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6 min read

We can stop the largest Medicaid cuts ever

House Republicans know they're about to take a vote that could end their careers. Here's how we beat them.
We can stop the largest Medicaid cuts ever

Republicans want to deliver Donald Trump the worst cuts to Medicaid in US history.

In the dim of Sunday night, the Republicans on the Energy and Commerce Committee released their recommendations for the reconciliation bill moving through the House.

The bottom line: “CBO estimates that these three actions would increase the number of people without health insurance by at least 13.7 million in 2034.”

And beyond that, these proposed cuts, which Republicans then aim to shovel directly to the best off Americans, would break the “foundational promise” of the program.

“Medicaid is supposed to be a lifeline for people,” posted Bobby Kogan, Senior Director of Federal Budget Policy for the Center for American Progress. “The foundational promise of a good society should be food, housing, and health. Republicans want to break that for Medicaid.”

You should dig into Kogan’s analysis if you’re interested. In short, these cuts use oppressive administrative burdens to make the program more expensive and painful for patients, providers, and their families, all with the twin goals of uninsuring more Americans and increasing misery for those who are already enrolled.

As you probably know

Medicaid is the glue that holds America together.

It is the largest provider of health insurance in the United States. It’s essential for Americans with disabilities, pregnant mothers, 50-64 year olds, those suffering from addiction, rural hospitals, and our economy in general.

Cutting it while shoveling more tax breaks to the richest humans on earth would be indefensible, but the party that has empowered the wealthiest man alive to kill the poorest kids on earth is that kind of mood.

Yet I want you to know that we can win this fight. We must. I often think of how much more gruesome and deadly the pandemic would have been if Trump succeeded in gutting Medicaid. Well, thanks to Trump's incompetence and Bobby Jr.'s malfeasance, we know another pandemic is coming.

We have the chance to stop the most vulnerable from paying for the greed of the most coddled.

A few thoughts to keep in your head

We start with the premise that there are no “moderate” or “centrist” Republicans in the House of Representatives—only vulnerable ones.

Every House Republican voted for the broad outlines of the attempt to extract money from the poorest Americans and lavish it on the richest. They all stand by Trump’s lawlessness and war on the Constitution. But several of them do have reason to be worried about their careers, even before the shelves in stores go bare, thanks to Trump’s tyranny through trade wars.

Democrats are already leading in the generic ballot. Trump’s approval rating has essentially flipped since the inauguration, with nearly 52% disapproving of him while almost 44% approve.

Even during Trump’s strongest electoral performance of his political career, his party still lost seats in the House, despite his winning the popular vote, a feat that rarely occurs. That’s why Republicans have the slimmest House majority in 100 years.

This leads us to the vice in which vulnerable Republicans find themselves:

  1. Vulnerable House Republicans will face extraordinary pressure to cut Medicaid, which will likely include death threats if Trump targets them, and stopping them will take a near miracle.
  2. Vulnerable House Republicans know that gutting Medicaid could cost them their careers, no matter how sly the gamesmanship of the rhetoric around the cuts or how targeted and “poll-tested” these cuts are.

They will regret this vote

David Valadao of California’s 22nd district is a vulnerable Republican who knows that a vote to uninsure millions can cost him power.

After his votes to repeal the Affordable Care Act and gut much of Medicaid cost him his seat in 2018. He clawed his way back into the House. Thanks to his vote to impeach Trump in 2021, he has burnished his image as separate from the GOP and MAGA. That led him to win by double digits last year in a race Democrats targeted.

But Valadao knows that nothing reminds people of why they hate all Republicans than their passion for robbing the poor to plump the richest. This is why he has been instrumental in getting Speaker Johnson to pull the most obvious cuts from this bill. However, he has only succeeded in burying the damage, not eliminating it.

House Republicans have focused on enshittifying Medicaid as a whole, directly insuring fewer people but dooming everyone on the program, which requires some extreme need of some sort, to a shorter and more miserable life. The result will be a sicker country with fewer hospitals, especially in rural areas, all for no one’s benefit except the GOP’s billionaire donors.

Making this a painful vote in the House is key

Over the weekend, Alexandria Ocasio-Cortez made her case for why she thinks the House can stop this attack on Medicaid, even before it reaches the floor.

Here's the key point:

Even if it gets out of committee, Speaker Johnson is dealing with a core group of vulnerable Republicans who are upset about the tax bill and the lack of relief for targeted increases on blue states.

If he cannot offer them that, they have reason to smite him and this whole process.

Stopping this bill in the Senate, where Republicans have remained in solidarity in support of Trump’s sprint toward dictatorship, will be tough if not impossible, as there’s no John McCain to throw a final thumbs down. And they’re all, as Lisa Murkowski noted, terrified of Trump. 

However, the most persuasive approach to Murkowski, Susan Collins, Thom Tillis, or even Bill Cassidy, or some other wildcard who would have to be the fourth 'no’ to kill this bill, is to make this process as painful as possible for Republicans in the House.

Call your reps

The case to these vulnerable Republicans is simple: Gut Medicaid to fluff the rich, and we will end your careers. That’s not what you should tell their staffers when you call, but it’s what you should be thinking and telling your friends.

If your member of Congress is on the House Energy & Commerce Committee (see below), use this tool AOC's team set up.

Republicans

Otherwise, 5calls.org makes calling super easy.If you’d like to use the best language on the call, Matthew Cortland has an amazing script, and their Bluesky and Patreon will provide you with the best insights on this fight, both from an insider's and a beneficiary’s perspective.

You may be wondering

Who are the vulnerable Republicans? Depending on how quickly the country wakes up, there could be dozens. So, everyone should contact anyone who represents us in DC to make sure they know we’re watching.

But we do know the most vulnerable Republicans by name because they have identified themselves during this process by revealing their anxiety about the cuts. They include: Reps. David Valadao (Calif.), Don Bacon (Neb.), Jeff Van Drew (N.J.), Rob Bresnahan (Pa.), Juan Ciscomani (Ariz.), Jen Kiggans (Va.), Young Kim (Calif.), Rob Wittman (Va.), Nicole Malliotakis (N.Y.), Nick LaLota (N.Y.), Andrew Garbarino (N.Y.) and Jeff Hurd (Colo.).

If those are your representatives, your local Indivisible group is surely working to ensure they understand that the costs of this vote could be measured in their greatest nightmare: less power.

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Published by:

Jason Sattler

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