Why A Shutdown? - Because The GOP Doesn't Care About American's Health Care!

As I write this, the United States government is only hours away from a shutdown. Why is the shutdown imminent? The simple answer is because the Republicans think tax cuts for the rich was more important than protecting health care for Americans.

When the Republicans passed their "big beautiful bill", they partially funded it with cuts to Medicaid and the Affordable Care Act. These cuts would take Medicaid away from several million people - people who would not be able to afford any kind of health insurance. They also eliminated the expanded help for people buying insurance through the Affordable Care Act. That means the insurance premiums for that insurance would rise sharply - maybe as much as 75%.

Higher insurance premiums don't mean much for the rich (with their huge tax cuts), but it is a serious matter for working and middle class Americans who are already struggling to keep up with inflation of groceries and nearly everything else. Many would no longer be able to afford the insurance.

The Democrats decided to take a stand. They have pledged to block the GOP's continuing budget resolution until health care is restored for millions of Americans by stopping the cuts to Medicaid and the ACA. It is the right stand to take.

Americans won't be happy about the government shutting down. But the Democrats must make their position clear and keep repeating it until the Republicans cave. They must make sure the public understands they will vote to reopen the government as soon as the health care for millions of Americans is assured.

There will be a lot of blame tossed around for the shutdown, but the Democrats will come out ahead as long as the public understands what they are trying to achieve. The people of all states need their health care insurance - even those in the red states.

Republicans angered a majority of Americans by making the health care cuts to give the rich a huge tax break. Allowing the government to shut down because they don't care about restoring health insurance is just going to make that mistake even worse. It will give them the blame for the shutdown, and if they don't cave quickly, could cost them seriously in the 2026 elections.

The Democrats are doing the right thing. I hope they have the fortitude to stick with it.

The Republicans Will Regret Drastically Cutting Medicaid

The following post is by Nobel Prize economist Paul Krugman: 

If the One Big Beautiful Bill Act — which is, incredibly, the legislation’s actual name — goes into effect, Medicaid will be cut by around a trillion dollars over the next decade. 

What is Medicaid? Like Medicare, it’s government-provided health insurance. But unlike Medicare, it’s “means-tested”: your income has to fall below a certain level before you’re eligible. This makes Medicaid a program for the poor or near-poor — and that, for many on the right, suggests a political opportunity.

Ostensibly, the right attacks Medicaid because it costs too much. I mean, it’s a government program, which means that it must be riddled with waste, fraud, and abuse, right? And surely there must be millions of lazy people getting health care through Medicaid who should be getting up off their couches and going to work.

The reality is that none of this is true.

No doubt there’s waste and fraud in Medicaid, as there is in any system created and run by human beings. But overall Medicaid provides essential health care relatively cheaply. Once you adjust for the relatively poor health of the average Medicaid recipient — chronic illness can make you poor! — Medicaid appears to have significantly lower costs than private insurance:

Actually, in some ways Medicaid resembles the health care systems of other advanced countries, which are much cheaper than U.S. health care (while achieving equally good results) largely because they’re more cost-conscious, willing to bargain hard with drug companies, say no to expensive procedures of dubious medical benefit, and so on.

Meanwhile, the vast majority of Medicaid recipients either are working or can’t work — they’re disabled or need to stay home to care for others:

Oh, and one thing we know from repeated experience is that adding work requirements to Medicaid does not, in fact, lead to more people working.

I don’t know how many of the right-wingers clamoring for drastic Medicaid cuts believe the stories they tell about waste and lazy Americans who won’t get a job. My guess, though, is that they don’t care whether these stories are true. They’re going after Medicaid because they see it as a soft target — a program that helps lower-income Americans, and who cares about them? Medicaid’s beneficiaries, they imagine, are the new welfare queens driving Cadillacs.

But a funny thing has happened to public opinion about Medicaid. The share of Americans covered by the program has increased a lot over the past 15 years:

And the fact that so many Americans now receive Medicaid means that many peoplehave either benefited from the program or know people who have. And as a result the program has become remarkably popular:

83 percent favorability — 74 percent among Republicans! — is incredibly high. In fact, Medicaid appears to have slightly higher favorability than apple pie.

