Bizarro GOP Plan: Cut Health Spending to Pay for an Unpopular War

Our most recent book is The Comeback: The 2024 Elections and American Politics. The second Trump administration has been full of ominous developments -- now including a war in the Middle East.

In early February, a YouGov poll found majorities of Americans supported increasing government spending on veterans (74%), Social Security (69%), Medicare (67%), aid to the poor (64%), Medicaid (59%), and the environment (52%).   Only 34% wanted to increase defense spending -- that that was before the Iran war, which is unpopular.  Last week, Pew found 61% disapproved of Trump's handling of the war, and 59% said that US made the wrong decision to use military force in Iran.

In that light, the House GOP's spending plans sound politically insane.  Peter Sullivan at Axios:

Republicans are considering reductions in federal health spending to help pay for a budget bill containing as much as $200 billion to fund the Iran war and immigration enforcement.

Why it matters: New efforts to rein in health programs are sure to be controversial and open the GOP up to election-year attacks that they're cutting health care to pay for an unpopular war.

Driving the news: Top House Republicans are looking at health care offsets addressing fraud in federal programs, as they did during last year's debate over the budget law that made deep cuts to federal Medicaid spending and imposed first-time work requirements.

Trump Doing Unpopular Things

Our new book is The Comeback: The 2024 Elections and American Politics. The first year of the second Trump administration  has been full of ominous developments.  Americans are noticing.

PRRI:

A new national survey released today by Public Religion Research Institute (PRRI) in partnership with the Brookings Institution reveals Americans’ responses to the unprecedented actions taken so far by President Donald Trump during his second presidential term. The survey — the 16th annual American Values Survey — also examines Americans’ concerns about the economy and how democracy is working, what it means to be “truly American,” and opposition to building internment camps for undocumented immigrants and allowing ICE agents to mask their identity.

Majorities of Americans say that the Trump administration cuts in federal funding for health care (60%) and universities and research institutions (55%), the implementation of new tariffs (54%), and the increase in funding for Immigration and Customs Enforcement (ICE) (52%) have gone too far. Across all areas, independents hold views more aligned with Democrats. For example, most Democrats (90%) and independents (67%) say that cuts in federal funding for programs such as Medicaid, Medicare, and the Affordable Care Act have gone too far, compared with only 25% of Republicans

Sarah Fortinsky at The Hill:

A majority of Americans said in a new poll they disapprove of President Trump’s plans to demolish part of the East Wing in the White House to make room for his $250 million ballroom.

In the YouGov America poll, released on Wednesday, 53 percent of Americans said they strongly or somewhat disapprove “of the decision to demolish part of the East Wing of the White House as part of the renovations,” while 24 percent approved and 24 percent said they are unsure.

Jason Lange at Reuters:

More than half of Americans, including about three in 10 Republicans, believe President Donald Trump is using federal law enforcement to go after his enemies, according to a new Reuters/Ipsos poll that also found growing concern about U.S. political divisions nine months into his second term in office.

Some 55% of poll respondents in the six-day poll, which closed on Monday, agreed with a statement that the Republican president is using law enforcement to target his enemies, while 26% disagreed and the rest were unsure or did not respond. Some 85% of the poll respondents who identified themselves as Democrats agreed, as did 29% of the Republican poll takers.

 

Some Green Shoots for Democrats

Our new book is The Comeback: The 2024 Elections and American Politics. The second Trump administration is off to an ominous start. Democrats have problems, but still take hope.

Mike Allen at Axios:

Here's the five-part theory of the case for why Dems are optimistic about 2026, as laid out by more than a dozen of their top campaign staffers:

1. The "big, beautiful bill" is polling terribly.
2. Cuts to Medicaid and the Affordable Care Act are expected to make the "big, beautiful bill" even more unpopular.
3. Prices are still high despite Trump promising to bring them down. Economic approval had long been one of Trump's consistent political strengths. Now it's not.
4. Trump's deportations are getting blowback after going well beyond violent criminals and gang members. Polls show Republicans losing an advantage on one of their key issues in the 2024 election.
5. Democratic enthusiasm. A recent CNN poll found 72% Democrats and Democratic-aligned voters are extremely motivated to vote in the midterm elections, compared to just 50% of Republicans and Republican-aligned voters.

Washington Post:

How closely are Americans following news about government files from the federal investigation of Jeffrey Epstein, and what do they think about President Donald Trump’s handling of the issue? The Washington Post texted 1,089 people Monday to ask.

The Post’s poll found that most Americans are paying at least some attention to news about the Epstein files. Americans largely disapprove of how Trump is handling the issue, with most Democrats and independents disapproving and Republicans expressing a mix of approval and uncertainty. Most Americans strongly support releasing all files in the Epstein case and suspect the documents contain embarrassing information about Trump, Democrats and billionaires.

Megabill and CA Republican House Members

 Our new book is The Comeback: The 2024 Elections and American Politics. It includes a chapter on congressional and state elections.

Dan Walters at CalMatters:

“Congressman David Valadao is doing exactly what he promised: delivering real results, restoring fiscal sanity, and fighting for California families,” NRCC spokesman Christian Martinez said. “His vote is proof that strong leadership and commonsense still matter in Washington.”

A couple of hours later, Protect Our Care California, a health care advocacy organization with close ties to Democratic Party leaders, announced that it will air video ads criticizing Valadao and nine other Republican congressional members for their votes.

“Representative David Valadao just voted for the largest health care cuts in history in order to fund tax breaks for billionaires and big corporations, and we’re going to make sure that every single one of their constituents knows it,” said Matthew Herdman, director of Protect Our Care California.

The ads are aimed at Valadao and other members of California’s Republican congressional delegation, including Young Kim and Ken Calvert, because they are considered to be the most vulnerable incumbents as the two major parties battle over control over the House in next year’s elections.

...

