Washington Post, December 6, 2017
Jeff Stein

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House Speaker Paul D. Ryan (R-Wis.) said Wednesday that congressional Republicans will aim next year to reduce spending on both federal health care and anti-poverty programs, citing the need to reduce America's deficit.

“We're going to have to get back next year at entitlement reform, which is how you tackle the debt and the deficit,” Ryan said during an appearance on Ross Kaminsky's talk radio show. "... Frankly, it's the health care entitlements that are the big drivers of our debt, so we spend more time on the health care entitlements — because that's really where the problem lies, fiscally speaking.”

Ryan said that he believes he has begun convincing President Trump in their private conversations about the need to rein in Medicare, the federal health program that primarily insures the elderly. As a candidate, Trump vowed not to cut spending on Social Security, Medicare, or Medicaid. (Ryan also suggested congressional Republicans were unlikely to try changing Social Security, because the rules of the Senate forbid changes to the program through reconciliation — the procedure the Senate can use to pass legislation with only 50 votes.)

“I think the president is understanding that choice and competition works everywhere in health care, especially in Medicare,” Ryan said. "...This has been my big thing for many, many years. I think it's the biggest entitlement we've got to reform.”

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