Republicans Want to Put Poor People Through Hell to Fund Tax Cuts for the Rich
In 2017, President Donald Trump passed a series of tax cuts that netted major corporations and the ultra wealthy billions in savings — while producing barely noticeable gains for working-class Americans.
Now, as Speaker Mike Johnson (R-La.) and Republicans look to extend and expand Trump’s 2017 tax cuts — and further redirect wealth upwards — they’re preparing to gut Medicaid and rob the poor of their health care.
The proposed federal budget approved by the House last week called for over $2 billion in generally unspecified spending cuts. What it does specifically instruct is for the House Energy and Commerce Committee to find $880 billion to cut between now and 2034. The committee’s largest fiscal charge, by far, is the budget for Medicaid, which provides government-funded health insurance to over 70 million Americans.
Republicans are openly conceding that the health care program is in their crosshairs, but if the goal of Trump’s second administration is the elimination of fraud and waste in favor of “efficiency,” targeting Medicaid betrays their true intentions.
Medicaid, which finances roughly 4 in 10 births in the U.S., provides comprehensive health coverage to low-income Americans and the disabled. The program is unusually efficient and has lower per-capita costs than private health insurers or even Medicare.
“The money spent on Medicaid is less than the money spent on Medicare, or that private insurers themselves spend on health care,” says Brandon Novick of the Center for Economic and Policy Research.
“If you wanted to address the actual reasons why health care costs are high, well then you’re going to have to actually tackle the monied interests, the pharmaceutical companies, insurance companies, the hospitals that cause costs to be high,” Novick explains. “It’s like an octopus with all the tentacles screwing people in some way. They’re not going to touch any of that, but they’re going to say that the one program that actually spends the least on the same services, we’re just going to boot people off it, and that’s going to do anything.”
Republicans have long used work requirements to disguise cuts to social programs as moralistic anti-mooching accountability for aid recipients. On February 7, Rep. Dan Crenshaw (R-Texas) and Sen. John Kennedy (R-La.) proposed legislation that would require “able-bodied adults without dependents who receive Medicaid benefits to work or volunteer for at least 20 hours per week,” asserting that the measure “could save taxpayers more than $100 billion over 10 years.”
Some Republican lawmakers, like Missouri Sen. Josh Hawley, have opposed sweeping Medicaid cuts but say they could support adding work requirements to the program. Speaker Johnson recently claimed on CNN that Republicans won’t touch Medicaid, before noting that adding work requirements polls well.
“You don’t want able-bodied workers on a program that is intended, for example, for single mothers with two small children who’s just trying to make it,” Johnson said. “That’s what Medicaid is for. Not for 29-year-old males sitting on their couches playing video games.”
Mandating that “able-bodied” adults on Medicaid work in order to receive coverage would likely inflict pain on some Americans who are, in fact, disabled. Applying for disability benefits is a grueling process — many people are denied the first time, and some people give up.
Work requirements would also create an additional layer of bureaucracy that could result in people losing benefits despite being technically eligible. This already happens thanks to Medicaid’s strict income caps. (You can’t earn a decent living and be on Medicaid.) States are required to verify Medicaid recipients’ low incomes annually, and people can be disenrolled for “procedural” reasons if they miss a phone call or piece of mail — even if they qualify.
As an example of how work requirements can wreak havoc on the lives of Medicaid recipients and the states where they live, Novick points to Georgia. The state rejected the option to expand Medicaid coverage under the Affordable Care Act, instead implementing its own program — called Pathways to Coverage — that allowed the state to provide Medicaid to low-income Georgians who reported working or volunteering 80 hours as a condition of their continued coverage.
So far, the results have been abysmal. The Georgia program managed to enroll fewer than 10,000 participants in over a year, a fraction of the estimated 240,000 eligible. The cost of care for patients was eclipsed by the volume of bureaucratic and administrative costs — including from tracking the monthly work requirements.
“Work requirements are literally the embodiment of bureaucratic waste and inefficiency that Republicans decry,” Novick says. In 2019, a study published by the Office of Government Accountability found that “costs to administer work requirements may range from millions to hundreds of millions of dollars per state. However, [the Centers for Medicare and Medicaid Services] does not consider these costs when approving work requirements, which are not supposed to increase Medicaid spending.”
Novick published an analysis of the Republican plan last month, estimating that “36 million Americans could lose their Medicaid coverage as a result of recently suggested proposals to impose work requirements by congressional Republicans.”
Deep cuts to Medicaid would only be the tip of the spear in a Republican economic agenda that promises to deal critical blows to the American working class and poor while further enriching the ultra-wealthy. Trump has been angling to launch a trade war with Canada and Mexico — the nation’s two largest trade partners — since taking office, one that would drive up the price of consumer goods, agricultural products, and manufacturing.
Through only the most barely coded language, Trump and his close economic advisers are acknowledging that Americans will feel the economic stress. When asked Tuesday about the possibility of increased consumer prices, Treasury Secretary Scott Bessent said he expected there to be a “transition period.” On Wednesday, Secretary of Commerce Howard Lutnick told Fox News: “There is going to be a short period of time where there will be some higher prices on certain products. It is not inflation, that’s nonsense.” During his Wednesday speech before a joint session of Congress, Trump admitted to the nation that “there’ll be a little disturbance” as a result of tariffs, “but we’re OK with it.”
Meanwhile, Elon Musk and his so-called Department of Government Efficiency (DOGE) are firing tens of thousands of federal employees, leaving the essential programs they managed in peril. The president has openly celebrated Musk at every turn, and has essentially transformed him into an unelected co-president. On Wednesday, Trump lauded the steps Musk has taken to gut the government. “We’re just getting started,” Trump told Congress of his administration’s actions.
What’s next for Trump and Musk seems to be a mass purge of the Department of Veterans Affairs, which will reportedly lay off over 80,000 employees, many of whom are veterans themselves. The cuts will likely have disastrous effects on the department’s ability to manage veterans’ benefits, health care, education, and crisis resources.
It’s bad, and the GOP knows it. Republican leaders are now advising lawmakers to avoid face-to-face interactions with their increasingly angry constituents.
They’re also planning an extension and expansion of tax cuts that will largely benefit the richest Americans. According to an analysis of the proposed extension by the Center on Budget and Policy Priorities, “households with incomes in the top 1 percent (who make more than roughly $743,000 per year) would get tax cuts averaging $62,000 a year, compared to only about $400 a year for households with incomes in the bottom 60 percent (who make roughly $96,000 or less).”
In addition, the “richest 0.1 percent of taxpayers, those with incomes over $3.5 million a year, would receive an average annual tax cut of $314,000. These 200,000 multi-millionaires would receive more total dollars in tax cuts than the 187 million families with incomes in the bottom 60 percent.”
Like the 2017 tax cuts, the extension proposed by Republicans would not cut into the national debt, but expand it.
“It’s like $4.5 trillion in tax cuts and $2 trillion in spending cuts,” says Novick. “They do this thing every time where the spending doesn’t match the tax cuts, so they have a provision that says the tax cuts will spur such economic growth, so tax revenues will actually go up. What this is basically saying is: We think you’re all stupid, because we’ve done this several times before, and this has never happened.”
“That kind of makes the situation worse,” he adds, “because it’s almost like they’re gutting part of Medicaid and other programs to pay for tax cuts — but just kidding, they actually don’t really pay for them. We’re still gonna get a bigger debt and deficit.”
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