Valadao’s vote for the bill is especially noteworthy because Democratic voters outnumber Republicans by 12 percentage points in the San Joaquin Valley’s 22nd Congressional District, two-thirds of his constituents rely on Medi-Cal (California’s version of Medicaid) for their health care, and he had repeatedly promised not to vote for any reductions in the program.

The Megabill Aftermath

 Our new book is The Comeback: The 2024 Elections and American Politics. It includes a chapter on congressional and state elections.

Maeve Reston and Theodoric Meyer at WP:

History and dismal public polling suggest President Donald Trump’s $3.3 trillion tax bill, approved by Congress this week, could help Democrats win back the House in the 2026 midterm elections.

The bill is deeply unpopular — with nearly 2-to-1 opposition, according to a Washington Post-Ipsos poll conducted in June. But Republicans still have an opportunity to shape public perception of the bill because more than a third of Americans had no opinion of it and two-thirds said they had heard either little or nothing about it.

...

While Trump made substantial inroads with low-income voters in the 2024 election, the top 10 percent of earners get about 80 percent of the bill’s benefits, according to the University of Pennsylvania’s Wharton budget model. The bill also makes deep cuts to federal support for wind and solar power and other renewable technologies — leading some experts to warn that the legislation could raise energy prices for consumers at a time when demand is soaring

....

Trump has pledged not to cut Medicaid and has falsely claimed that the bill simply targets waste, fraud and abuse in the program. But at least 17 million Americans will lose their health care coverage, according to nonpartisan estimates — the result of the bill’s cuts to Medicaid, the expiration of subsidies for health insurance on the Affordable Care Act marketplaces, and other Republican changes. That could pose a major liability for vulnerable Republicans such as Rep. David G. Valadao, who represents a district in California’s Central Valley with one of the highest numbers of Medicaid recipients in the country, according to an analysis by KFF.

...

The bill includes a $6,000 deduction for seniors — which stemmed from Trump’s campaign pledge — but the provision will not benefit tens of millions of low-income seniors, who do not have a sufficient tax liability to claim the deduction. Our colleague Jeff Stein has the details on who will benefit here

...

Working-class voters in the swing state of Nevada — many of whom work in the hospitality industry — frequently cited Trump’s promises to eliminate taxes on tips and overtime as a reason they were leaning toward voting for Trump. Partially fulfilling those promises could help Republicans running in three Democratic-held House seats in Nevada that are perennial battlegrounds. (Both provisions will be phased out at the end of 2028.).

 

Don't overlook this. By backloading Medicaid cuts until 2027/2028, Trump and GOP have ensured that the bloodbath will start when JD Vance's 2028 campaign really gets going. "Working class populist" Vance will have to defend that carnage in real time.https://t.co/1gjAxXtLaA pic.twitter.com/HhB1ojuLuu

— Greg Sargent (@GregTSargent) July 5, 2025

The Megabill Missed Opportunity

Our new book is The Comeback: The 2024 Elections and American Politics.

Congress is about to pass the unpopular debt-exploding, Medicaid-cutting megabill. Charlie Mahtesian at Politico:

One astute conservative student of the realignment likened the legislation “to a death march through a series of choices that nobody really wanted to be making.”

“[It’s] not something that has an especially coherent logic to it or much prospect of actually accomplishing the things that I think people want,” Oren Cass, founder of the think tank American Compass and a leading advocate of conservative economic populism, told POLITICO Magazine recently.

The failure to imbue the legislation with more of a Trumpist ideological throughline may be due to a few factors; perhaps it’s Trump’s well-known aversion to wonky policy details, or the fact that most Republican lawmakers are still loyal to the Reaganite economic policy they came up with even as they now publicly bow to Trump.

But whether the sprawling bill is ultimately judged a policy success or failure, it lacks an original vision to hold together the constituencies Trump has improbably knitted together — tax relief, border spending, safety net cuts and Biden policy rollbacks aren’t a theory of the case. Sure, it has a few Trumpian frills that nod to the president’s populist campaign pledges, but they are largely small-bore and were scaled back by senators anyway. “No tax on tips” became a temporary tax deduction on tips, for instance. The brief musings about a tax hike on upper-income earners quickly were extinguished by opposition from Republicans on Capitol Hill.

Decades from now, no one will point to this legislation as a key building block of a lasting Republican coalition. It’s more likely to be remembered for the $3.3 trillion it is estimated to add to the national debt.

The legislation isn’t just a missed opportunity. It’s also a striking departure from the more disciplined efforts to reshape and reckon with an evolving party that happened in the last Republican administration before Trump. When George W. Bush occupied the White House, Karl Rove, his political architect, pursued a master plan to lock in the party’s newly emerging coalition and ensure its viability over the long haul. The creation of Medicare Part D, the program’s new prescription drug benefit, was designed to blunt the Democratic advantage on health care issues. Immigration reform, which failed, was a nod toward consolidating Bush’s gains with Latino voters.

The Iraq debacle made the efforts moot, but some of the residual effects of Rove’s work remains visible today: the GOP’s edge in the exurbs, its dominant position among evangelicals, the party’s gains with Catholics.

If anything, the megabill threatens to peel off some of the new constituencies of the ascendant Republican coalition or give them cause for concern. The Medicaid spending cuts stand to hit working class people of color and in rural America hard, from the Trump Belt of Appalachia to the Southwest. The income tax cuts and expanded child care tax credit will be warmly welcomed, but wealthier Americans will benefit more.

It’s revealing that there is no quarter of the new coalition that is wildly enthusiastic about the package. Polling suggests Americans largely disapprove of the megabill, though there is support for some of its individual provisions. More important, from the standpoint of the future of the MAGA coalition, are findings like this one: According to a June Washington Post-Ipsos poll on the bill, non-white, non-college graduates — an important part of the new coalition — oppose it by a 41 percent to 18 percent margin. Without voters like them, it isn’t really much of a realignment.

