Synthetic tabular data are often evaluated by distributional similarity, privacy distance, or train-on-synthetic-test-on-real predictive performance, but these criteria do not ensure validity for causal inference. We show that fully generative tabular synthesizers, including GAN- and LLM-based models, can preserve predictive utility while distorting average treatment effect (ATE) estimates. The failure is structural: ATE preservation requires both a realistic covariate law and an accurate treatment-effect contrast, whereas prediction loss penalizes treatment-effect error only through an overlap-weighted term. We formalize this mismatch through sensitivity and loss-decomposition results, and identify an analogous decomposition in block-level next-token prediction under log loss. Motivated by the tabular causal analysis, we propose a hybrid synthetic-data framework that generates covariates while modeling treatment and outcome mechanisms separately, allowing causal-purpose treatment assignment such as randomized synthetic assignment. We evaluate this framework in three settings: ATE preservation under fully generative versus hybrid synthesis, targeted augmentation for practical positivity problems, and synthetic simulation engines for comparing OR, IPW, AIPW, and TMLE before real-data analysis. Across synthetic and ACTG experiments, hybrid synthesis improves causal fidelity relative to fully generative baselines; LLM-based hybrid synthesis is often more faithful than CTGAN for ATE preservation and finite-sample estimator benchmarking.