'Damaging cuts' to Medicare and Social Security are looking more likely with McCarthy as House speaker. Here's what it will mean for retirees.

• Rep. Kevin McCarthy won his election as House speaker after conceding to conservative holdouts.
• Those concessions likely include budget cuts that will threaten Medicare and Social Security.

House Republicans elected Rep. Kevin McCarthy as speaker of the House after a historically lengthy election process. That could be bad news for some retirees.

That's because of the types of concessions McCarthy had to make to secure his seat. Reporting over the past few days strongly suggests that those concessions are related to entitlement programs like Medicare and Social Security, which Republicans have waged war against for decades.

"To win over holdouts in the House Freedom Caucus, McCarthy struck a series of concessions that include opening debate on spending bills and vows not to raise the debt limit without major cuts to the likes of Social Security and Medicare," The New York Times reported.

That's become clearer as the week has advanced: GOP leaders gave a slide presentation to Republican House members on Tuesday outlining their budget and spending priorities, CNN reported. According to a screenshot of the presentation viewed by CNN, the spending priorities were vague but mentioned reforms to "mandatory spending programs" that could include Social Security and Medicare.

Those cuts would likely make expenses tighter for doctors and put vital healthcare out of reach for some older patients. If healthcare providers get less money through Medicare, they won't be able to hire as many nurses, doctors, and other staff, as well as fund necessary equipment for services. It affects the quality of care patients are able to get and can even impact how many Medicare patients a healthcare provider can take on, Christian Shalgian, the director of advocacy and health policy at the American College of Surgeons, told Insider in November.

Democrats expressed relief when they maintained control of the Senate by a hair and won more House seats than projected after the midterm elections in November. But it looks like some House Republicans are already strong-arming the policy direction of their renewed majority. Policy experts told Insider there's reason to fear for the fate of major programs that help seniors in the US.

"The risks to Medicaid, as well as other programs like Medicare, are now quite serious," Edwin Park, a public policy professor at Georgetown University who focuses on health policy, said.

'Damaging cuts to Medicaid could be on the table'

McCarthy's eventual election was delayed by the House Freedom Caucus, a nearly 50-strong group of far-right Republicans who are dead set against what they consider excessive government spending.

Their agenda isn't explicit about what that means for Social Security and healthcare plans, but as Park pointed out, the Republican Study Committee's 2023 plan shows that those programs may be on the chopping block.

For example, Republicans propose converting Medicaid and Affordable Care Act subsidies to block grants, which would cut spending by $3.6 trillion over 10 years.

"That would obviously be strongly opposed by the Senate and the White House," Park said, but "the holdouts were clear that they would hold raising the debt limit hostage to major spending cuts, and it is possible that smaller, damaging cuts to Medicaid could be on the table, even if the most draconian cuts are dropped."

Park said that restrictions on the use of healthcare providers' taxes to finance the state share of Medicaid costs was one example of a smaller, damaging cut. Nearly all states employ these restrictions, but the budget would dispense with such use of provider funds. The RSC plan also proposes eliminating the state use of provider taxes entirely, Park noted.

"Hopefully it does not come to that, but it seems like the holdouts do not understand the dire consequences of default," he said.

Mary Johnson, a Social Security and Medicare policy analyst at the Senior Citizens League, also told Insider that the RSC's 2023 plan is a good bellwether for what House Republicans have planned, but that a Democrat-controlled Senate and outrage from older constituents might halt their agenda.

"Time and again, older constituents and their families have quashed plans to cut cost-of-living adjustments and other proposals that lacked the support of the trust and support of the voters," she said.

Johnson also noted that any sort of stalemate over budget negotiations could endanger the timely payment of Social Security benefits, which would hurt seniors.

"Senior advocates often point to the fact that Congress has never failed to lift the debt limit and pay Social Security benefits on time," she said, but "after the difficulty electing a speaker of the House, this may be time to say 'never say never.'"