Joni Ernst Gaffe

Our forthcoming book is The Comeback: The 2024 Elections and American Politics.  It includes a chapter on congressional and state elections. Senator Joni Ernst (R-IA) might have a competitive reelection race next year.  Yesterday's gaffe will not help.  Alexander Bolton at The Hill

Iowa Sen. Joni Ernst (R) pushed back against constituents who shouted out at her recent town hall meeting that cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) would cause people to die, responding, “Well, we’re all going to die.”


The awkward moment came at a town hall meeting on Friday in Butler, Iowa, while Ernst defended the spending reforms in a House-passed budget reconciliation package that are intended to stop people who crossed into the country illegally from receiving federal benefits.

JUNE 1 UPDATE: Then she made it worse with a sarcastic video.

 

Absolutely bonkers — Joni Ernst doubles down on her “we are all gonna die” defense of Medicaid cuts while walking through a cemetery pic.twitter.com/tZrhtvODeK

— Aaron Rupar (@atrupar) May 31, 2025

Maybe the reference to Jesus was an effort to shore up her evangelical base after this:

#ICYMI: The Air Force revealed earlier this year that a general who oversaw its lobbying before Congress had inappropriate relationships with five women.

Sources say one of the women whose relationship with him was scrutinized was Sen. Joni Ernst.https://t.co/97qos9S9hC

— ProPublica (@propublica) June 1, 2025

Ramming Reconciliation: "Close Your Eyes"

Our forthcoming book is The Comeback: The 2024 Elections and American Politics. The second Trump administration is off to an ominous start.

At The Bulwark, Jonathan Cohn notes the lack of deliberation about the budget reconciliation bill:

Consider where this process was just one week ago, with no legislative language and no commitment to specific proposals. The only indications of what GOP leaders had in mind were broad statements they made in speeches and other appearances, along with ambiguous leaks to the press.

When they released an actual bill last Sunday evening, they announced at the same time that the Energy and Commerce Committee would take it up on Tuesday—not even two days later, and so quickly that the Congressional Budget Office wouldn’t have time to produce a full, detailed cost estimate. Then came the hearings themselves: an uninterrupted, 26-hour run through deliberations (the “markup” of the legislation) that ended with a party-line vote to approve the bill and send it to the Budget Committee, where it now sits.

In all, lawmakers had less than 72 hours to digest, debate, and vote on deep Medicaid cuts that—according to CBO’s preliminary, partial estimate—will cause more than 7 million Americans to lose health insurance and millions more to face higher medical costs.1

...

But the longer the debate goes on, the more indefensible those claims look. Every passing day gives analysts more time to publish damning information, like these analyses showing coverage losses by state and congressional district. And the more this information gets out, the easier it is for organizations and activists to press their case.

Something along these lines happened in 2017, when Republicans were trying to pass legislation that would repeal the Affordable Care Act. Every time a new projection showed big coverage losses, every time a major organization announced it opposed legislation, every time activists showed up at a congressional town hall, passing repeal became more difficult politically—until, finally, the effort failed.

As it happens, the GOP leaders from that time tried to do what the current GOP leadership is doing now: ram legislation through before the opposition could stop it. And they were doing so even after having, for years, insisted Democrats somehow hadn’t given the original Affordable Care Act enough time for debate

In April, Trump told House Republicans: "Close your eyes and get there." 

Medicaid Messaging

Our forthcoming book is The Comeback: The 2024 Elections and American Politics.

Hans Nichols at Axios:

The short-term funding bill only deals with discretionary spending and won't affect spending levels for Social Security, Medicare, and Medicaid, according to GOP leadership aides.But in the GOP's separate budget reconciliation package, lawmakers have instructed the Energy and Commerce Committee to cut some $880 billion, which will be very difficult to do if they don't touch Medicaid.

The bottom line: It was unclear if Friday's Democratic demands on Medicaid apply to the CR or the bigger tax and spending package that has yet to fully take shape. But both House leaders are signaling to their rank-and-file that they expect party loyalty on next week's vote.

Dr. N. Adam Brown at MedPage Today:

Medicaid serves lower-income adults, children, pregnant women, and people with disabilities, as well as dually-enrolled Medicare-Medicaid older adults. Despite the talking point that people on Medicaid "don't work," 92% of adults under 65 who are on Medicaid and don't receive other social security benefits work full or part-time.

While 80 million Americans are insured through Medicaid, many people don't think of themselves as "on Medicaid" -- even when they are.

Why? Because Medicaid is not branded as Medicaid in most states. If you tell a patient in South Carolina they might lose Medicaid, their eyes may glaze over. Tell them Healthy Connections is at risk? You have their attention. In Tennessee, Medicaid is TennCare and in Ohio it is the Buckeye Health Plan. In Florida, Medicaid sounds like an orange juice brand: Simply Healthcare. (Seriously, it feels like that moniker should have an exclamation point behind it.)

Adding to the confusion, many states offer Medicaid coverage contracted through private companies. These types of plans are state-funded, private insurance-branded programs (called managed care organizations) often featuring actual private insurance logos, a fact that further distances them from their federally funded origin. No wonder Tennesseans shrug when we talk about Medicaid recipients. They don't think, or even know, they are one. And if they do not know the issue applies to them, they may be less likely to oppose cuts.

In every state, we need to call Medicaid by its real name.
...

This is why healthcare advocates need to translate the impact of cuts at the individual, family, and community level. Instead of saying "Republicans want to reduce Medicaid by $880 billion" try, "If Republicans' Medicaid plans come to fruition, you could lose your Buckeye Health Plan health insurance." Or try explaining how these cuts could erode their child's access to care. Nearly half of U.S. children rely on Medicaid and 40% of all births are covered by Medicaid. Cutting the program would destabilize pediatric practices, many of which already operate on thin margins. If parents think they already have to wait too long to get a well-child visit, just wait until these cuts take effect.

Midterms on the Horizon

Our forthcoming book is The Comeback: The 2024 Elections and American Politics. It includes a chapter on congressional and state elections.

