One Big Beautiful Destruction of Medical Care as We Know It

 

One Big Beautiful Destruction of Medical Care as We Know It

Decimation of Medicaid Support for the Poor & the Elderly

It’s actually called “THE ONE, BIG, BEAUTIFUL BILL” by the House Ways and Means Committee defined and sponsored a House “reconciliation bill” (where the Senate supermajority will not be required for a floor vote) is the omnibus super-bill reconciling the House approved federal budget with Trump and ultra-rightwing GOP hardliners who want major tax cuts for the rich. The “pro-business at all costs” is everywhere. It seems that the only Trumpy sacred cow remains tariff land.

You can see the trend of supporting business at every turn. The FCC is declawed from true regulation, focused on Trump critics and “woke” programming instead. NOAA and the EPA have been told that since there’s no such thing a “man-induced climate change,” they need to stop monitoring the obvious evidence of climate change. Worker safety (OSHA) has been downgraded. Criminal investigatory powers (DOJ, SEC, FBI, etc.) over a pile of white-collar crimes – from consumer fraud and the Foreign Corrupt Practices Act to violations of financial crimes arising from business fundraising – has been suspended or vastly reduced… but woe to individuals who protest against causes that Donald Trump supports and note how these agencies are now helping ICE pursue individual undocumented aliens. Trump tells Americans, tighten your belts! Anybody want a 13-year-old 747-8 fit for a king? King Trump, the Emir of Washington, D.C. The retrofit would be in the billions!

In short, ordinary citizens don’t matter much… unless the administration so oversteps is anti-individual, pro-business obsessions that GOP (really MAGA) members of Congress truly believe that if they don’t pay attention to some seminal federal programs and preserve (even expand) them – like Social Security, Medicare, Veterans’ benefits and, importantly, Medicaid – they will be blown out of office at the midterms (if those even take place). For GOP fiscal hardliners, they want our egregious deficit to stabilize and even be reduced (we’re spending almost a trillion dollars a year just paying interest on our deficit borrowings)… but extending the expiring 2017 corporate tax cut (which did not pay for itself or create tons of new, well-paying jobs as promised, instead adding trillions to the deficit), and adding even more trillions of new, additional tax cuts that tend overwhelmingly to benefit only the rich, are worth it for MAGA elected legislators.

Given the abysmal failure of Elon Musk’s DOGE to do much in the way of bona fide federal budget cutting – the final tally of his efforts suggest we would be lucky to get 3% of the two trillion dollars of cuts he originally proposed – the only way to scale back that federal budget is to slash defense spending (which is unthinkable to the GOP rightwing) and go for the federal social programs with a meat axe. Musk, probably the most hated man in the United States, is all for a major slash and burn of these social programs, calling Social Security a “Ponze scheme.” As Congress and DOGE tear away at the administrative staffing needed to make these programs work, pretending that they are leaving the underlying benefits intact, it is apparent that that such cuts are hardly enough. Since elderly voters form a significant part of the GOP base, and since Congress and the Trump administration hold America’s poor in particular disdain, the only programs that are vulnerable include food stamps (SNAP), school lunch programs and, most of all, Medicaid.

Medicaid is complicated, often including major state “opt-in” benefits, but has functioned as the nation’s safety net for the poor (including the working poor), the elderly (especially where nursing home care is required), and the disabled. Since the United States is the only developed country on Earth that does not have government-sponsored universal healthcare, millions of Americans are without insurance… and many of those rely on Medicaid to survive. But if the eligibility and work rule requirements (which have never worked anywhere where applied) that are part of this new House reconfiguration are enacted, as many as 13 million Americans will live without even this safety net.

