devastating Big, Ugly Bill, and exorbitant military misadventures, forgive us for observing that none of Trump’s real agenda feels very “America First.”
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Watch Anne Montgomery take apart TrumpRx here.
Listen to our podcast about how the Trump administration is mucking with traditional Medicare here.