Abby Livingston at Puck:

The midterms are already here: In normal times, the first quarter of the off-year congressional election cycle is sleepy and sluggish. But these, obviously, are not normal times. Hakeem Jeffries and his Democratic caucus are already steeped in the fundraising and recruitment fight, and last month, House Dems raised $9.2 million—their largest haul ever in an off-year January—compared to the N.R.C.C.’s $6 million. This isn’t just because of the committee’s storied digital fundraising: Many members, including Massachusetts’ Richard Neal and New Jersey’s Frank Pallone, have been hosting fundraising dinners. A group of House progressives hosted one last night, and the Congressional Black Caucus’s
political arm will host one in early March. Along with member dues, I’m told by a senior House Democratic campaign aide that this extra push has brought in $2.8 million, or nearly a third of the January haul.

But the more pressing task for both parties is recruitment, which will lay the foundation for the next two years. As Politico’s Elena Schneider reported this week, federal workers who fell victim to DOGE cuts might become a new talent pool of House candidates. Meanwhile, the Dems are also eyeing a huge potential get: Jimmy McCain, the Marine veteran and son of the late Arizona Republican Senator John McCain, to run against David Schweikert in Arizona’s 1st congressional district. Of course, the defection of the so-called McCain Republicans has been partly credited with flipping the state to Joe Biden in 2020, and for some high-profile statewide losses—Blake Masters and Kari Lake—for the party’s right wing.

For the Republicans, the recruitment picture is murkier: A party consultant told me there’s talent in the wings, but potential candidates are waiting on two developments. The first is the fate of the shutdown/debt ceiling/tax-and-spending-cuts negotiations this spring. The second is the price of eggs, which has supplanted the price of gasoline as the leading political economic indicator in my conversations. Republicans might also have to spend some of their recruitment energy on their incumbents. I’m hearing that, for a smattering of pre-Trump Republican members, this congressional term is turning out to be even more miserable than the last one—which, of course, included the defenestration of Kevin McCarthy. My impression is that if it weren’t for their party’s micro-margin in
the House, some Republican reps would be considering resignation.

Max Cohen at Punchbowl News:

House Majority Forward, the HMP-aligned organization, will launch a national cable ad Monday that attacks Republicans for threatening Medicaid. The HMF ad acts as the initial salvo in the Medicaid messaging wars ahead of the 2026 midterms, where House Democrats have forecasted that they will focus on health care access.

The ad centers on the recently adopted House GOP budget resolution, which the narrator says “opens the door to $880 billion in Medicaid cuts.”

The spot also argues that the potential Medicaid changes are “all to fund massive tax cuts for Elon Musk and billionaires.”

Next week, House Majority Forward will run similar ads in 20 battleground districts nationwide.

In other ad news: Liberal outside group Unrig Our Economy is running two new ads targeting vulnerable Reps. Mariannette Miller-Meeks (R-Iowa) and Juan Ciscomani (R-Ariz.) for supporting the House GOP budget resolution.

 

Backlash

Our forthcoming book is The Comeback: The 2024 Elections and American Politics. The second Trump administration is off to an ominous start. People are starting to notice.

Hannah Knowles at WP:

Town halls this week for congressional Republicans from Georgia to Wisconsin to Oregon grew testy as voters showed up to vent, outraged at the firing of workers and the Department of Government Efficiency’s access to sensitive data. Protesters showed up around the country at lawmakers’ offices.

The backlash extends far beyond federal workers in the Beltway, reaching purple districts that will decide control of Congress in 2026 and swing states like Georgia that helped return Trump to the White House. Layoffs just hit the Atlanta-based Centers for Disease Control and Prevention. Funding freezes have halted clean-energy projects championed by President Joe Biden.

Catherine Lucey, Meridith McGraw, Lindsay Wise at WSJ:

At a town-hall meeting in a Republican-friendly, Atlanta-area congressional district, boos rained down on GOP Rep. Rich McCormick as he tried to defend President Trump’s efforts to slash the federal government.

In one tense exchange before the hundreds of people there, a woman challenged McCormick over how he would “rein in the megalomaniac in the White House,” according to a video of the Thursday event posted by the Atlanta Journal-Constitution. Eventually, McCormick—whose district backed him by a nearly two-to-one margin last year—acknowledged the audience’s concerns.

“I don’t want to see any president be too powerful,” McCormick said. His office didn’t immediately respond to a request for comment.

The contentious scene was one of a series of clashes in GOP congressional districts across the country in recent days that offered an early warning for the White House. While Trump is broadly giving voters what he promised during his campaign, the scope and unilateral nature of his early executive actions, as well as his upending of longstanding foreign alliances, is throwing some Republican lawmakers on the defensive.

At a recent town-hall meeting in West Bend, Wis., Rep. Scott Fitzgerald (R., Wis.) was questioned about spending cuts by the Department of Government Efficiency and Trump’s blaming of Ukraine for Russia’s invasion, according to local news reports. Rep. Kevin Hern (R., Okla.) and Rep. Cliff Bentz (R., Ore.) also found themselves pressed at similar forums about Elon Musk’s involvement in the DOGE downsizing effort, which has included mass firings of federal workers, local reports show.

Protesters gathered outside some GOP offices in Arizona, Iowa, Pennsylvania and New York. Phone calls continue to pour into Republican and Democratic offices following an uptick last month when the Trump administration placed a temporary freeze on federal loans and grants, affecting programs such as Head Start.

Melanie Zanona, Sahil Kapur and Ben Kamisar at NBC:

The House’s sweeping budget plan to advance President Donald Trump’s agenda could result in steep cuts to Medicaid and food stamps, putting a key group of Republicans in a politically difficult position ahead of a potential vote next week in the narrowly divided chamber.

There are a handful of House Republicans who represent parts of the country where sizable shares of the populations receive government assistance from Medicaid and the Supplemental Nutrition Assistance Program, according to an NBC News analysis of the most recently available Census Bureau data

The lawmakers from the 10 GOP-held districts with the highest percentages of Medicaid or SNAP beneficiaries span the ideological and geographical spectrum. They include members from deep-red districts, such as Speaker Mike Johnson of Louisiana and veteran Rep. Hal Rogers of Kentucky, as well as those in competitive battlegrounds, such as Reps. David Valadao of California, Rob Bresnahan of Pennsylvania and Monica De La Cruz of Texas.