It’s true that some states, like California, extend that safety net even to undocumented aliens… but some wise bureaucrats noticed that these workers, many of whom handle our food supply chain, could easily accelerate a pandemic that would take us all down if denied access to medical care. Ironically, it is the red states that have the largest proportion of Medicaid users, a fact not lost on Republicans facing reelection in 2026. Writing for the May 14th ABC News, Lauren Peller and John Parkinson tell us: “A growing number of House Republicans -- from moderates to hardliners -- are expressing grievances with key components of the megabill encompassing President Donald Trump’s legislative agenda -- threatening to undercut the package’s momentum ahead of an expected vote late next week.

“Speaker Mike Johnson faces yet another critical test of his speakership and must corral his divided conference around the final reconciliation package in the House. Johnson can only afford to lose three GOP defections and currently there are enough lawmakers signaling opposition to stop the bill from advancing to the Senate… House Freedom Caucus Chairman Andy Harris called the Medicaid plan ‘a joke.’… ‘The proposal to stop waste, fraud, and abuse in Medicaid will do little to achieve that. The common-sense work requirement for able-bodied adults doesn’t start for four years (into the next administration) and CAN BE WAIVED by any state for ‘hardship’ that they determine (and they will). What a joke. The swamp is real. And by the way…the federal government should NOT pay states more for able-bodied, working-age adults on Medicaid than it pays states for children, pregnant women, seniors, and people with disabilities on Medicaid,’ Harris said in a post on X…

“Republicans voted 30-24 to advance the bill to the House Budget Committee, which will tie together the 11 bills under reconciliation on Friday [5/9]… Ranking member Frank Pallone, D-N.J., said Democrats put up a ‘good fight’ throughout the markup. Democrats held up photos and told emotional stories of their constituents who rely on Medicaid, warning that millions of Americans will go uninsured under the GOP plan… Democratic Rep. Alexandria Ocasio-Cortez got into a testy exchange with GOP Rep. Randy Weber around 3 a.m. Wednesday [5/7] when she asked a question about consequences for those who had miscarriages under the proposal's new work requirements to receive Medicare.”

Yet, the bill covers more than just Medicaid. Writing for the May 14th Los Angeles Times, Lisa Mascaro and Kevin Freking explain: “House Republicans proposed sweeping tax breaks… in President Trump’s big priority bill, tallying at least $4.9 trillion in costs so far, partly paid for with cuts to Medicaid, food stamps and green energy programs used by millions of Americans.

“The House Ways and Means Committee… seeks to extend the tax breaks approved during Trump’s first term — and boost the standard deduction, child tax credit and estate tax exemption — while adding new tax breaks on tipped wages, overtime pay, Social Security benefits and auto loans that Trump promised during his campaign for the White House.

“There’s also a tripling of the state and local tax deduction, called SALT, up to $30,000 from $10,000 for couples, which certain high-tax state GOP lawmakers from New York and California already rejected as too meager. Private universities would be hit with a hefty new tax on their endowments, as much as 21%, as the Trump administration goes after the Ivy League and other campuses. And one unusual provision would terminate the tax-exempt status of groups that the State Department says support ‘terrorists,’ which civil society advocates warn is a way to potentially punish those at odds with the Trump administration…

“On Sunday [5/11], House Republicans on the Energy and Commerce Committee unveiled the cost-saving centerpiece of the package, with at least $880 billion in cuts largely to Medicaid to help cover the cost of the tax breaks… Although Republicans insist they are simply rooting out ‘waste, fraud and abuse’ to generate savings with new work and eligibility requirements, Democrats warn that millions of Americans will lose coverage. In the 15 years since Obamacare became law, Medicaid has expanded as most states have tapped into federal funds.” The cuts to IRS staffing alone will cost us almost a trillion dollars, but rich folks won’t be able to be audited as much! Think of all those tenements in major urban areas homeless encampments are filled with healthy people? Think if an epidemic were to break out there, only they would be impacted? 

I’m Peter Dekom, and if you are not at least middle class in the United States (and even that may not be enough), the government policy of slamming the less affluent in our society generates a great big MAGA “meh” or even a Trumpy “screw you for being poor” look of disdain.