The War on Social Security, Medicare, and Medicaid
Elderly folks need to resist the extreme threat to their health and well-being that will result from the Trump regime’s attempt to dismantle these Congressionally mandated programs.
Photo by Barbara Burgess on Unsplash
If Donald Trump wins the war against Social Security, Medicare, and Medicaid, my wife and I will be among the casualties. That is not a hyperbolic assertion.
Whether we like it or not, my generation is now in a war for our very existence. Our parents’ generation survived the Great Republican Depression and defeated the fascist opponents of democracy in World War II.
For our part, we addressed America’s original sin of slavery and discrimination by supporting the Civil Rights Movement and eventually enacting into law legal protections for the rights of all citizens. Many of us were also veterans of the War in Vietnam or opposed to our government’s policy in prosecuting that war. We, too, have known conflict.
But the stakes for us personally are even higher now. The health and well-being of millions of us and the generation immediately following us are now threatened directly. The wider war of the Trump regime against our entire democratic system includes targeted reduction or elimination of Congressionally mandated social service programs that date from the mid-1930s.
Remember, we were born when Franklin Roosevelt was President. These programs – Social Security in 1935 and, later under Lyndon Johnson, Medicare and Medicaid – are keeping millions of us alive and healthier than earlier generations.
If you are a member of my cohort (commonly called the Silent Generation) who is unconcerned about these developments, you need to wake up and find your voice.
My Dependence on Social Security and Medicare
As a retired college professor and administrator, my personal circumstances are not typical. Through a series of unfortunate events – including the timing of my retirement, chronic health issues, and employment difficulties – my retirement nest egg was eventually depleted.
When I retired in 2005, my wife and I purchased a house in Connecticut at the top of the housing market just prior to its collapse and the Great Recession. Finding another position in higher education proved to be difficult. Although my wife is considerably younger, her career ambitions were hampered by several debilitating, chronic health conditions. We struggled to make ends meet for several years.
Although I accepted an appointment as a graduate dean in 2011, I was compelled to resign from that position in 2016 at age 74. Further attempts to find academic employment proved fruitless. I resorted to resuming my writing and consulting business which enjoyed temporary success, but which also produced only sporadic income.
Although my wife earned a master’s degree, there were no employment opportunities in her chosen field. Because of continuing health conditions, she has now accepted a demanding remote position with a technical firm in the healthcare sector.
For my part, I collect a monthly Social Security payment which I augment by part-time work as a grant writer for a local nonprofit. Although I’m in good health, full-time employment is no longer possible.
When my wife’s paycheck is added to my Social Security payment, we’re getting by. But in today’s economy (especially!) there is no guarantee of employment for her or of Social Security income for me.
Because of our health considerations, we must follow a special diet (about which I’ve written previously) that elevates our food bill higher (and rising quickly!) than for most people. That means that my Social Security payment covers our rent or our food (plus a few other expenses), but not both.
If my Social Security payment goes away, we will lose one of our monthly financial pillars. I will also lose health insurance coverage since my Medicare premium is automatically deducted from my Social Security payment (as it is for most other recipients). Imagine surviving in your 80s without health insurance!
One further consideration: if my health fails to the point where I need skilled care either at home or in a facility, I will also be dependent on Medicaid for support. There is no alternative.
So, I take the Trump regime’s intention to effect large cuts in all three programs very personally. If the programs are eliminated or reduced, my wife and I face the prospect of being out on the street. As you will see from the numbers below, we’ll have plenty of company – to the point where American society will become utterly broken.
Cuts in Staff and Resources
If you get your news from mainstream, corporate outlets (e.g., NBC, CBS, ABC, The Washington Post, The New York Times, The Los Angeles Times) you might be somewhat, but not fully, aware of what’s happening. If you get your news from outlets such as FOX News, I’m sorry to inform you that you are in the dark regarding basic facts.
To get right to it, the Trump regime has implemented or proposed the following staff and resource reductions:
Social Security – 7,000 employees laid off (about 12% of SSA’s workforce) but is planning to cut 50,000 jobs (50% of workforce),[1] 26 local offices are expected to close in 2025 with more later.[2]
Medicare and Medicaid – 300 jobs eliminated at CMS focused disproportionately on programs that benefit older persons, persons of color or those with disabilities,[3] but 10,000 more layoffs are planned for Health and Human Services in addition to 10,000 who have already accepted early retirement.[4]
Number of Persons Served
Those of us over age 65 should remember that we’re not alone. Millions depend on these services for financial support, health insurance and treatment, and help in the event of disability or other traumatic events.
