Way too complicated.
In 1965, Congress created a monstrosity when it passed Medicare and Medicaid. They KNEW they were going to have to pay a lot of bills. They did not know, at the time, that the promise to pay bills without limit would create an entire industry.
Congress lost the ability to meet its promise to pay without limit through taxation by 1986. Since then, they have been printing and borrowing money as fast as possible to keep up.
Almost all of them, RAT and GOP, understand that continued spending under a “pay without limit” promise will cause a disaster. The reason so many of them have gone for commiecare is that the commies promise that they have a solution.
Most non-communist Members and Senators, being not too bright, have not a clue about how to avoid the obvious upcoming collapse. AND, they understand that their constituents will NOT be happy with them if they allow disaster while they are in office.
That’s it in a nutshell. They are not bribed, most of them, and they are not blackmailed.
They’re just ordinary mooks who are stuck with Medicare and Medicaid and who are clueless about what to do about it.
That is a good theory, one of the better ones out there.
The only way to balance that portion of the budget screwed over by Medicare and somewhat by medicaid is to reduce expenditures by however they can even to the extent of saying to those over say 70: take two asperins and call me next year, if you can.