Health and the Deficit

Our forthcoming book is The Comeback: The 2024 Elections and American Politics. It notes that neither candidate talked a lot about specific deficit reduction plans.


Meredith Lee Hill at Politico:

House Republicans in competitive districts warned GOP leaders Thursday: We could lose our seats if you gut Obamacare to pay for a massive border, energy and tax bill.

A group of about a dozen centrist Republicans delivered the message in a meeting with GOP Whip Tom Emmer (R-Minn.) and other senior lawmakers, according to four Republicans familiar with the meeting who were granted anonymity to speak frankly. GOP members are already concerned that they’re poised to lose their trifecta and a swath of seats in the 2026 midterms — they worry GOP efforts to pare back the Affordable Care Act could pour fuel on the fire.

Hans Nichols at Axios:

GOP tax writers are gathering support for creative ways to make the price tag $0 for extending Trump's 2017 tax cuts.

Why it matters: The procedural and budgetary gambit will free Republicans from the burden of finding the $4 trillion in spending cuts. But deficit hawks, including member of the House Freedom Caucus, haven't completely signed off on the novel approach.

Zoom in: Scott Bessent, Trump's nominee for Treasury secretary, has privately indicated to senators that he's sympathetic to their view that the cost of extending the 2017 tax cuts should be zero, according to people familiar with the matter.

By the numbers: Under a "current law baseline," extending Trump's personal and estate tax cuts will cost $4 trillion over 10 years.The tax cuts expire at the end of 2025, and the Congressional Budget Office has to score how much revenue the Treasury will miss if Congress passes it for another 10 years.

But what if Congress runs the numbers from a different starting point, and considers "current policy"?

Current policy has the tax cuts in place (at least until the end of the year). Among friends, say Republicans, what if we use current policy as the baseline? Then extending the tax cuts will cost … zero.

Cutting Programs for Low-Income Americans is Bad Politics for the GOP

 In Defying the Odds, we talk about the social and economic divides that enabled Trump to enter the White House. In Divided We Stand, we discuss how these divides played out in 2020.  

House Republicans want to cut the budget without cuts to Social Security, Medicare, and the military.  David Leonhardt at NYT:

The largest remaining category involves health care spending that benefits lower- and middle-income families, including from Medicaid and Obamacare. Hard-right Republicans, like some in the Freedom Caucus, have signaled they will propose reductions to these programs. Party leaders, for their part, have said they would eye cuts to anti-poverty programs such as food stamps.

But cuts like these would have a big potential downside for Republicans: The partisan shifts of recent years mean that Republican voters now benefit from these redistributive programs even more than Democratic voters do.

As The Atlantic’s Ronald Brownstein recently wrote, “The escalating confrontation between the parties over the federal budget rests on a fundamental paradox: The Republican majority in the House of Representatives is now more likely than Democrats to represent districts filled with older and lower-income voters who rely on the social programs that the G.O.P. wants to cut.”

Almost 70 percent of House Republicans represent districts where the median income is lower than the national median, according to researchers at the University of Southern California. By contrast, about 60 percent of House Democrats represent districts more affluent than the median.

The politics of class, as Brownstein puts it, have been inverted.

Primaries in Kansas, Michigan, and Missouri

In Defying the Odds, we discuss congressional elections as well as the presidential race. 

The Democrats' Akin ploy failed in Kansas.  James Arkin and Ally Mutnick report at Politico:

Rep. Roger Marshall won the GOP primary for an open Senate seat in Kansas on Tuesday, turning aside the controversial Kris Kobach — to the relief of Republicans concerned that Kobach could put not just the state but the party's Senate majority at risk this fall.

With nearly all the votes tallied, Marshall had 40 percent of the vote, to only 26 percent for Kobach. The result was a more decisive victory for Marshall than expected by many Republicans, who had predicted with deep concern that the race was a tossup going into Tuesday.

...
 Republicans got another piece of good news in Kansas on Tuesday, when Rep. Steve Watkins was ousted in his primary by state Treasurer Jake LaTurner, who has seized on Watkins’ litany of ethical and legal transgressions, including felony charges of voter fraud in the closing weeks of the primary. Some Republicans feared Watkins' renomination could have jeopardized the party's hold on an otherwise GOP-leaning House seat.

Clare Foran at CNN:

Freshman Democratic Rep. Rashida Tlaib of Michigan has prevailed against a Democratic primary challenge from Detroit City Council President Brenda Jones, CNN projected Wednesday morning.

In Michigan's 13th Congressional District, Tlaib faced a rematch in Tuesday night's Democratic primary against Jones, who beat her once before to serve out the remainder of former Rep. John Conyers' term, but lost to Tlaib in the full-term election for the seat in the heavily Democratic district.

As a member of the so-called progressive "Squad," Tlaib, who made history in 2018 along with Minnesota Rep. Ilhan Omar as the first two Muslim women ever to serve in Congress, has a number of built-in advantages as she runs for reelection, including high name recognition, the ability to raise significant amounts of money and a devoted national following. At the same time, however, Tlaib has faced controversy over some outside-the-mainstream political positions and at times she has faced criticism, including from Democrats, over statements related to Israel.

Nicholas Fando at NYT:

Cori Bush, a progressive activist and a leader of the swelling protest movement for racial justice, toppled Representative William Lacy Clay Jr. of Missouri in a Democratic primary on Tuesday, notching the latest in a stunning string of upsets against the party establishment.

Ms. Bush, 44, had captured nearly 49 percent of the vote by late Tuesday evening compared with 45.5 percent for Mr. Clay, according to The Associated Press. She had tried and failed to unseat Mr. Clay in 2018, but this year rode a surge in support for more liberal, confrontational politics within the Democratic Party amid the coronavirus pandemic and the national outcry over festering racial inequities.