What this suggests is that Republicans who consider Medicaid a soft target, a program that only benefits inner-city rats, are going to be shocked by the blowback if they do manage to eviscerate this key piece of American health care.

The Public Is Unhappy About Proposed Cuts To Medicaid

 

The charts above are from a survey done by the Kaiser Family Foundation between May 5th and 26th of a nationwide sample of 2,539 adults, with a 3 point margin of error.

The Three Huge Lies Trump Is Telling About Medicaid

This is most of a post by Robert Reich:

Trump is busily working the Senate this week in an effort to get his Big Ugly Bill across the finish line. Given the Republicans’ close margin in the Senate, he can afford to lose only three Republican senators. . . .

I think what Senate Republicans are most afraid of is the way this will look to the average American — a Republican reverse Robin Hood strategy of taking from the poor and working class (mostly in Medicaid cuts but also food stamps and other programs they depend on) in order to finance a tax cut for the rich, while still busting the budget. 

In essence, then, the question is whether Trump and his lackeys will be able to fool the American people. 

Herewith, the Trump Republican lies about Medicaid, followed by the truth. 

1. “We’re not doing any cutting of anything meaningful. The only thing we’re cutting is waste, fraud and abuse. With Medicaid, waste, fraud, and abuse. There’s tremendous waste, fraud, and abuse.” (Trump on May 20)

Rubbish. Here’s the truth: The bill passed by the House will reduce federal spending on Medicaid by at least $600 billion over a decade and reduce enrollment by about 10.3 million people, according to a preliminary estimate from the Congressional Budget Office.

Most changes to Medicaid have little to do with waste, fraud, or abuse as defined by the Centers for Medicare and Medicaid Services.

The single largest source for savings — estimated to be about $280 billion — comes from a new requirement for Medicaid recipients to provide proof of employment.

But about 64 percent of adult recipients already work; those who do not work can still qualify under current eligibility criteria.

Work requirements in pilot programs have done little to encourage employment and instead create an impediment for those who already work or have qualifying exemptions like a disability but struggle to meet the new reporting requirements.

2. “We are not cutting Medicaid in this package. There’s a lot of misinformation out there about this …. The numbers of Americans who are affected are those that are entwined in our work to eliminate fraud, waste, and abuse. So, what do I mean by that? You got more than 1.4 million illegal aliens on Medicaid. (Speaker Mike Johnson)

Utter BS. Here’s the truth: Unauthorized immigrants are not eligible for federally funded Medicaid, except in emergency situations. States are required to verify immigration status to determine eligibility. 

3. “The One Big, Beautiful Bill also helps get our fiscal house in order by carrying out the largest deficit reduction in nearly 30 years with $1.6 trillion in mandatory savings.” (Karoline Leavitt, White House press secretary)

Baloney. Here’s the truth: The Congressional Budget Office estimates that the bill will increase the deficit by $3.8 trillion; the Committee for a Responsible Federal Budget estimates $3.1 trillion including interest; the Penn Wharton Budget Model estimates $2.8 trillion; and the Tax Foundation estimated $1.7 trillion when factoring in economic growth.

Most Voters Oppose Cuts To Funding Of Social Programs

 

The chart above reflects the results of the Economist / YouGov Poll -- done between May 16th and 19th of a nationwide sample of 1,558 registered voters, with a 2.9 point margin of error.

Tax Cuts For The Rich And Benefit Cuts For The Vulnerable

 

The chart and conclusion above are from the Economic Policy Institute.

Medicaid Work Requirement Is A Solution For A Problem That Doesn't Exist

 The following is part of a post by Matt Bruneig in The New York Times:

House Republicans have proposed adding work requirements to Medicaid, the health insurance program serving tens of millions of low-income Americans. Their plan, unveiled Sunday, would, with a few exceptions, strip coverage from childless adults who cannot document at least 80 hours of monthly employment. . . .

Imposing work requirements on Medicaid is a fundamentally misguided policy. In the debate over work requirements, it is easy to get sucked into abstract moral theorizing about what a society owes people who can work but refuse to do so. This sort of philosophizing is interesting, but it tends to elide the fact that it is employers, not workers, who make hiring, firing and scheduling decisions.

Last year, over 20 million workers were laid off or fired at some point from their jobs. Many of those workers ended up losing not just all of their income but also their employer-sponsored health care. Medicaid is supposed to provide a backstop for these workers, but if we tie eligibility to work, they will find themselves locked out of the health care system because of decisions their employers made, often for reasons beyond their control.

