Donald Trump’s “One Big Beautiful Bill,” which features more tax breaks for the rich and cuts programs that help working people, survived several near-death experiences as “moderate” Republican lawmakers promised they would never vote to strip Medicaid and food stamps from their constituents or blow up the national debt with tax breaks for the rich, but Republican House and Senate leaders reeled enough of them in to bring the ugly bill home for the Lyin’ King’s signature on July 4.
Trump got the budget reconciliation bill through the Senate with the narrowest Republican majority, as Vice President JD Vance broke a tie July 1. Sen. Josh Hawley, R-Missouri, who had said he could not vote to strip Medicaid from his constituents, flipped his vote to “yes” after Republican leaders made some changes in the language, and Sen. Lisa Murkowski, R-Alaska, switched to "yes" after securing concessions for her state, leaving Sen. Thom Tillis of North Carolina, who said he would not seek re-election after Trump threatened to primary him, Rand Paul of Kentucky and Susan Collins of Maine voting “no.”
In the House, five “solid” Republicans who opposed the bill July 2 collapsed to two “no” votes after they were summoned to the White House to visit with the president. They returned with Trump merchandise and gave the Big Lie Party a 216-214 win on July 3.
One of the flippers, Rep. Derrick Van Orden of Wisconsin, denied they were pressured. “The president of the United States didn't give us an assignment. We're not a bunch of little bitches around here, OK? I'm a member of Congress. I represent almost 800,000 Wisconsinites," Van Orden told journalists near the back entrance to the House of Representatives chamber.
Responding to Van Orden's claims on the social media platform X, Rashida Tlaib (D-Michigan.) said, "Yes, he did, and yes, you are."
Republicans overcame a unified Democratic minority to enact $5 trillion in tax breaks over the next 10 years, mainly benefitting the rich, while budgets for programs helping working people are cut. The bill provides $350 billion for Trump’s border and national security agenda, which will allow Trump to expand the Immigration and Customs Enforcement force to abduct immigrants and hold them in remote detention centers, such as the “Alligator Alcatraz” concentration camp in the Florida Everglades while they await deportation. New immigrants would face new fees, including a minimum $100 fee when applying for asylum protection.
To partly offset the lost tax revenue and new spending, Republicans imposed cuts that will save $1 trillion from Medicaid and $300 billion from the Supplemental Nutrition Assistance Program (a.k.a. “food stamps) for people below the poverty line in the next decade.
Republicans argue they are trying to adjust the safety net programs for the population they were initially designed to serve, mainly pregnant women, the disabled and children, and root out what they describe as waste, fraud and abuse.
“What we’ve talked about is returning work requirements,” House Speaker Mike Johnson told reporters in early April.“So, for example, you don’t have able-bodied young men on a program that’s designed for single mothers and the elderly and disabled. They’re draining resources from people who are actually due that. So if you clean that up and shore it up, you save a lot of money, and you return the dignity of work to young men who need to be out working instead of playing video games all day.”
The bill requires adults receiving Medicaid and food stamps to prove they work at least 80 hours a month, including older people up to age 65. Parents of children 14 and older also would have to meet the program’s work requirements. The verification also will be required for the Affordable Care Act’s federal premium subsidies, which could also leave some middle-income Americans uninsured.
There’s also a proposed new $35 co-payment that can be charged to patients using Medicaid services.
More than 71 million people rely on Medicaid, which expanded under President Obama’s Affordable Care Act, and 40 million use the Supplemental Nutrition Assistance Program. About 64% of adult Medicaid recipients work either full-time or part-time, according to a study by the Kaiser Family Foundation in May. Others do not hold traditional jobs but 12% have caregiving responsibilities, 7% attend school and 10% have an illness or disability that prevents them from working.
That leaves about 8% of Medicaid recipients who are not working for other reasons, including retirement, inability to find work or other reasons.
Within this group, nearly 80% are women, according to nonpartisan researchers at the University of Massachusetts Boston, who analyzed Census Bureau data from the 2023 American Community Survey (ACS) to reach their conclusion.
Medicaid recipients who are in this smaller group of able-bodied recipients are primarily women who are, on average, 41 years old. A quarter are over 50. Most have a high school education or less. They are also poor: Their average household of 4.4 people has an annual median income of less than $45,000, Barbara Rodriguez noted at 19thNews.com.
“This is really an attack on formally caregiving, older women who have a very hard time getting back into the workforce — not young men who are able bodied and sitting around because they don’t feel like working,” said Alison Barkoff, a health policy professor and program director at the George Washington University Milken Institute School of Public Health.
The Congressional Budget Office estimates 11.8 million Americans would become uninsured by 2034 and 3 million more would not qualify for food stamps, also known as SNAP benefits.
Also, Trump’s imposition of tariffs are expected to cost American consumers $2 trillion in higher costs for imported goods, if the tariffs are left in place over a decade, Dean Baker, senior economist at the Center for Economic and Policy Research, estimated. “Taking a low-end figure of $2 trillion, that would come to $16,000 per household over the next decade,” Baker wrote.
Republicans are proposing to dramatically roll back tax breaks designed to boost clean energy projects fueled by renewable sources such as energy and wind. The tax breaks were a central component of President Joe Biden’s 2022 landmark bill focused on addressing climate change and lowering health care costs.
A provision thrown in at the final hours will provide $10 billion annually to rural hospitals for five years, or $50 billion in total. The Senate bill originally provided $25 billion for the program, but that number was upped to win over holdout GOP senators and a coalition of House Republicans warning that reduced Medicaid provider taxes would hurt rural hospitals. However, hospital administrators say that is not nearly enough to make up for the anticipated shortfall.
Altogether, the Congressional Budget Office projects the bill would increase federal deficits over the next 10 years by nearly $3.3 trillion from 2025 to 2034.
To cap it off, the bill contained a provision to increase the nation’s debt limit, by $5 trillion, to allow continued borrowing to pay the debts Trump and the Big Lie Party have piled up so far. So much for fiscal conservatism on the right. — JMC