James Hohmann at WP:

The vibe inside the House Democratic Caucus has changed dramatically since Alexandria Ocasio-Cortez toppled Joe Crowley, then the No. 4 in party leadership, two summers ago in a primary. AOC, as everyone calls her, is a member of the self-described “Squad” of four far-left liberals who won their seats in 2018. Another member of that quartet, Rep. Rashida Tlaib, easily fended off a primary challenge on Tuesday in Michigan from the president of the Detroit city council, who is more aligned with the Democratic establishment and only lost by 900 votes last time.

Clay is the third Democratic incumbent to lose a primary this year. Rep. Eliot Engel, the chairman of the Foreign Affairs Committee, lost to former middle school principal Jamaal Bowman last month in New York. Rep. Dan Lipinski (Ill.), who chairs a railroads and pipelines subcommittee, lost in March to activist Marie Newman in Chicago largely because of his opposition to abortion rights.

Speaking to supporters in a purple mask, Bush thanked a list of far-left groups for supporting her bid, including the Democratic Socialists of America. “I will never take for granted the movement that got me here,” she said. “An incremental approach isn’t going to work any longer. We’ve decided that we’re not going to wait any longer for change.”

 Rachel Roubein at Politico:

Missouri voters on Tuesday approved Medicaid expansion to many of the state’s poorest adults, making their conservative state the second to join the Obamacare program through the ballot during the pandemic.

The Missouri ballot measure expands Medicaid to about 230,000 low-income residents at a time when the state’s safety net health care program is already experiencing an enrollment surge tied to the pandemic’s economic upheaval. The measure was supported by 53 percent of voters.

A winning streak: Missouri becomes the sixth Republican-led state where voters have defied GOP leaders to expand Medicaid, just weeks after Oklahoma voters narrowly backed the program. No state has ever voted down such a ballot initiative in recent years, underscoring the popularity of Medicaid expansion even in parts of the country hostile to Obamacare.

Trump Budget: A Gift to Democrats

In Defying the Odds, we discuss the tax and economics issue in the 2016 campaign.  The 2019 update includes a chapter on the 2018 midterms. and explains why the Trump tax cut backfired on Republicans.

Jeff Stein and Erica Werner at WP:

The White House on Monday proposed a $4.8 trillion election-year budget that would slash major domestic and safety net programs, setting up a stark contrast with President Trump’s rivals as voting gets under way in the Democratic presidential primary.

The budget would cut Medicaid and the Children’s Health Insurance Program and also wring savings from Medicare despite Trump’s repeated promises to safeguard Medicare and Social Security.

It takes aim at domestic spending with cuts that are sure to be rejected by Congress, including slashing the Environmental Protection Agency budget by 26.5 percent over the next year, and cutting the budget of the Health and Human Services department by 9 percent. HHS includes the National Institutes of Health and the Centers for Disease Control and Prevention, which will see a budget cut even as the coronavirus spreads -- although officials said funding aimed at combating the coronavirus would be protected.

Bloomberg was quick on the draw:

The death toll from the Coronavirus is rising by the day.

Our country needs a leader who will fight for public health.

Instead, Trump is planning to cut $3 billion for global health services. pic.twitter.com/TS9hq24TTf

— Team Bloomberg (@Mike2020) February 11, 2020

Medicaid. Disability. Food stamps.
Trump promised to protect them.
His new budget will gut them.
And the lies just keep on coming. pic.twitter.com/oEcKje5J9k

— Team Bloomberg (@Mike2020) February 10, 2020

It's true — Trump does not care about your Medicare, Medicaid, or Social Security.https://t.co/6paHXkXgSM pic.twitter.com/U3ThIz9hkW

— Team Bloomberg (@Mike2020) February 10, 2020

Acknowledgement of Harm

In Defying the Odds, we talk about the political impact of economic and regulatory policy.

Coral Davenport and Kendra Pierre-Louis at NYT:

A major scientific report issued by 13 federal agencies on Friday presents the starkest warnings to date of the consequences of climate change for the United States, predicting that if significant steps are not taken to rein in global warming, the damage will knock as much as 10 percent off the size of the American economy by century’s end.

The report, which was mandated by Congress and made public by the White House, is notable not only for the precision of its calculations and bluntness of its conclusions, but also because its findings are directly at odds with President Trump’s agenda of environmental deregulation, which he asserts will spur economic growth.

Mr. Trump has taken aggressive steps to allow more planet-warming pollution from vehicle tailpipes and power plant smokestacks, and has vowed to pull the United States out of the Paris Agreement, under which nearly every country in the world pledged to cut carbon emissions. Just this week, he mocked the science of climate change because of a cold snap in the Northeast, tweeting, “Whatever happened to Global Warming?”

But in direct language, the 1,656-page assessment lays out the devastating effects of a changing climate on the economy, health and environment, including record wildfires in California, crop failures in the Midwest and crumbling infrastructure in the South. Going forward, American exports and supply chains could be disrupted, agricultural yields could fall to 1980s levels by midcentury and fire season could spread to the Southeast, the report finds.

Noam Levey and Evan Halper at LAT report ton regulatory and legal filings acknowledging multiple kinds of harm from Trump's deregulatory policies.

The Department of Education, for example, did not report how many student borrowers would be affected by a proposed rule issued earlier this year making it more difficult for students who have been defrauded by colleges or universities to get debt relief. Nor did the agency report how much more debt these students could face.

Only when borrowers sued did the agency acknowledge in court filings that scaling back the federal government’s debt relief program had left students with $56.9 million in additional debt.

Similarly, the Department of Health and Human Services has been granting states permission to impose work requirements on Medicaid beneficiaries without any assessment of how many people could lose health coverage as a result.

Many advocates fear that the administration may simply stop reporting potential adverse effects from their proposals.

To date, however, agencies have acknowledged that several of the administration’s highest-profile policy shifts would likely cause significant harm.

