Is Trump cutting Medicare to give tax breaks to billionaires?

"I paid into Medicare my whole life. Trump wants to cut it just to pay for tax breaks to billionaires." - "Bill A.," in Priorities USA ad released July 23, 2019

It's always catnip for The Fact Checker when we receive an email from a super PAC announcing a new ad campaign. This one especially caught our eye because Priorities USA, a Democratic-leaning group, dubbed it the "Let's Be Honest" campaign.

That's a high bar for any ad campaign - but this ad fails to clear it. It's another example of what we call "Mediscare," mixed in with some bashing of the wealthy.

The ad purports to show a couple who have been farmers for 42 years - "Bill A." and "Mona A." At first, it seems the ad would delve into the impact that President Donald Trump's policy of putting tariffs on Chinese goods has had on U.S. farmers, but then it veers into familiar territory for a Democratic attack ad.

"I paid into Medicare my whole life. Trump wants to cut it just to pay for tax breaks to billionaires," Bill says.

"It's just the rich wanting to be richer, and the rest of us are just going to have to deal with it," Mona adds.

The ad closes with this line: "Trump's economy isn't working for us."

The ad is clearly trying to thread a needle, given an unemployment rate among the lowest in the past half-century. But we're interested in Bill's claim that Trump wants to cut Medicare "just to pay for tax breaks to billionaires."

Trump's 2020 budget did propose reductions in anticipated spending on Medicare, but it was completely unrelated to the tax cut passed by Congress in 2017.

In fact, that tax cut was not paid for - despite misleading claims by administration flacks. That's one reason the budget deficit is soaring despite the booming economy.

The ad says the tax cut was for "billionaires," but the nonpartisan Tax Policy Center found that in 2018, 80.4 percent of all taxpayers would have a tax cut, compared with about 5 percent experiencing a tax increase. The top 0.1 percent - taxpayers with incomes above $3.5 million - were estimated to receive about 7.9 percent of the total federal tax change in 2018. So there's an imbalance, but that tax cut was not just for billionaires.

As for Medicare, we have noted before that Trump's Medicare reductions mostly built on proposals made by President Barack Obama (who of course was attacked by Republicans for cutting Medicare). Some of the cuts claimed by Democrats were not cuts; Trump simply proposed moving those parts of Medicare to different parts of the budget, but the spending would mostly continue at an inflation-adjusted rate. Depending on how you do the math, that brings the "cuts" down to between $515 billion and $575 billion between 2020 and 2029.

Those sound like big numbers, but here's some context. Medicare spending is projected to grow more than $10 trillion over the course of the decade, so it's essentially a 5 percent reduction in projected spending. Outlays for Medicare are estimated to be 3.5 percent of the gross domestic product in 2029, compared with 2.9 percent in 2018.

Moreover, most of these so-called cuts are not coming at the expense of seniors; they are intended to reduce out-of-pocket costs for seniors by making the program more efficient. The administration says the cost reductions would extend the solvency of the Medicare trust fund by eight years.

The Committee for a Responsible Federal Budget estimates that 85 percent of the $575 billion in the savings for Medicare in Trump's budget come from provider reductions, many of which follow a path first charted by Obama.

Moreover, these proposals generally have bipartisan support. The long-term budget deal struck by House Speaker Nancy Pelosi, D-Calif., and Treasury Secretary Steven Mnuchin mostly concerned discretionary spending, but it included extending the "mandatory sequester" - a 2 percent reduction in Medicare provider payments that is already in effect through 2027.

Another Trump proposal would cap how much drugmakers can hike their prices on Medicare, saving $65 billion. The administration recently swung its support behind a similar bipartisan effort, led by Sens. Chuck Grassley, R-Iowa, and Ron Wyden, D-Ore. The Congressional Budget Office estimated the plan would reduce $85 billion in Medicare spending over 10 years and reduce out-of-pocket costs for beneficiaries by $27 billion, a statement from Grassley's office said.

"Bob," of course, does not seem to know any of that. Priorities USA did not respond to repeated requests for comment.

The campaign season has barely begun, but there's little excuse for this line of attack. There is no connection between the tax cut and Trump's proposed Medicare reductions - many of which have bipartisan support. "Bob" has little to worry about - and could even see his prescription costs and hospital bills go down.

It takes a lot of gall to claim you've launched a "Let's Be Honest" campaign with a Four Pinocchio ad.

Four Pinocchios

An award-winning journalism career spanning nearly three decades, Glenn Kessler has covered foreign policy, economic policy, the White House, Congress, politics, airline safety and Wall Street. He was The Washington Post's chief State Department reporter for nine years, traveling around the world with three different Secretaries of State. Before that, he covered tax and budget policy for The Washington Post and also served as the newspaper's national business editor. Kessler has long specialized in digging beyond the conventional wisdom, such as when he earned a "laurel" from the Columbia Journalism Review