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Think the House GOP's budget bill endorsed by the president is harmful to low-income families, working people, and the overall health of our society? You probably don't know even the half of it.
The House Republican budget passed Tuesday night calls for massive cuts in health coverage, food assistance, and help paying for college, among some other areas, to pay for huge tax giveaways for wealthy households and businesses. This betrays President Trump’s campaign promises to protect families who struggle financially, as well as his specific pledge to not cut Medicaid, which provides health coverage for 72 million people. While raising costs for families and increasing both poverty and the number of people without health coverage, the budget would swell deficits — all to further Republicans’ expensive and skewed tax agenda.
Both the House and Senate budgets significantly miss the mark on what should be their basic goals: lowering costs, increasing opportunity, and responsibly addressing our nation’s long-term priorities, including reducing future economic risks associated with high deficits. But the enormity of program cuts called for by the House budget stand as a singular threat to the well-being of people in every state, city, and rural community, threatening to take away their health coverage, make health care more expensive, and make it harder to afford food and college.
The Senate should reject the House cuts both now and if Congress ultimately moves ahead with a second budget plan and reconciliation bill this year.
The quick math on the House budget shows a stark equation: the cost of extending tax cuts for households with incomes in the top 1 percent — $1.1 trillion through 2034 — equals roughly the same amount as the proposed potential cuts for health coverage under Medicaid and food assistance under the Supplemental Nutrition Assistance Program (SNAP).
The House Republican budget’s path of higher costs for families, more people without health coverage, increased poverty and hardship, and higher debt — all in service to tax cuts for the wealthy and profitable business interests — is the wrong direction for our nation.
Under what set of values does a budget target those who struggle to pay their bills for severe cuts, while giving an annual tax cut averaging $62,000 for those who make $743,000 or more a year? The tax cut for these wealthy households is greater than the annual family incomes for most of the 72 million people — 1 in 5 people in the U.S. — who have health coverage through Medicaid. And the $62,000 figure doesn’t account for the likelihood that this budget would shower large corporations with more tax breaks, given that it allocates $900 billion more than extending the existing tax cuts would cost.
The enormous cuts this budget calls for would increase costs, hardship, and poverty for individuals and families across the country. To be clear, the specific proposals that House Republicans have been considering for weeks to make these program cuts are largely not about curbing fraud and abuse, as some claim. For example, proposals to cap federal funding, shift costs to states, or impose harsh work requirements that trip people up with red tape are aimed at cutting health coverage and food assistance for honest people who need help, not reducing fraud.
And the impact of these cuts could be grave: think of a person who loses health coverage through Medicaid and can’t get cancer treatment, an older and frail adult who loses the home-based care they need to stay out of an institution, a young adult who can’t get insulin to control their diabetes, a parent who skips meals so their children can eat, or an older worker who loses their job and has no way to buy groceries. Make no mistake, these cuts would affect people in every state and of all races and ethnicities. At the same time, the impacts would often be especially severe in poorer states with less ability to fill in for federal cuts and among Black, Latino, and Indigenous people and people in rural communities, who have lower incomes and thus are more likely to qualify for food assistance and health coverage.
The House budget would require the Energy and Commerce Committee to cut at least $880 billion; the Agriculture Committee to cut at least $230 billion; the Education and Workforce Committee to cut at least $330 billion; and other committees to also cut programs to reach a cumulative target of at least $1.5 trillion in cuts through 2034. The magnitude of these reductions would force congressional committees to make enormous cuts in Medicaid, SNAP, student loan assistance and other vital sources of support when they develop the “reconciliation” spending and tax bill that follows the budget resolution.
But as massive as these cuts are, they don’t show the full picture of the overall program cuts that the House budget may generate. The committee targets are minimums or “floors” — meaning the committees must cut at least that amount and may cut more. And a provision included by the House Budget Committee during its consideration of the resolution pushes the committees to cut more, by requiring the overall level of program cuts to reach $2 trillion to retain the full $4.5 trillion in tax cuts.
Beyond this budget’s basic effects of taking away health, food, and other vital assistance from people who struggle to afford the basics and making student loans more expensive to partially offset tax cuts for the wealthy, it would have at least three other harmful impacts.
