Trump's mega-bill will hurt the health of his own voters

The Hill

2 days ago

Even a Trump critic has to agree that Medicaid does have problems with fraud and abuse.
But the problem with Medicaid isn't due to people cheating or failing to fill out the paperwork to prove they qualify as the working poor. No, the problem is health care 'providers' gaming the system, overbilling and pocketing profit, knowing they'll rarely face real consequences. These corporate bad guys draining Medicaid are labeled by critics as the health care 'crime families.'
But those cheats are avoiding penalties as President Trump targets middle-class and poor people who rely on Medicaid. And a lot of them are his own voters.
Trump promised not to cut into their Medicaid benefits. He said this explicitly, pledging that 'we're not going to do anything with that, other than if we can find some abuse or waste … but the people won't be affected.'
Yet under Trump-backed legislation there will be cuts to federal funding to help with the cost of doctor visits and nursing homes. That hurts the large segment of Trump voters who get medical attention thanks to Medicaid.
But hold on. Sen. Mitch McConnell (R-Ky.), a fierce defender of GOP political interests as the former Senate Majority Leader and often a Trump critic, voted for the bill.
'I know a lot of us are hearing from people back home about Medicaid,' McConnell reportedly told his Senate GOP colleagues at a closed-door luncheon. 'But they'll get over it.'
Get over it, senator?
McConnell is not alone in his judgment that voters will look the other way, ignoring the withdrawal of medical treatment now provided by Medicaid. Vice President JD Vance said last week that cuts to Medicaid are 'immaterial.' Sen. Joni Ernst (R-Iowa) dismissed concern about Medicaid by telling a townhall that 'we're all going to die.'
There is dissent among some Republicans aware that Trump built a working-class, populist base that includes a lot of people on Medicaid.
Listen to Steve Bannon, the former Trump aide and far-right podcaster: 'A lot of MAGAs are on Medicaid. If you don't think so, you're dead wrong. You can't just take a meat axe to it.' The numbers indicate that Bannon is right.
More than 20 million Republicans are on Medicaid. In recent focus groups with Trump voters in states such as Kentucky, Ohio and North Carolina, many said they never expected Trump to back such deep Medicaid cuts — and they're worried about what it means.
Another famed Trump supporter, Elon Musk, is also making the point that Trump is harming his political base while failing to effectively cut government spending. 'Every member of Congress who campaigned on reducing government spending and then immediately voted for the biggest debt increase in history should hang their head in shame!' Musk wrote. 'And they will lose their primary next year if it is the last thing I do on this earth.'
Polling by Fox News backs these GOP critics. A June poll found that 59 percent of voters oppose the Trump bill, and 45 percent of people who say they understand the bill said it will 'hurt' their family.
As NPR reported last week, 'The Senate plan to slash Medicaid and ACA marketplace funding could lead to nearly 12 million more people without insurance by 2034 … That in turn would harm the finances of hospitals, nursing homes and community health centers, which would have to absorb more of the cost of treating uninsured people, and may force them to reduce services and employees, as well as close facilities.'
The high number of Trump supporters who rely on rural hospitals and health centers will specifically feel the impact. As Sen. Ruben Gallego (D-Ariz.) noted, the bill will result in cuts to substance abuse treatment, which includes opioid and addiction care as well as combating fentanyl use. Those programs are funded by Medicaid.
'It's shameful,' said House Democratic Leader Hakeem Jeffries, warning 'people will die' and calling the bill an 'all-out Republican assault on health care.' He declared the House floor a 'crime scene' shortly before the GOP majority voted to pass it.
That rhetoric is not fearmongering. Consider just a few problems already being pointed out by critics of Trump's bill.
According to AIDS United, 40 percent of American adults living with HIV rely on Medicaid.
A Brown University analysis finds that 579 U.S. nursing homes are now at high risk of closure.
As the Kaiser Family Foundation reported, Medicaid pays for over 40 percent of births nationally and nearly half of births in rural areas. It is the largest payer of pregnancy-related services. Cuts will be especially devastating in states like Louisiana, Mississippi, New Mexico and Oklahoma.
Halting abortion has been a mainstay of GOP policy, and now many babies and their mothers will suffer as a result of cuts passed by Republican lawmakers who built their careers as opponents of abortion.
Abortion rights advocates are sure to make the case that Republicans who voted for these cuts may end up with more deaths on their hands than any abortion provider.
So, will voters 'get over it' as McConnell suggests?
We'll see. The first test comes in four months in gubernatorial elections in Virginia and New Jersey — where a combined 3.2 million people rely on Medicaid.
Juan Williams is senior political analyst for Fox News Channel and a prize-winning civil rights historian. He is the author of the new book 'New Prize for These Eyes: The Rise of America's Second Civil Rights Movement.'