Nowhere has this been more apparent than at the EPA, an agency that has long set the standard for evaluating the costs and benefits of proposed regulatory moves.

When Trump in 2017 ordered the EPA to scrap President Obama’s landmark initiative to fight climate change by limiting power plant emissions, agency scientists reported the move would cause up to 4,500 premature deaths annually.

Everybody Hates Trumpcare

Rep. Jim Cooper has a list of organizations opposing Trumpcare.  Add the American Nurses Association, too.

• AARP: This bill would weaken Medicare’s fiscal sustainability, dramatically increase health care costs for Americans aged 50-64, and put at risk the health care of millions of children and adults with disabilities, and poor seniors who depend on the Medicaid program for long-term services and supports and other benefits. 
• American Medical Association: …we cannot support the AHCA as drafted because of the expected decline in health insurance coverage and the potential harm it would cause to vulnerable patient populations. As you consider this legislation over the coming days and weeks, we hope that you will keep upmost in your mind the potentially life altering impact your decisions will have on millions of Americans who may see their public, individual or even employer-provided health care coverage changed or eliminated. 
• American Hospital Association: Any ability to evaluate The American Health Care Act, however, is severely hampered by the lack of coverage estimates by the Congressional Budget Office (CBO). Lacking that level of analysis and needed transparency, we urge that Congress should wait until an estimate is available before proceeding with formal consideration.
• Federation of American Hospitals: Based on our review of the American Health Care Act (AHCA) as currently drafted, and in the absence of a Congressional Budget Office analysis and estimate of the cost and coverage impacts that might allay our concerns, we have significant issues with this legislation.
• American Diabetes Association: On behalf of the nearly 30 million Americans living with diabetes and the 86 million more with prediabetes, the American Diabetes Association (Association) is writing to express our serious concerns with the American Health Care Act…we have serious reservations about many of the proposals in this bill. Our initial areas of concern include the tax credit proposal, proposed changes to Medicaid, potential disruption of coverage and repealing the prevention and public health fund.
• American Cancer Society Cancer Action Network:…reduced federal funding combined with state-specific eligibility and enrollment restrictions will likely result in fewer cancer patients accessing needed health care. For low-income individuals these changes could be the difference between an early diagnosis when outcomes are better and costs are less or a late diagnosis where costs are higher and survival less likely.
• American Health Care Association (AHCA)/National Center for Assisted Living (NCAL): The residents in long term care centers are uniquely vulnerable. More than one million individuals call nursing centers their home and most rely on Medicaid for their care. This bill will cut Medicaid funding for seniors and individuals with disabilities, jeopardizing access to the care they need. We strongly encourage Congress to protect Medicaid access for seniors and people with disabilities in the Obamacare repeal and replace effort.
• America’s Essential Hospitals: We are particularly disappointed lawmakers seem willing to consider this bill in committee without a Congressional Budget Office score and an estimate of how the bill might impact healthcare coverage. A score is crucial, as this legislation could place a heavy burden on the safety net by reducing federal support for Medicaid expansion over time and imposing per-capita caps on the program.
• America’s Hospitals and Health Systems: We are very concerned that the draft legislative proposal being considered by the House committees could lead to tremendous instability for those seeking affordable coverage. Furthermore, we are deeply concerned that the proposed Medicaid program restructuring will result in both the loss of coverage for current enrollees as well as cuts to a program that provides health care services for our most vulnerable populations, including children, the elderly and disabled.
• American Public Health Association: This proposal would jeopardize the health and lives of many millions of Americans…American lives are on the line…It is particularly troubling that legislators plan to consider this proposal without a score from the Congressional Budget Office. We urge House members to oppose this plan and instead strengthen our nation’s commitment to improving the health and safety of all Americans.
• National Disability Rights Network: The legislation revealed by House Republicans last night is a giant step backwards in the treatment and care of individuals with disabilities…It permits discrimination against people with disabilities in the insurance market for their pre-existing conditions…The National Disability Rights Network urges the House not to send people with disabilities back to a time when it was nearly impossible for us to obtain health insurance, live in the home of our choice or participate in community life. We will never go back to those days. Never.
• Consortium For Citizens with Disabilities: While many of the policy points are troubling, it is simply unconscionable to use the Medicaid program to pay for the repeal of the ACA, the repeal of corporate and provider taxes, and to provide new tax benefits for individuals. Medicaid provides services and supports that maintain the health, function, independence, and well-being of 10 million enrollees living with disabilities.
• Easterseals: Easterseals is greatly concerned that AHCA removes the federal funding guarantee that currently exists in Medicaid. People with disabilities rely on Medicaid-funded services such as attendant care, adult day and home health services to remain in their homes and communities and live productive lives.
• National Family Planning & Reproductive Health Association (NFPRHA): When people do not have access to the family planning care and education they need, they are more vulnerable to sexually transmitted disease and at a greater risk of unintended pregnancy and poor birth outcomes, all of which have high personal costs and translate into increased expense across the entire health care system. Lawmakers should block this dangerous measure and return to thoughtful, bipartisan deliberation on improving access to affordable, high-quality health care in this country. There is too much at stake.
• National Partnership Women and Families: The Republican repeal bill is an affront to women and families. It reflects its authors’ determination to deny women access to quality, affordable health care, including the comprehensive reproductive health care and abortion services that are essential to their health, equality and economic security… This bill takes us back to the days when there were few benefit standards or consumer protections in place – to a time when insurers were the ones who decided what and who they would cover, what doctors we could see, and where we could get care.
• National Physicians Alliance: The National Physicians Alliance opposes the draft Republican House bill revealed last night. We believe the drastic cuts it proposes to Medicaid, coupled with the substantial reductions in subsidies that helped millions afford healthcare would be extremely detrimental to our patients… All the while, the proposed legislation hands millionaires, billionaires and health insurance CEOs a massive new tax break.