First, the House budget resolution and the proposals House Republicans are considering could result in enormous cost shifts to state, local, territorial, and tribal governments, which are already facing tougher fiscal conditions than in recent years. For example, some of the proposed cuts in Medicaid and SNAP would force states to pick up a much larger share of the programs’ costs or leave people without needed help. In reality, states will not make up for all or even most of the federal cuts, and families will lose health coverage and food assistance.
Second, while this budget aims to extend all of the tax cuts skewed to the top, it fails to call for extending a tax cut that is well targeted to people who need it: the improved premium tax credits under the Affordable Care Act. Failure to extend this tax cut would raise health care premiums for more than 20 million people, including at least 3 million small business owners and self-employed workers.
And third, even with the budget’s huge cuts in assistance, and the suffering those cuts would inflict on individuals and families, it would still increase our nation’s debt because of the enormous cost of its tax cuts. When you strip away this budget’s fuzzy math with its $2.6 trillion macroeconomic gimmick — which is far beyond expert organizations’ estimates (including estimates of conservative organizations) of possible economic effects from extending the tax cuts from President Trump’s first term and enacting potential new tax cuts — the federal debt under the House budget would increase over the next ten years compared to Congressional Budget Office projections of current law.
Even with the budget calling for a $4 trillion increase in the statutory debt limit, we calculate this limit would be reached in November 2026, only 21 months from now, under the policies assumed under this budget.
The House Republican budget’s path of higher costs for families, more people without health coverage, increased poverty and hardship, and higher debt — all in service to tax cuts for the wealthy and profitable business interests — is the wrong direction for our nation. It is also directly at odds with the recent election in which so many people expressed concern about their ability to afford food, housing, health care, and other necessities — and at odds with the promises made to them by President Trump.
Republicans are hiding behind fantastic economic assumptions which they know are false in order to hide the true effects of their agenda—one that raises costs, strips away healthcare, and increases poverty—all in service of giving the super-rich another tax giveaway.
The budget plan that the House is scheduled to consider this week would add to the deficit as it calls on committees to cut $2 trillion primarily from programs that help people secure health coverage, buy groceries, and pay for college to partially offset a $4.5 trillion tax cut, with benefits that are skewed toward the wealthy. Yet the House Budget Committee (HBC) Republicans attempt to hide their plan’s additions to the deficit with unrealistic assumptions of how tax cuts will drive economic growth.
They assert that the economy will grow more than 40 percent faster each year over the coming decade than the Congressional Budget Office (CBO) projects, yielding a ten-year “economic bonus” that would reduce the projected deficit by $2.6 trillion. Their budget math rests on this flawed bonus. Without it, the HBC plan would increase the deficit relative to CBO’s projections, even with its massive spending cuts in Medicaid and SNAP that would take away health care and food from people who are struggling to afford the basics.
This economic bonus is not credible.
CBO projects that real economic growth — growth after considering inflation — will average around 1.8 percent per year from 2026 to 2035. In contrast, the House assumes growth of 2.6 percent a year. This increase is far beyond a typical “rosy scenario” and instead reflects “fantasy math,” as the Committee for a Responsible Federal Budget aptly describes it.
HBC Republicans have defended their assumed growth rate by saying it is below the post-war historical average. But that is misleading. The nation’s labor force grew strongly in the post-war years, particularly as the baby boomers reached working age and because women joined the labor force in large numbers. Today, the baby boomers are retiring, and current population growth depends on immigration, which the Trump Administration is seeking to curb.
Republicans point to the extension of the expiring provisions of the 2017 tax cuts as a key driver of their assumed additional growth. But CBO comes to a much different conclusion. In its baseline projection, CBO assumes the tax cuts expire as scheduled and concludes that “the expiration of the individual income tax provisions of the 2017 tax act does not significantly affect CBO’s projections of real GDP.”
That means that extending the expiring tax cuts, as the Republicans propose, would similarly have little effect on economic growth. Overall, CBO has found that the positive economic effects of the tax cuts alone were quite modest, and that their high cost (which increases federal borrowing and leads to lower private investment) offsets any resulting economic growth. Thus, even if the costs of the tax cuts were completely offset, the economic bonus would be only a small fraction of what HBC Republicans claim. To the extent the program cuts harm investments in the future — economic support and good health care for children, education at all levels, medical and scientific research, infrastructure maintenance and development — those cuts work against better sustainable economic growth.