Social Security – about 73.2 million people receive Social Security benefits
Retirement Benefits – 54.7 million (average monthly amount = $1,980.86
Disability Benefits – 8.3 million (average monthly amount = $1,580.76)
Survivor Benefits – 5.6 million[5]
Medicare
Age 65 and over – 61 million (50.3% in Medicare Advantage)
Under 65 – 7.3 million (disability health insurance)[6]
Medicaid
Children under 18 – 33 million
Adults aged 19-64 – 27 million
Senior persons 65 and older – 7 million
Persons with disabilities – 10 million[7]
Many people mistakenly assume that Medicaid only supports children from financially disadvantaged families. That is not the case.
Medicaid is the primary payer for long-term care for older persons in skilled nursing facilities, assisted living facilities, and home/community-based care services.
Statistics are important to grasp the significance of the Trump regime’s war on our social safety net. But statistics cannot tell the whole story.
What Should Be Done
My Silent Generation and the one immediately following – the Boomers who are now entering their 80s – need to get busy and realize that the challenge we face is not merely a matter of saving our social safety net. To focus just on that turns our struggle into a “special interest” issue that is socially divisive. After all, who wants to help just a bunch of old people?
No, our we must oppose fascism and restore democracy in order to build a humane, civilized society.
I do not refer to “fascism” lightly. The current trend toward a technocracy (as subset of oligarchy) has been led by what some call the “PayPal Mafia” – a group of founders and executives of PayPal including Peter Thiel, Roelof Botha, David Sacks, and Elon Musk.
These four individuals all have South African roots personally or through their families that include engagement in fascist, pro-Nazi activities in Canada and South Africa. For further information, watch the following video.
"The PayPal Mafia": The South African Oligarchs Surrounding Trump, from Elon Musk to Peter Thiel
Interview with Christ McGreal, former South Africa correspondent for The Guardian, on Democracy Now! 10 February 2025.
My point here is that these people aim to destroy democratic societies, which they consider weak and inefficient, in favor of technocratic societies that are run with ruthless efficiency by the very few. Donald Trump’s despotic actions indicate that he agrees with their intentions, provided that the result enriches him and his inner circle.
That is why the regime intends to eliminate the U.S. federal bureaucracy and loot the non-military programs that comprise the bulk of the federal budget.
Why would they go after Social Security, Medicare, and Medicaid? Because, as John Dillinger reportedly said when asked why he robbed banks, “That’s where the money is.”
This means that the fate of programs that support the elderly is tied inextricably to that of government programs in education, healthcare (including mental health), scientific research, environmental concerns, agriculture, the arts and humanities, and infrastructure. This struggle is not just for the well-being of old people. It’s for the well-being of everyone.
I urge people in my cohort to become actively engaged in resisting the Trump regime who are waging war on us. We should do so because most of us have the time, knowledge, and resources to bring to bear in ways that younger people might not.
Here are some concrete suggestions:
Contact federal, state, and local officials. The central phone number for both houses of Congress is (202) 224-3121. Phone calls are usually more effective than email or letters.
If you can, share your personal story or that of your family with local media. Mere statistics are never as effective as personal, emotional accounts.
Contact national advocacy groups and work with local chapters whenever possible.
Talk to relatives, friends, and neighbors. Make sure that they understand the details and the gravity of the situation.
Trump and his minions are moving quickly. Our situation is dire. We don’t have much time to prevent permanent, devastating damage. It’s time for us to conquer fascism just as our parents did.
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NOTES
[1] SSA, “Social Security Announces Workforce and Organization Plans,” 28 February 2025, https://blog.ssa.gov/social-security-announces-workforce-and-organization-plans/.
[2] AP, “A list of the Social Security offices across the US expected to close this year,” 19 March 2025, https://apnews.com/article/social-security-offices-closures-doge-trump-b2b1a5b2ba4fb968abc3379bf90715ff
[3] Julie Carter, “Trump Administration and DOGE Eliminate Staff Who Help Older Adults and People with Disabilities,” Medicare Rights Center, 3 April 2025, https://www.medicarerights.org/medicare-watch/2025/04/03/trump-administration-and-doge-eliminate-staff-who-help-older-adults-and-people-with-disabilities
[4] CNBC, “Medicare, Medicaid agency cuts jobs from minority health office, other divisions…,” 4 April 2025, https://www.cnbc.com/2025/04/04/cms-makes-job-cuts-as-rkf-jr-guts-hhs.html.
[5] Social Service Administration, https://www.ssa.gov/policy/docs/quickfacts/stat_snapshot/.
[6] CMS, Medicare Monthly Enrollment, 4 April 2025, https://data.cms.gov/summary-statistics-on-beneficiary-enrollment/medicare-and-medicaid-reports/medicare-monthly-enrollment
[7] CMS, Data Medicaid, https://data.medicaid.gov/dataset/bffd757a-3ae9-42fc-809a-820c2919496b; Kaiser Family Foundation, “Medicaid Enrollees by Age,” https://www.kff.org/medicaid/state-indicator/medicaid-enrollees-by-age/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D