Social Security's trust fund runs dry in 2032 and Medicare's isn't far behind — should Congress raise taxes, slow benefit growth, or both, before the automatic cuts hit?
Each issue breaks into the specific questions Congress actually fights over. Read each position, then head to the interactive version of this issue to mark which reflects your view and build a message to your representatives.
Social Security's trust fund is now projected to run dry in 2032, and scrapping the payroll tax cap on high earners would close most of the gap without cutting a single benefit. The 2032 insolvency date is a year earlier than last year's estimate, and it would trigger an automatic benefit cut for everyone on the program unless Congress acts first. Part of the shortfall exists because the payroll tax only applies to the first $184,500 of income — earnings above that are never taxed for Social Security at all.
Every credible solvency proposal mixes higher revenue with slower benefit growth for higher earners — that's what fixed Social Security in 1983, and it's likely what fixes it now. The 1983 Greenspan Commission combined both approaches, and it's the only time in the program's history Congress has actually shored up its finances ahead of a crisis. The bipartisan PROMISE Act, introduced days after the 2026 Trustees Report moved up the insolvency date, matters less for its specific numbers right now than for getting both parties back to the table before 2032.
This is fundamentally a demographic problem — falling birth rates and a shrinking ratio of workers to retirees — not just a revenue problem. Simply raising taxes on high earners treats the symptom without addressing why the ratio of workers to retirees keeps shrinking. Gradually raising the retirement age to reflect longer life expectancy, as multiple past bipartisan commissions have proposed, is a fairer long-term fix than an open-ended tax increase that still may not fully close a decades-long shortfall.
Repealing WEP and GPO in January 2025 corrected a decades-old injustice that cut Social Security benefits for millions of teachers, firefighters, and other public servants. For over 40 years, these provisions reduced or eliminated benefits simply because a public servant also earned a pension from a job not covered by Social Security. That penalty fell hardest on people who'd spent entire careers in public service, which is exactly the population Social Security is supposed to protect.
This passed with genuinely overwhelming bipartisan support — 327-75 in the House, 76-20 in the Senate — showing it was never really a partisan fight, just a stalled one. That kind of margin is rare on anything touching Social Security, which tells you both parties agreed the underlying unfairness needed fixing. Members on both sides knowingly accepted the tradeoff — moving up program-wide insolvency by roughly six months — as the cost of fixing a specific, well-documented problem.
Repealing WEP and GPO added a projected $195 billion to federal deficits over ten years, worsening the very crisis the program already faces. That repeal moved Social Security's insolvency date closer by about six months, even though it was popular and passed with wide bipartisan margins. It's a reminder that even popular, bipartisan fixes to Social Security have real fiscal costs — and this one wasn't offset with a funding source.
Medicare negotiated drug prices directly with manufacturers for the first time in the program's history, saving beneficiaries an estimated $1.5 billion a year — and a new orphan-drug carve-out threatens to undo part of that. The first ten negotiated prices took effect January 1, 2026, delivering real, immediate savings to beneficiaries. The 2025 tax law's expansion of which orphan drugs are exempt from negotiation reopens a loophole for exactly the kind of blockbuster drugs the program was designed to reach.
The negotiation program has survived a change in administration essentially intact, and the real open question now is whether its scheduled 2028 expansion proceeds as planned. The current administration's April 2025 executive order kept the program running while directing changes to its implementation, rather than trying to repeal it outright — a sign of durable, if contested, support. CMS issued its first formal rulemaking in June 2026 to expand the program toward Part B drugs by 2029, even as the 2025 reconciliation law narrowed the program's reach for orphan drugs.
Government-set price ceilings, however popular in the short term, risk reducing the capital available for developing the next generation of treatments. Drug development for rare diseases is especially capital-intensive relative to the size of the patient population it eventually serves. Protecting orphan-drug development from price controls, as the 2025 tax law does, keeps incentives intact for treatments serving small, underserved patient populations who might otherwise be deprioritized.
MedPAC estimates Medicare Advantage plans will be overpaid by roughly $1.2 trillion through 2035, and those overpayments are already raising premiums for every Medicare beneficiary, not just Advantage enrollees. Most of that overpayment comes through 'upcoding' — documenting diagnoses that were never actually treated in order to inflate government payments to the plan. Those inflated payments are already raising Part B premiums for all Medicare beneficiaries, including the majority who never enrolled in a private Medicare Advantage plan at all.
The bipartisan No UPCODE Act targets the specific mechanics of upcoding without touching the broader question of whether Medicare Advantage itself should exist — and that's where the real agreement is. Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR) built the bill around chart reviews and health risk assessments, the specific tools used to inflate risk scores. A narrow, mechanics-focused fix like this can attract support from members who disagree sharply on Medicare Advantage's broader role in the program.
Medicare Advantage gives seniors real benefits traditional Medicare doesn't — dental, vision, hearing coverage, and an out-of-pocket cap — and many seniors choose it for exactly those reasons. Traditional Medicare doesn't cap out-of-pocket costs the way most Medicare Advantage plans do, which matters enormously for seniors with serious ongoing health needs. Overly aggressive payment cuts risk forcing insurers to shrink those supplemental benefits, which would effectively punish the many beneficiaries who've chosen a private plan for real, practical reasons.
Social Security's COLA is calculated using an index built around what younger urban wage earners buy, not seniors — and seniors are shortchanged as a result. The CPI-W index used to set the COLA doesn't reflect that seniors spend far more of their income on health care, which inflates faster than the overall basket of goods it tracks. The government's own experimental CPI-E index for Americans 62 and older has historically shown seniors need bigger increases than the CPI-W actually provides.
Switching to CPI-E would help seniors on average, but it isn't free — it would require additional revenue to avoid worsening trust fund solvency. A more accurate COLA formula means larger annual increases, which draws down the trust fund faster unless it's paired with new revenue. One pending bill pairs the CPI-E switch with raising the payroll tax cap on incomes over $400,000 in the same legislation, addressing both the accuracy problem and its cost together.
The CPI-E is still an experimental, research-only index the Bureau of Labor Statistics has never certified as ready to set actual federal benefits. Switching formulas rests on the assumption that seniors' spending patterns are uniformly different from everyone else's, which the data doesn't cleanly support across all seniors. The more honest fix for eroding purchasing power is addressing underlying cost drivers directly — like Medicare Part B premiums — rather than changing the inflation formula used to calculate benefits.