WASHINGTON — President Trump had a blunt message for Montana voters last week, an unapologetic reprise of the promise to protect Medicare and Social Security that he used during the 2016 presidential campaign to successfully appeal to older, blue-collar voters.
“They’re going to hurt your Social Security so badly, and they’re killing you on Medicare. Just remember that. I’m going to protect your Social Security,” Mr. Trump said at a campaign rally in Billings on behalf of Matt Rosendale, a Republican Senate candidate.
“Do you remember when I ran?” Mr. Trump asked the cheering crowd, recalling how he had accused the other Republican presidential contenders of wanting to destroy the safety net for older Americans. “I said I’m not touching Social Security. Everybody said — well — and everybody else wanted to do things with Social Security. I said, we’re not touching your Social Security.”
The president’s message once again runs counter to many in his own party, including Speaker Paul D. Ryan, who have long argued for cuts in entitlement programs like Medicare and Social Security. But this time, as Mr. Trump made clear at the Montana rally, his target is not his fellow Republicans, but Democratic candidates in the midterm election contests this fall.
And unlike in 2016, Mr. Trump now has a record of his own on health care: He has supported Republican budgets that seek to trim entitlements like Medicare, and he has backed highly unpopular efforts to repeal parts of the Affordable Care Act, increasing hospital reimbursement costs for the program.
Still, the president’s White House strategists believe that recent calls from progressives like Senator Bernie Sanders, an independent from Vermont, for “Medicare for all” — a single-payer health care system — give Mr. Trump an opportunity to challenge Democrats on health care in their races.
“Disastrous policies like ‘Medicare for all’ is in our estimation terrible politics,” said Bill Stepien, the White House political director. “As the president sees Democrats rushing to the left and leaving seniors behind, he feels that it is incumbent to draw attention to the disastrous Democratic policies.”
But if the president thinks that his new Medicare and Social Security attacks are the key to preventing a Democratic takeover of Congress in November, he may be expecting too much.
Mr. Trump falsely charged in Billings that Democrats “want to steal trillions of dollars from Medicare” and will “destroy your Social Security.” The 2016 Democratic Party platform promised to protect and expand Social Security, and Democratic lawmakers have proposed legislation to increase, not reduce, benefits from the retirement program.
And Mr. Trump himself is vulnerable to accusations of hypocrisy for championing a tax cut even as the financial outlook for entitlement programs has worsened. In June, the government said that less money was flowing into Medicare, and projected that the program’s trust fund would be depleted by 2026, three years earlier than previously estimated.
In June, a government report calculated that the Social Security fund that provides benefits to the elderly will run out of money in 2034, one year earlier than had been previously estimated.
Mr. Sanders has assailed Mr. Trump for what he called a cynical attempt to scare Democratic voters with Medicare and Social Security warnings that have little merit.
“It will not shock a lot of people to tell you that the president of the United States is lying again, as he does every day,” Mr. Sanders said in an interview. “As everybody who follows Congress understands, it is not the Democrats who want to cut Medicare and Social Security.”
Democratic strategists predict that the president’s attacks will not work because their party has spent decades earning a reputation as the defenders of Medicare and Social Security. They say the president and his allies are grasping for a lifeline to save them from losses in November.
“The American public will see it as B.S.,” said Brad Woodhouse, a veteran Democratic strategist and the executive director of ProtectOurCare.org, a liberal health care group. “The president and the Republicans have near-zero credibility on this issue. It is a scare tactic born of complete and utter desperation.”
The wild card may be how voters react to a growing demand among Democrats for a single-payer, government-run health care system. Mr. Sanders has proposed legislation to create that kind of health care system, and scores of Democratic candidates have endorsed the idea.
Senator Tammy Baldwin, Democrat of Wisconsin, wrote an op-ed last year titled: “Why I support Medicare for all and other efforts to expand health coverage.”
Several other Democratic senators, including some who are weighing a run for president in 2020, have backed the idea, though Democratic candidates running in conservative states like West Virginia, Indiana and North Carolina have distanced themselves from that approach.
And last week, former President Barack Obama for the first time embraced the idea of “Medicare for all,” saying in a speech that it was one of the “new ideas” that was powering Democratic candidates to success across the country. In the past, Mr. Obama had dismissed the notion, saying that most Americans were satisfied with the employer-based system of private insurance.
In Montana, Mr. Trump presented an apocalyptic vision of what extending Medicare would look like. “They’re going to ruin your Medicare. Watch. They want to turn America into Venezuela. I don’t think so,” he said, prompting boos from the audience. “Democrats would destroy Medicare with ‘Medicare for all’ — you heard that — ‘Medicare for all,’ until they run out of money, which would be like in the third day.”
Republicans point to a study suggesting that a “Medicare for all” program could cost $32 trillion over a decade. The Republican National Committee echoed Mr. Trump’s message in an email to reporters on Tuesday: “Under Democrats’ Dream of a Single-Payer Health Care System, Medicare Recipients Would Lose Out on Quality and Coverage,” the email asserted.
In Maine, the Republican House incumbent has begun airing a campaign ad that accuses Jared Golden, his Democratic opponent, of supporting “a risky scheme” to end Medicare. Mr. Golden’s campaign called the ad “a desperate attack” with no merit.
Mr. Sanders said the Republican attacks were wrong. He said a single-payer health care system would eliminate all private insurance premiums and co-pays, saving most people thousands of dollars in health care costs each year. He said the system would also provide vision, dental and hearing coverage for seniors.
“Our proposal will end up costing the vast majority of people far less,” Mr. Sanders said.
But that message is hardly universal among Democratic candidates. Many, instead, are highlighting efforts by Mr. Trump and the Republican Party to repeal the Affordable Care Act, including popular provisions like coverage for pre-existing conditions.
“What those voters are concerned about is the way that the Republican Party’s health care agenda will increase their costs and jeopardize their coverage for pre-existing conditions,” said David Bergstein, a spokesman for the Democratic Senatorial Campaign Committee.
And some, like two endangered incumbents, Senators Claire McCaskill of Indiana and Joe Donnelly of Indiana, have accused their opponents of wanting to slash Medicare to pay for the tax cuts they have supported.
Mr. Stepien shrugged off the Democratic efforts. He said that Mr. Trump will continue to keep ratcheting up the pressure on Democrats about the “Medicare for all” proposal.
“There’s not an elected official in the Democrat Party who should not be firmly stating whether they should be for or against this radical proposal,” he said.