Even workers who are able to get and keep jobs do not decide how many hours they are scheduled for. Many low-wage employers assign shifts based on real-time estimates of consumer demand, resulting in unpredictable work hours for their employees. Through no fault of their own, these workers frequently see their schedules drop below 80 hours a month. The resulting income instability creates significant hardships for them. Eliminating their health insurance would only make things worse. . . .

There is not an epidemic of non-working able-bodied adults living high on Medicaid, despite such claims from the Trump administration. Medicaid work requirements are a solution to a problem that doesn’t exist. According to the Census Bureau’s current population survey, around 46 percent of Medicaid beneficiaries are children or people age 65 or older, age groups that are not expected to work.

Of the working-age beneficiaries, about half are working, and an additional quarter have a work-limiting disability. An additional one-fifth will work at some point in the next year or come off Medicaid sometime in the ensuing 15 months. This means that only 6 percent of working-age enrollees are not engaged in work long term, which is just 3 percent of the entire Medicaid population. . . .

For those fundamentally opposed to Medicaid and the welfare state more generally, the fact that these new requirements would create administrative barriers that disenroll eligible recipients may be seen as a feature, not a bug. I suspect that for many of the Republican policymakers who endorsed work requirements, the goal of such a policy isn’t genuinely to increase employment or remove support from only those who refuse to work. Rather, it is to redirect resources from lower-income Americans toward those at the top. And for that purpose, it is indeed well designed.

Most Americans Oppose Cutting Medicaid

 

The charts are from the Fabrizio Ward Poll -- done between March 20th and 24th of a nationwide sample of 1,000 registered voters, with a 3.1 point margin of error.

Cutting Medicaid To Pay For Low Taxes On The Rich Is A Terrible Trade!

The following is a small part of an excellent article in the Economic Policy Institute:

Keeping taxes low for the richest households and corporations is the clearest legislative priority of the Trump administration and the Republican congressional majority. Many provisions of the 2017 tax law (often called the Tax Cuts and Jobs Act or the TCJA) are expiring this year. Extending these provisions would provide hugely disproportionate benefits to the richest households.

To illustrate the difference in benefits depending on household income, the range would extend between less than $0.35 per day for the poorest households to $860 per day for the top 0.1%. For the bottom 20% of U.S. households, extending these provisions would give them an average of less than $0.35 per day. For households in the second income fifth, the benefits would be $1.20 per day, and for the middle 20% of the income distribution, the benefits would be $1.80 per day. Yet for the richest 1% of households, the benefits would jump to $165 per day, while the top 0.1% would see benefits of $860 per day.

Besides being unfairly distributed, the cost of the overall tax cut is large enough to put huge stress on other parts of the economy, no matter how it’s paid for. The most damaging way to pay for this would be to enact large cuts in spending programs that provide benefits to economically vulnerable families. Last week, House Republicans approved a budget resolution calling exactly for these types of cuts, including $880 billion in cuts that will inevitably fall on Medicaid, the program that provides health insurance for low-income Americans who cannot otherwise afford it.

Medicaid is, by far, the largest program in the federal government aimed predominantly at alleviating poverty. In 2024 it provided health insurance coverage for over 80 million people each month. The juxtaposition of prioritizing lower taxes for the richest families while proposing steep cuts to the nation’s largest program aimed at alleviating poverty could not be more clarifying for the economic debate in front of us.

The benefits of extending expiring provisions to the TCJA are easy to summarize. They will boost incomes trivially for the large majority of families but significantly for the richest households, leading to greater income inequality. The costs of Medicaid cuts are a bit harder to summarize because they are so broad and will cascade far into the future. The summary of what these cuts will do is clear. They will greatly increase hardship and misery for already struggling families, they will reduce opportunities in the future for kids who will grow up less healthy and poorer because their families lack access to Medicaid, and they will put enough strain on the nation’s overall economy that they will make a future recession far more likely.