CBO is not alone in its findings. Economists at a range of other institutions — such as the Joint Tax Committee, Tax Foundation, Tax Policy Center, Penn-Wharton Budget Model, Yale Budget Lab, and American Enterprise Institute — have also examined the economic effects of extending the 2017 tax cuts. None came up with estimates anywhere near those assumed by the House plan.
The House Republicans point to other Trump Administration actions as further rationale for their economic assumptions, such as spending cuts, deregulation, and increasing production of fossil fuels. But their views of the impact of the Administration’s policies on the economy are one-sided, ignoring its policies that are likely to slow growth. For instance, the Administration’s policy of mass deportations and restrictions on new lawful immigration will dampen labor force growth. Analysts estimate that immigration will fall from 3 million in 2024 to 500,000 in 2026.
Similarly, the Trump Administration’s tariff policy could increase prices, possibly by 1.7 to 2.1 percent, and lower economic growth as much as 1.0 percentage point, according to recent estimates by the Yale Budget Lab.
In the end, the assumed economic bonus is a pure gimmick that House Republicans are using to try hide the true effects of their agenda that raises costs, takes health care away from people, increases poverty and hardship, worsens inequality, and increases the deficit.
Defeating Republican efforts to slash health coverage for the nation's poor, said one observer, is also an opportunity "to expose and deepen the fractures in Trump's coalition, and to shatter the illusion that he can't be stopped."
Defenders of Medicaid are sounding the alarm over plans by the Republican Party—led by President Donald Trump and House Speaker Mike Johnson—to eviscerate the nation's healthcare system used by low-income individuals and families, warning that the attack would jeopardize healthcare for tens of millions of the poorest Americans as part of an effort to give the wealthiest individuals and corporations massive tax breaks.
Internal divisions within the House GOP caucus have hinged on the overall size of cuts to federal spending in their yet-to-be-released budget blueprint, with competing proposals ranging from $1.25 trillion in cuts up to $2.5 trillion. Of that overall number, hundreds of billions in Medicaid cuts may come in the form of block grants to states, caps on per capita costs, and work requirements.
"For months," wrote Paul Heideman on Monday in Jacobin, "Republicans have said that their budget will cut spending in order to pay for making permanent Trump's tax cuts for the rich, which are set to expire this year."
One of the key targets of their austerity plan, he notes, is Medicaid, which Republicans, as reported by Politico on Tuesday, believe they can cut by an estimated $800 billion or more over the next decade.
"They are cutting healthcare to pay for tax cuts for billionaires."
Echoing the call of other progressive voices, Heideman argues that opponents should seize on the tensions within the GOP—where right-wing hardliners are openly calling for cuts while those in more swing districts have expressed increasing anxiety about what happens politically if they take the axe to a program that is resoundingly popular with voters.
CNNreporting on Monday about the behind-the-scenes maneuvering within the caucus quoted one unnamed Republican lawmaker who said that some members want "to cut to the bone" when in it comes to Medicaid and other programs. While the lawmaker said they were "willing to cut a lot" from the federal budget, "if you cut the essential stuff that affects people every day, you will lose the majority in two years. I can guarantee it.”
Meanwhile, Politico offered more evidence that Trump and House Republicans are still not on the same page:
GOP leaders told senior Republicans in a series of private meetings Monday that Trump wasn’t yet on board with the major Medicaid cuts it would take to secure up to an additional $800 billion in savings, according to three people familiar with the conversations who, like the others, were granted anonymity to describe the private talks.
Johnson and senior Republicans are wary of pursuing the Medicaid reforms only for Trump to publicly bash the move. GOP leaders indicated in private meetings Monday that "they need to work with Trump" on the Medicaid issue before proceeding, according to one of the people.
As Heideman notes, one can't fully understand the attacks on Medicaid—which could boot tens of millions of people out of the program—without recognizing the GOP's parallel strategy for massive tax giveaways for the rich and corporations:
Republicans are hoping to extend the tax cuts passed in Donald Trump's first term. These tax cuts, which were the only substantial legislative accomplishment of Trump's first term, were massively skewed toward the rich. The average household in the top 1 percent of income earners received about $60,000, while the average of the bottom 80 percent of households received only $762.
