The Senate health care bill would cut hundreds of billions of dollars from Medicaid, a program that Donald Trump once promised not to touch.
The Better Care Reconciliation Act unveiled on Tuesday would phase out extra money provided to states to expand Medicaid and restructure the program in ways that would reduce spending on it over the long term.
In May of 2015, one month before he launched his campaign for president, Trump told the conservative Daily Signal that he would not touch the Social Security, Medicare or Medicaid programs.
“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump said. “Every other Republican is going to cut, and even if they wouldn’t, they don’t know what to do because they don’t know where the money is. I do.”
He made the same point on Twitter, arguing that primary rival Mike Huckabee had stolen his idea:
This is not the first time Trump’s campaign promise has looked like it’s at risk. In May, the Trump Administration proposed a federal budget that incorporated cuts to Medicaid that were included in the House version of the health care bill. The Trump budget also called for an additional $600 billion reduction in the Medicaid budget over the next ten years.
Both the House and Senate versions of the bill would dramatically change Medicaid. The House bill would institute a per capita cap on how much the federal government spends on each recipient and allow states to receive a block grant instead. The Senate bill would also tie the annual growth rate to standard inflation, instead of medical inflation, causing a reduction in funds over time.
“This is a bill that would end Medicaid as we know it, rolling back Medicaid expansion, cutting federal support for the program even more than the House bill,” Senator Chuck Schumer said on Thursday.
More Must-Reads from TIME
- Donald Trump Is TIME's 2024 Person of the Year
- Why We Chose Trump as Person of the Year
- Is Intermittent Fasting Good or Bad for You?
- The 100 Must-Read Books of 2024
- The 20 Best Christmas TV Episodes
- Column: If Optimism Feels Ridiculous Now, Try Hope
- The Future of Climate Action Is Trade Policy
- Merle Bombardieri Is Helping People Make the Baby Decision
Write to Jack Brewster at jack.brewster@time.com