Conclusion

Low taxes for the rich and for corporations is the highest legislative priority of the Trump administration and congressional Republicans. To get there, they are willing to cut federal programs that are utterly vital to the incomes and security of vulnerable families. These cuts will not just cause harm to individual families, they will cascade, leading to hospital closures in rural counties, higher medical debt, lower earnings from future workers who will suffer from poorer health decades from now, and could even put upward pressure on federal budget deficits in the long run. In the very near term, these cuts will make the United States economy far more vulnerable to any recessionary shock. Nothing about this policy package—tax cuts mostly for the rich and benefit cuts for the vulnerable—is good for the vast majority of families in this country.

Trump Approves Of Massive Medicaid Cuts (After Promising Not To Cut It)

The following is part of a post by Dan Rather:

Trump said time and again on the campaign trail to trust him, entitlements were safe. After he was elected, he promised to “love and cherish” Medicaid. As recently as February 18, he reiterated that pledge to Sean Hannity on Fox “News.” “It’s going to be strengthened but won’t be touched. Medicare, Medicaid, none of that stuff is going to be touched.”

On social media a day later, Trump reversed himself, endorsing the Republican House budget plan that included a directive for the Energy and Commerce Committee to find $880 million in cuts. Most or all of those cuts are likely to come from Medicaid. “The House Resolution implements my FULL America First Agenda,” Trump wrote on Truth Social.

But Trump can’t have it both ways. Enabled by his MAGA brethren in Congress, the new administration is looking for $1.5 trillion in savings over the next decade to fund tax cuts for corporations and the wealthiest Americans. According to the nonpartisan Congressional Budget Office, this cannot be accomplished unless cuts are made to entitlement programs, specifically Medicaid, at least to start.

Medicaid is designed specifically to help Americans most in need — who also have the least political clout. The program provides health insurance to more than 72 million poor and disabled Americans. That’s one in five people. Eighty percent of poor children (and 39% of all American children) get insurance through Medicaid. It also provides coverage for 63% of nursing home residents and 41% of adults with disabilities and pays for 41% of all births.

Under the current system, the federal government and state governments share the cost of coverage, though the federal government shoulders considerably more of the costs than the states. Any federal cuts will mean states will either have to reduce coverage or raise taxes to make up the budget shortfall.

America is the richest nation in the world. How much more money do the already-wealthy need? And is lowering taxes for the rich at the expense of the poor and disadvantaged really good for the country — short- and long-term?

Hospital Beds Are Decreasing - And Republicans Want To Make It Worse

 

Researchers have determined that the availability of hospital beds is decreasing. Between 2009 and 2019, the hospital occupancy rate was 63.9%. By 2024, the rate had risen to 75.3%. It is estimated that by 2035 the occupancy rate will reach 85%.

An 85% rate is deemed to be a shortage, because medical officials say at that rate "basic hospital operations can become dysfunctional and even unsafe".

The reason for the decrease is two-fold - an increase in the number of senior Americans (who require more hospital care than you're people) and hospitals that are closing their doors and going out of business.

This is especially true in rural areas, where many hospitals are having trouble meeting their expenses - and many are closing each year.

Sadly, the Republican in Congress are planning to make things worse - not better. How? By making a huge cut in Medicaid funding. In the bill under consideration, they want to cut Medicaid by more than $800 million. 

This would be devastating for many hospitals, especially in rural areas. These hospitals rely on Medicaid to provide the money they need to keep operating. Without the Medicaid money, they will have to close.

And it won't be just rural hospitals that will be hurt. The rural people will have to then travel to urban areas to get hospital treatment. That will decrease the number of hospital beds available in urban areas.

It is critical for everyone's medical care that hospitals everywhere remain open. That means it is critical to maintain Medicaid funding at the present level (or increase it).

NOTE - Republicans are now considering a continuing resolution to keep the government open. While that would avoid the draconian cuts to Medicaid they want, it would include smaller cuts to it. And it would just delay the larger cuts until September. That's not a solution.

KFF Poll Shows GOP Cutting Medicaid Would Be A Huge Mistake

 

The charts above are from the Kaiser Family Foundation Poll -- done between February 18th and 25th of a nationwide sample of 1,322 adults, with a 3 point margin of error.

Voters Oppose Cuts To Medicaid, Medicare, And Social Security

 

The charts above reflect the results of the Economist / YouGov Poll -- done between March 1st and 4th of a nationwide sample of 1,491 registered voters, with a 3.4 point margin of error.