All of this largesse for the rich was expensive; estimates are it will cost the government nearly $2 trillion over ten years. Because of this, a number of Republicans in Congress insist that any extension of the tax cut must be accompanied by spending cuts to prevent it from adding massively to the deficit. With a razor-thin majority in the House, these deficit hawks could sink any attempt by Trump and the GOP leadership to ram the cuts through in spite of their impact on the deficit. Finding a way to substantially cut Medicaid spending has thus become central to the larger GOP budget plan.
On Tuesday, the Center on Budget and Policy Priorities (CBPP) detailed how one Republican approach to cutting Medicaid—a federal spending freeze that would cap per capita costs—would drastically increase financial pressure on the state programs that administer Medicaid programs.
"If federal funding drops sharply," warned Elizabeth Zhang, a CBPP research assistant, "states would be forced to scale back Medicaid by cutting people from the program, slashing benefits for remaining enrollees, reducing payments to hospitals and physicians—or a combination of all three. This would harm Medicaid enrollees across the program."
Pushing back against the proposed assault on a program that serves over 80 million people each year, all 47 members of the Senate Democratic Caucus on Monday sent a letter to Majority Leader John Thune (R-S.D.) saying he and his Republican colleagues should "reject proposals that use Medicaid as a piggy bank for partisan priorities and continue to defend the importance of this vital program." According to the letter:
Republicans are proposing cuts to the Medicaid program from hundreds of billions to multiple trillions of dollars. Cuts to Medicaid through drastically changing the program's financing structure or imposing additional barriers to coverage are dangerous to the millions of people who rely on the program. These proposals will also force states to make difficult decisions that will result in millions getting kicked off their coverage and providers struggling to keep their practices open. States simply cannot absorb these massive funding cuts without hurting children, seniors, people with disabilities, tribal populations, patients with chronic illnesses, and many other Americans who rely on Medicaid.
"The American people should be assured," the letter concluded, "that Medicaid will be protected."
Last week, as Common Dreamsreported, a separate CBPP report estimated that a GOP proposal to institute work requirements for Medicaid recipients could result in 36 million people being axed from the life-saving program. Predictions such as this could be why, as Politico noted, "Trump and his team are worried those cuts will invite political blowback."
The problem for progressives is that Republicans have discovered that while cuts to Medicaid are demonstrably unpopular with the voting public, the implementation of so-called "work requirements" has received more traction in opinion polls. As such, GOP leaders, including House Majority Leader Rep. Steve Scalise (R-La.), may believe they have a new way to trick people into helping them undermine or destroy the program.
This is why Heideman argues it is key for Medicaid defenders to be adamant in their opposition and clear in their messaging when it comes to work requirements or other deceptive messaging about Republican intentions.
Work requirements for Medicaid, Heideman argues, should be called exactly what they are: cuts. As he explains:
During the first Trump administration, states were granted waivers to institute work requirements. Only Arkansas actually implemented the policy, and the results are instructive. About a quarter of Medicaid recipients subject to the requirement (about 18,000 people) lost coverage while the waiver was in effect. Yet the requirement produced zero effect on employment. People kicked off Medicaid were no more likely to have jobs than they were while they were on it.
The reason for this is simple. Most people on Medicaid are already working. Among those that aren’t, most are either disabled, taking care of a family member, or going to school. There simply aren’t that many people on Medicaid who could go get a job, even if their health care is cut off. Moreover, work requirements often lead to people who technically shouldn’t be removed from the program being kicked off because they haven’t supplied the proper paperwork establishing their employment. Work requirements do nothing to make people work more. They simply kick people off the rolls.
Larry Levitt, executive vice president for health policy at Kaiser Family Foundation, pointed out last week that "92% of Medicaid adult enrollees are working, or are not working due to caregiving, an illness or disability, or school attendance."
So while Speaker Johnson and other Republican leaders have tried to say they are not proposing cuts to Medicaid in their pending budget blueprint, informed critics are pointing out that this a blatant falsehood.
Heideman says that the battle to defend the program is important in its own right but also has broader political implications.
"Defeating Medicaid cuts is an urgent priority over the coming months," he argues. "It's an opportunity to reestablish the popularity of the welfare state as a principle of American politics and to hand Trump and the GOP a much-needed defeat. Because of the GOP's disarray, it also has the potential to hamstring the party's only substantive legislative priority. Finally, this kind of work can provide some balance and ability for longer-term coordination amid the daily outrage that the administration is committing. The Left should not let this opportunity slip by."