IT'S ABOUT MEDICAID STUPID
The big beautiful gift to Democrats
Any day for the next 15 months that a Democratic congressional candidate doesn't mention Medicaid is a lost day.
The Republicans' self-styled "Big Beautiful Bill" is a gift for Democrats if they keep focused. It's unpopular for a clear reason: it provides major tax cuts principally for the wealthy, partially paid for with close to a $1 trillion cut in Medicaid, which covers 71 million poor and working class Americans. Medicaid is the lifeblood for many rural hospitals.
The Congressional Budget Office estimates more than 10 million Americans will lose their health care coverage. Other analysis notes, with cuts also in the Affordable Health Care Act, more than 13 million will lose health care coverage.
This is a political slam dunk for Democrats who for years have charged that Republicans will come after your health care. Any day for the next 15 months that a Democratic congressional candidate doesn't mention Medicaid is a lost day.
The Republicans' self-styled "Big Beautiful Bill" is a gift for Democrats if they keep focused. It's unpopular for a clear reason: it provides major tax cuts principally for the wealthy, partially paid for with close to a $1 trillion cut in Medicaid, which covers 71 million poor and working class Americans. Medicaid is the lifeblood for many rural hospitals.
The Congressional Budget Office estimates more than 10 million Americans will lose their health care coverage. Other analysis notes, with cuts also in the Affordable Health Care Act, more than 13 million will lose health care coverage.
This is a political slam dunk for Democrats who for years have charged that Republicans will come after your health care.
They now can say they have gone after your health care; communities and rural hospitals will be devastated.
The White House and GOP congressional leadership contend the bill really doesn't take coverage away from deserving recipients, it'll all come from fraud and undocumented workers. As they say in the South that dog won't hunt; cutting close to a trillion dollars in Medicaid and not hurting anyone, really?
There are some good Republican witnesses. Sen. Thom Tillis, a North Carolina conservative Republican, said the legislation "betrays the promise" that Trump and others made not to cut Medicaid. He fears hundreds of thousands in his state will lose coverage with great harm to hospitals and rural communities.
There's Missouri's Josh Hawley, who after promising to oppose cuts in Medicaid then, unlike Sen. Tillis, provided the key vote for the measure. Within weeks he was proposing to undo many of the Medicaid cuts, while falsely claiming the bill really doesn't cut individual benefits.
In an Atlantic article, the former Missouri Republican Senator, Jack Danforth, dismisses Hawley's proposal as a political gimmick to minimize political fallout. The head of the state's rural health association said because of the Hawley-supported legislation "people are going to die, especially when rural hospitals start closing."
Former Treasury Secretary Larry Summers is a Democrat but one that the party's left wing has often derided as too moderate. He wrote that the Big Beautiful Bill makes him "ashamed to be an American" -- something I never imagined from this establishment figure -- with powerful specificity: a seriously disabled patient is likely to lose Medicaid coverage for rides to medical appointments or huge reductions in home health care workers.
In Pennsylvania earlier this month, Vice President Vance displayed the Republican challenges to sell the Big Beautiful Bill. He stressed tax breaks for overtime work, tips and for many seniors. He didn't mention those are temporary while most of the more generous provisions for wealthier taxpayers are permanent.
Tellingly, according to press accounts, he never mentioned Medicaid.
Governors and local officials are bracing for the impact. Maryland Gov. Wes Moore, in the Carville-Hunt Politics War Room podcast, said under this "cruel bill," 250,000 Marylanders will lose health care coverage and rural hospitals will have to close with the loss of a quarter billion dollars of rural health care funds.
"This is the greed act of 2025," Moore charges, "the largest upward consolidation of wealth we have ever seen."
Also the bill, with the massive tax cuts, increases the deficit by $3.4 trillion over the next decade. For as long as I can remember fears about deficits didn't register as a voting issue. With this legislation, under the current trajectory, the Congressional Budget Office estimates there would be an automatic sequestration that reduces social security benefits by $490 billion. That would register.
One of the Republican defensive rejoinders is to criticize the Congressional Budget Office. Ok, take the Penn-Wharton model whose findings mirror CBO's, adding that the measure features a transfer of wealth from the young to older Americans, and exacerbates income inequality.
That model is from Donald Trump's alma mater.
The other contention, more a hope, is that since these Medicaid cuts don't take effect until after the midterms they may not resonate politically. They should remember 2010 when Republicans scored landslide congressional victories running against the recently enacted Affordable Health Care Act.
The ACA wasn't scheduled to take effect until 2014.
A potential downside for Democrats is getting distracted. Trump is a master of creating new controversies. Last week, he accused former President Barack Obama of treason and demanded that the professional football team the Washington Commanders restore its previous nickname, which many found offensive.
Democrats need to avoid getting ensnared in these distractions. They are scoring points by demanding transparency on Trump's involvement with the late Jeffrey Epstein, a sexual predator. I believe there may well be a White House and Justice Department coverup, but doubt this scandal has political legs.
