Medicare was nowhere on the trail. It’ll be in the spotlight in the next Congress.

Republicans will likely take over the majority in the House. And despite a campaign season about crime and inflation, a surefire standoff next year will be over the debt ceiling, an attempt to cut Medicare, Medicaid and Social Security spending.

Republicans say they will tell President Joe Biden to accept reductions or they won’t vote to raise the debt ceiling. The problem with not raising the debt ceiling is doing so would make it illegal for the federal government to pay bills it’s legally obliged to pay — theoretically prompting a default on the national debt and a global financial meltdown — so it’s a true game of chicken.

Democrats could theoretically defuse this plot by passing a debt ceiling increase during the lame-duck session of Congress. But congressional leadership’s public stance is they have other priorities for the limited floor time, and quietly several Democrats on the Hill tell me they welcome the coming fight over entitlements so they have no real desire to avert a standoff.

Many Democrats believe a GOP push to cut Social Security, Medicare and Medicaid will be a political fiasco for Republicans — just as it was when they tried the same thing in 1995, 2005, 2012 and 2018. These are very popular programs.

And while Democrats are divided along many cultural and demographic lines, one thing that still unites them is a belief in preserving the core achievements of FDR, LBJ and Barack Obama.

The question is who, if anyone, will blink.

Scenario one: Republicans cave again

At the heart of the entitlements issue is that the aging of the population and the tendency of the healthcare sector to grow faster than the economy ensures that Medicare, Social Security and Medicaid keep growing steadily as a share of GDP.

Republicans, the party that is more supportive of low taxes and less supportive of high levels of government spending, tend to dislike this trend. Over the past quarter century, every time a new GOP administration has taken office and every time a new GOP congressional majority has emerged to check a Democratic president, they have tried to slow the growth of these programs. Every time, they’ve failed.

Later, during George W. Bush’s presidency, the White House staked its political fortunes to a proposal to privatize Social Security. This died in Congress in a storm of political unpopularity, and Bush backed down.

With regard to Medicare, Trump stood his ground. But with regard to Medicaid, Trump embraced Obamacare repeal legislation that would have sharply cut the program. This was very unpopular, it failed in Congress, and in the final two years of his administration, Trump largely stopped talking about Medicaid cuts and certainly never revisited pre-Trump Republican orthodoxy that Social Security and Medicare need to be cut.

Yet this continues to be an important idea for many influential Republicans.

Scenario two: Republicans actually get it done

Republicans have slim odds of success, which is why Democrats probably struggled to turn this into a voting issue in the midterms. Americans have time and again heard warnings from Democrats that GOP majorities are putting Social Security, Medicare and Medicaid at risk, but it somehow never seems to happen.

What’s important to understand about the year to come is that even though it never happens, that’s not for lack of trying, and Republicans seem likely to take another run at it. And though unlikely, they could make it work.

This is, after all, their party’s fundamental ideological commitment. The repeated failures on this score are reason to be pessimistic about Republicans’ odds of success, but the sheer number of times they’ve tried underscores the depth of their commitment. Famously, the GOP commissioned an “autopsy” on the party after Romney’s defeat that recommended moderating on immigration. Equally famously, Trump found political success by ignoring this advice. But Republican elites didn’t offer this idea for no reason or because they’re stupid. They offered it because they didn’t like the substance of the alternate approach — the one Trump eventually took — which was to moderate on Social Security and Medicare instead.

Scenario three: Compromise breaks out

When Obama was president, his position wasn’t to oppose all cuts to Social Security, Medicare and Medicaid. Instead, he simply insisted that cuts should be balanced evenly with tax increases on the wealthy to achieve deficit reduction in a fair way.

This was a divisive proposal among Democrats, but Republicans rejected it out of hand, which made it easy for Obama to unify his team in opposition to an all-cuts approach. Republicans didn’t even counter the 50-50 proposal with a 75-25 offer — they held out for no revenue at all. That’s consistent with GOP ideological priorities (after complaining for eight years about deficits under Obama, they swiftly cut taxes under Trump) but it makes it genuinely very hard to actually accomplish spending reductions.

It seems hard to imagine a wild midterm campaign leading to something as earnest and dull as a bipartisan agreement on deficit reduction. But in theory, Republicans could replay their debt ceiling tactics from 2011 but then display more flexibility in the actual negotiation. Would this be weird and kind of surprising? Yes. But Republicans precisely replicated strategies that have failed in the past with no change of approach would also be kind of weird. And the other way this might break could be really scary.

Scenario four: Apocalypse now?

The truth is nobody really knows what will happen if neither side backs down in a debt ceiling standoff. Treasury officials and outside experts have traditionally framed a possible breach in apocalyptic terms — a default on the national debt, a collapse of the full faith and credit of the United States, and a global financial meltdown.

But what if, in a moment of extreme emergency, the president just ignored the debt ceiling and had the Treasury continue to roll over bonds as they came due, to issue Social Security checks as provided by law and to spend the money Congress has duly appropriated? In theory, this would be illegal. But the president could argue that it’s also illegal to not pay people the money they are legally owed. And he could cite the obscure fourth section of the 14th Amendment, which states that “the validity of the public debt of the United States … shall not be questioned.”

What would happen then? Well, investors might be leery of the new questionably legal bonds, and interest rates might rise. But the Federal Reserve is trying to raise interest rates to control inflation anyway. And who is going to sue to stop the continued payment of the bills? Who would even have standing to argue that they were harmed? What judge would dare throw the world into financial chaos?

Nobody has ever wanted to find out the answers to these questions. But next year we might.