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A Medicare War Is Coming. What Will Trump Do?

First Read is a morning briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter.
Nurse Allison Miller checks the blood pressure of a patient as nurses and physicians give free basic health screenings on July 10, 2012 in Los Angeles, Calif. Three days of free screenings in the Los Angeles area are part of the Medicare for All tour which made up to two dozen stops across California between June 19 and July 12.
Nurse Allison Miller checks the blood pressure of a patient as nurses and physicians give free basic health screenings on July 10, 2012 in Los Angeles, Calif. Three days of free screenings in the Los Angeles area are part of the Medicare for All tour which made up to two dozen stops across California between June 19 and July 12.David McNew / Getty Images file

First Read is a morning briefing from Meet the Press and the NBC Political Unit on the day's most important political stories and why they matter.

A Medicare war is coming. What will Trump do?

An interesting thing happened in the 2016 presidential race: There was no big fight over the politics of Medicare, seniors, and entitlements -- like there was in 2010, 2012, and 2014. (The reason why was due to Donald Trump’s promise not to touch entitlements, as well as the Clinton campaign’s effort to go after Trump on temperament, not policy.) But with Republicans in charge of the White House and Congress come Jan. 20, and with House Speaker Paul Ryan’s long-awaited effort to privatize/voucherize/restructure Medicare, entitlement politics are coming back. "Between this nomination of an avowed Medicare opponent [Trump HHS pick Tom Price] and the Republicans here threatening to privatize Medicare, it's clear that Washington Republicans are plotting a war on seniors next year," incoming Senate Democratic leader Chuck Schumer recently said, per Politico. The biggest unknown, however, is whether President-elect Trump goes along with Ryan’s plans.

Trump’s “I’m not going to cut Medicare” vs. “Modernize Medicare”

On the one hand, Trump declared that he wouldn’t touch Social Security or Medicare. “I’m not going to cut Social Security like every other Republican, and I’m not going to cut Medicare or Medicaid,” he said in a May 2015 interview, which is still featured on his campaign website. On the other hand, Trump’s transition website includes this sentence on health-care policy: “Modernize Medicare, so that it will be ready for the challenges with the coming retirement of the Baby Boom generation – and beyond.” Trump joining Ryan’s Medicare efforts could achieve a long-standing conservative goal, but open up the GOP to some mighty political attacks from Democrats in 2018 (including that Trump broke his promise on Medicare and entitlements). Or Trump blocking Ryan could uphold his promise on entitlements, especially with the kinds of voters who won him the election, but it would produce a significant fissure inside the GOP and conservative movement (which Democrats could still exploit). This will be one of the most important storylines to watch next year.

The Trump rallies are back

Trump heads to Cincinnati, OH to hold a 7:00 pm ET rally that’s the first leg of his post-election “Thank You Tour.” And it will likely continue to other states he won. Bloomberg News: “His post-election tour may take him to ‘swing states we flipped over,’ George Gigicos, Trump’s director of advance, told reporters on Nov. 17. Trump won Michigan, Wisconsin, Pennsylvania and Florida, all states President Barack Obama won twice.” But it’s striking that Trump will be visiting the states he won -- instead of reaching out to the places that didn’t vote for him. After all, according to the latest popular-vote numbers per the Cook Political Report’s David Wasserman, Trump trails Hillary Clinton by 2.5 million votes nationally, 48.2%-46.3%. To put the 2.5 million votes into perspective, they’re FIVE TIMES the size of Al Gore’s popular-vote win in 2000. Of course, it’s the Electoral College -- and not the popular vote -- that wins you the presidency. But it’s noteworthy that Trump’s national percentage (46.3%) is now closer to John McCain’s in 2008 (45.6%) than Mitt Romney’s in 2012 (47.2%).

The good, the bad, and the ugly of the bully pulpit

Before Trump’s event in Cincinnati, he and Vice President-elect Mike Pence hold an event in Indianapolis, IN to celebrate the news of those approximately 1,000 Carrier jobs that are no longer going to Mexico. We still don’t know the details of the deal, but it seems to include “incentives” from Pence’s administration. (Remember, he’s still the governor of Indiana.) “The incentives offered by the state were an important consideration,” Carrier said in a press release yesterday about the 1,000 jobs in Indianapolis. But another consideration? Try the federal contracts for Carrier’s parent company, United Technologies, according to the Indiana Business Journal. “[Indiana Economic Development Corporation board member John] Mutz said he doesn’t believe the impending incentive package ‘really is the major reason for the decision.’ That, he said, is likely because of Carrier Corp. parent company United Technologies Corp's desire to keep its hefty federal contracts. United Technologies and its subsidiaries collect about $6 billion annually from U.S. government contracts, making up about 10 percent of its overall revenue, according to CNN Money.” This Carrier move seems to epitomize the good, bad, and ugly of what the bully pulpit will look like in a Trump administration. The good: saving jobs and promoting the achievement. The bad: the federal government using arm-twisting tactics on a corporation. The ugly: potentially holding a business’s federal contracts as hostage to enact change.

House Democrats: Wash, rinse, repeat

That’s maybe the best way to summarize Nancy Pelosi’s 134-63 victory to remain House Democratic leader. House Democrats once again failed to win back the House (or even get close to it), and Pelosi is still in charge. “My heart is broken that we did not win the White House this time,” Pelosi said after the vote, per Roll Call. “Where we can engage, we will. Where we need to oppose, we will.” More from Pelosi: “I, quite frankly, feel more liberated than I ever have after a vote after such a hard charging campaign.”

Cabinet Watch

Here is our running list of possible candidates we’ve been hearing about so far. We’ll continue to update it as the president-elect’s team makes its choices final.

  • Secretary of State: Rudy Giuliani, John Bolton, Bob Corker, Mitt Romney, David Petraeus
  • Attorney General: Jeff Sessions OFFERED
  • Treasury: Steve Mnuchin OFFERED
  • Defense: Jim Talent, Tom Cotton, James Mattis
  • Homeland: Michael McCaul, David Clarke
  • Interior: Sarah Palin, Mary Fallin
  • HHS: Tom Price OFFERED
  • HUD: Ben Carson OFFERED (but hasn’t accepted)
  • Education: Betsy DeVos OFFERED
  • Commerce: Wilbur Ross OFFERED
  • Transportation: Elaine Chao OFFERED
  • Agriculture: Rick Perry, Sid Miller
  • CIA Director: Mike PompeoOFFERED
  • UN Ambassador: Nikki Haley OFFERED
  • National Security Adviser: Michael Flynn OFFERED
  • RNC Chair: Ronna Romney McDaniel, David Urban