Of course there should be criticism of the thuggish deportation policies that aren't predominately about migrants with criminal records. But if immigration is a centerpiece of elections it usually helps Republicans.
There are Democrats who insist rather than just oppose Trump, the party needs an agenda. First in midterms elections -- think 2010 or 2018 for Democrats -- the agenda is about the damage the incumbent Administration was doing. Full-fledged agendas are for Presidential years.
Moreover, Trump and his GOP congressional followers have given Democrats a perfect mini-agenda if they take control of Congress in 2027: repeal the Medicaid cuts, restore losses incurred by veterans and reinstitute the tax increases on multi-millionaires and billionaires to avoid reductions in Social Security benefits.
It all starts with Medicaid.
They now can say they have gone after your health care; communities and rural hospitals will be devastated.
The White House and GOP congressional leadership contend the bill really doesn't take coverage away from deserving recipients, it'll all come from fraud and undocumented workers. As they say in the South that dog won't hunt; cutting close to a trillion dollars in Medicaid and not hurting anyone, really?
There are some good Republican witnesses. Sen. Thom Tillis, a North Carolina conservative Republican, said the legislation "betrays the promise" that Trump and others made not to cut Medicaid. He fears hundreds of thousands in his state will lose coverage with great harm to hospitals and rural communities.
There's Missouri's Josh Hawley, who after promising to oppose cuts in Medicaid then, unlike Sen. Tillis, provided the key vote for the measure. Within weeks he was proposing to undo many of the Medicaid cuts, while falsely claiming the bill really doesn't cut individual benefits.
In an Atlantic article, the former Missouri Republican Senator, Jack Danforth, dismisses Hawley's proposal as a political gimmick to minimize political fallout. The head of the state's rural health association said because of the Hawley-supported legislation "people are going to die, especially when rural hospitals start closing."
Former Treasury Secretary Larry Summers is a Democrat but one that the party's left wing has often derided as too moderate. He wrote that the Big Beautiful Bill makes him "ashamed to be an American" -- something I never imagined from this establishment figure -- with powerful specificity: a seriously disabled patient is likely to lose Medicaid coverage for rides to medical appointments or huge reductions in home health care workers.
In Pennsylvania earlier this month, Vice President Vance displayed the Republican challenges to sell the Big Beautiful Bill. He stressed tax breaks for overtime work, tips and for many seniors. He didn't mention those are temporary while most of the more generous provisions for wealthier taxpayers are permanent.
Tellingly, according to press accounts, he never mentioned Medicaid.
Governors and local officials are bracing for the impact. Maryland Gov. Wes Moore, in the Carville-Hunt Politics War Room podcast, said under this "cruel bill," 250,000 Marylanders will lose health care coverage and rural hospitals will have to close with the loss of a quarter billion dollars of rural health care funds.
"This is the greed act of 2025," Moore charges, "the largest upward consolidation of wealth we have ever seen."
Also the bill, with the massive tax cuts, increases the deficit by $3.4 trillion over the next decade. For as long as I can remember fears about deficits didn't register as a voting issue. With this legislation, under the current trajectory, the Congressional Budget Office estimates there would be an automatic sequestration that reduces social security benefits by $490 billion. That would register.
One of the Republican defensive rejoinders is to criticize the Congressional Budget Office. Ok, take the Penn-Wharton model whose findings mirror CBO's, adding that the measure features a transfer of wealth from the young to older Americans, and exacerbates income inequality.
That model is from Donald Trump's alma mater.
The other contention, more a hope, is that since these Medicaid cuts don't take effect until after the midterms they may not resonate politically. They should remember 2010 when Republicans scored landslide congressional victories running against the recently enacted Affordable Health Care Act.
The ACA wasn't scheduled to take effect until 2014.
A potential downside for Democrats is getting distracted. Trump is a master of creating new controversies. Last week, he accused former President Barack Obama of treason and demanded that the professional football team the Washington Commanders restore its previous nickname, which many found offensive.
Democrats need to avoid getting ensnared in these distractions. They are scoring points by demanding transparency on Trump's involvement with the late Jeffrey Epstein, a sexual predator. I believe there may well be a White House and Justice Department coverup, but doubt this scandal has political legs.
Of course there should be criticism of the thuggish deportation policies that aren't predominately about migrants with criminal records. But if immigration is a centerpiece of elections it usually helps Republicans.
There are Democrats who insist rather than just oppose Trump, the party needs an agenda. First in midterms elections -- think 2010 or 2018 for Democrats -- the agenda is about the damage the incumbent Administration was doing. Full-fledged agendas are for Presidential years.
Moreover, Trump and his GOP congressional followers have given Democrats a perfect mini-agenda if they take control of Congress in 2027: repeal the Medicaid cuts, restore losses incurred by veterans and reinstitute the tax increases on multi-millionaires and billionaires to avoid reductions in Social Security benefits.
It all starts with Medicaid.