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 retirement trust fund is now projected to run dry in 2032 — a year earlier than last year's estimate — triggering an automatic benefit cut for everyone on the program unless Congress acts first. The shortfall exists partly because the payroll tax only applies to the first $184,500 of income; scrapping that cap for the highest earners closes most of the gap without cutting a single benefit.
Every credible solvency proposal requires some mix of higher revenue and slower benefit growth for higher earners — the 1983 Greenspan Commission model that last fixed Social Security did both. A bipartisan starting point, like the newly introduced PROMISE Act, matters less for its specific numbers than for getting both parties back to the table before the 2032 cliff forces an across-the-board cut nobody wants.
Simply raising taxes on high earners treats a demographic problem — falling birth rates and a shrinking ratio of workers to retirees — as a revenue problem, when it's structural. 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.
For over 40 years, the Windfall Elimination Provision and Government Pension Offset cut or eliminated Social Security benefits for millions of teachers, firefighters, and other public servants simply because they also earned a pension from a job not covered by Social Security. Repealing both, as Congress finally did in January 2025, corrected a decades-old injustice that fell hardest on people who'd spent careers in public service.
The Social Security Fairness Act passed with genuinely overwhelming bipartisan support — 327-75 in the House, 76-20 in the Senate — showing WEP/GPO repeal was never really a partisan fight, just a stalled one. Its main tradeoff, moving up program-wide insolvency by roughly six months, was accepted knowingly by members on both sides as the cost of fixing a specific, well-documented unfairness.
Repealing WEP and GPO added a projected $195 billion to federal deficits over ten years and moved Social Security's insolvency date closer by about six months, worsening the very crisis the program already faces — a reminder that even popular, bipartisan fixes to Social Security have to be paid for somehow, and this one wasn't.
For the first time in Medicare's history, the federal government negotiated prices directly with drug manufacturers, and the first ten negotiated prices took effect January 1, 2026 — saving beneficiaries an estimated $1.5 billion a year. The 2025 tax law's carve-out expanding which orphan drugs are exempt from negotiation just reopens a loophole for exactly the kind of blockbuster drugs the program was designed to reach.
The negotiation program itself has survived a change in administration essentially intact — 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. The open question is whether the program's scheduled 2028 expansion to Medicare Part B drugs proceeds as written or gets narrowed further.
Medicare drug price negotiation sets a government price ceiling that, however popular in the short term, risks reducing the capital available for developing the next generation of treatments. Protecting orphan-drug development from price controls, as the 2025 tax law does, keeps incentives intact for treatments serving small, underserved patient populations.
MedPAC estimates Medicare Advantage plans will be overpaid by roughly $1.2 trillion through 2035, mostly through 'upcoding' — documenting diagnoses that were never actually treated to inflate government payments. Those overpayments 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, from Senators Bill Cassidy (R-LA) and Jeff Merkley (D-OR), targets the specific mechanics of upcoding — chart reviews and health risk assessments used to inflate risk scores — without touching the broader question of whether Medicare Advantage itself should exist. That kind of narrow, mechanics-focused fix is where the real bipartisan agreement is.
Medicare Advantage gives seniors dental, vision, and hearing coverage traditional Medicare doesn't, along with an out-of-pocket cap traditional Medicare lacks — trade-offs many seniors actively choose. Overly aggressive payment cuts risk forcing insurers to shrink those supplemental benefits, effectively punishing the many Medicare beneficiaries who've chosen a private plan for real reasons.
Social Security's annual cost-of-living adjustment is calculated using the CPI-W, an index built around what younger urban wage earners buy — not seniors. Because seniors spend far more of their income on health care, which inflates faster than the overall basket, the CPI-E — the government's own experimental index for Americans 62 and older — has historically shown seniors need bigger increases than they get.
Switching entirely to CPI-E would help on average but isn't free — it would require additional payroll tax revenue to avoid worsening trust fund solvency, which is exactly what one pending bill proposes by raising the payroll tax cap on incomes over $400,000 in the same legislation that changes the COLA formula.
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, and switching formulas rewards the assumption that seniors' spending patterns are uniformly different from everyone else's — when the honest fix for eroding purchasing power is addressing underlying cost drivers like Medicare Part B premiums, not the inflation formula.