• AFL-CIO: The reality is, this isn’t a healthcare plan at all. It’s a massive transfer of wealth from working people to Wall Street. For more than a century, the labor movement has fought to make health care a right for every American. The Republican plan contradicts this very idea by making care less affordable and accessible. It’s bad for healthcare, it’s bad for working families, it’s bad for our economy and we will fully oppose it.
• American Federation of State, County, and Municipal Employees: The replacement plan put forward by congressional leadership is no replacement at all for the tens of millions of Americans who rely on the Affordable Care Act to keep their families healthy without fear of bankruptcy. It is simply a tax cut for corporations and the wealthy, funded by gutting Medicaid and shifting health care costs onto states and working families.
• National Council of La Raza (NCLR): This bill is a threat to America’s well-being and represents a step back to the days when health insurance was financially out of reach for too many working Americans. Our nation’s future depends on healthy and hard-working families. The changes to Medicaid will devastate a program that is a lifeline for 74 million vulnerable Americans, including children, people with disabilities, and 18 million Latinos. This effort to radically change the financing structure of Medicaid will jeopardize their lives.
• Asian & Pacific Islander American Health Forum: Many things are clear from the bill, yet many unknowns remain. What we know is that millions of Americans, including Asian Americans, Native Hawaiians and Pacific Islanders (AAs and NHPIs) relying on coverage under the ACA will be worse off. Under the guise of flexibility, this plan would end Medicaid as we know it by phasing in per-capita caps.
• National Committee to Preserve Social Security & Medicare: The ACA is a highly complex piece of legislation that includes many benefit increases for seniors on Medicare, contains many program improvements that help to drive the cost of health care down and extends the solvency of the Part A trust fund. For these reasons, we strongly believe that any replacement legislation should do no less than the ACA for our senior population.
• National Center for Transgender Equality: Under this bill, millions would lose coverage and millions more would pay more for their health care…President Trump and leaders in Congress don’t seem to understand that this is not a political exercise—they are playing with millions of Americans’ lives.
• United Methodist Church: This bill has been promoted as a “fix” to the health care system in the United States but will do nothing to improve access and affordability. Instead, it will harm many in the congregations and communities in which we live and serve. People will die because of efforts like this to roll back health care.
• The Episcopal Church: This current proposal falls woefully short of our spiritual calling to care for the ‘least of these,' as well as the noble values upon which our great nation was founded.
• Catholic Health Association of the United States: We strongly encourage the full House to reject this ‘replacement’ bill and work to craft legislation that addresses the real issues without creating unneeded chaos in the system and coverage loss for those who need health care.
• American Federation of Teachers (AFT): That Republicans are now trying to ram something through after keeping it under lock and key makes it clear that they want to hide the details and cost from the American people. If something sounds too good to be true, it is. They know that if their true intent were exposed, Americans would soundly reject their efforts.
• National Education Association: It’s time for the Republican leadership to come clean with the American people. Repealing the ACA will harm our students and their families by forcing cuts to critical programs, reducing financial support for lower-income Americans, and taxing the middle class. Bottom line, working Americans will pay more for less coverage while insurance executives and the wealthy get handouts.
• American Federation for Suicide Prevention: We must ensure the gains we have made in mental health and substance use disorder coverage remain in place so every American has a path to a more healthy and productive life.
• National Women’s Law Center: The House Republican ACA repeal bill would be devastating for women. Rather than protecting access to care and coverage, this bill undermines the infrastructure of our nation’s health system, targets low-income individuals, and restructures the system in favor of wealthier individuals. All of this comes at the expense of women, who will be particularly harmed by the repeal bill.
• Cystic Fibrosis Foundation: The bills released by the two House committees this week fail to adequately protect people living with cystic fibrosis and place the lives of millions of Americans living with serious and chronic diseases at risk.
• HIV Medicine Association: These proposals will not only harm individuals with HIV but will compromise our nation’s public health by leaving fewer with access to the antiretroviral treatment that keeps patients healthy and reduces their risk of transmitting HIV to near zero. We strongly urge the committees to reconsider the bill and the accelerated and non-transparent process with which these proposals have been advanced.
• Federal AIDS Policy Partnership: This is likely to result in a loss of coverage and services for individuals with HIV and millions of other low income individuals with chronic illnesses and diseases whose access to healthcare and lives depend on this vital program. Formal analysis and comment by the Congressional Budget Office, the Medicaid and CHIP Payment Access Commission and the Government Accountability Office is critical to evaluate how the 70 million Americans who rely on this program stand to be affected by the proposed changes.
• Leadership Conference on Civil and Human Rights: This proposal is truly disheartening. It doesn’t ensure that all Americans will continue to have health coverage, as its supporters claim. Rather, it drastically cuts financial assistance for low-income people living at or below the poverty line, undermines and places severe limitations on the Medicaid expansion, and proposes to defund Planned Parenthood centers from the Medicaid program.
• MomsRising: The American Health Care Act makes a mockery of every campaign promise Donald Trump made about health care. It sets the stage for deep, punitive, permanent cuts to Medicaid in just a few years, which would cause grave harm resulting in rationing care for some of the most vulnerable people in our country: low-income families, pregnant women, people with disabilities and the elderly. The Republican plan would allow insurance companies to raise premiums and out-of-pocket costs, especially for seniors. The only winners would be the wealthy.
• Children’s Defense Fund: The American Health Care Act would reverse progress and make children worse off by depriving them of the comprehensive and affordable child-appropriate coverage they are guaranteed today, jeopardizing their futures and also the nation’s future economic and national security.
• Families USA: The GOP health care proposal would be laughable if its consequences weren’t so devastating. This bill would strip coverage from millions of people and drive up consumer costs. It shreds the Medicaid social safety net that serves more than 72 million people, including many children, senior citizens and people with disabilities. And it once again leaves millions of people in America with chronic illness and disease at the mercy of insurance companies. 
• Consumers Union: The American Health Care Act would, as currently written, be a major step backwards for our nation’s children…marking up a bill that will impact millions of lives without a CBO score and without providing transparency and allowing for fair review is irresponsible and unfair to consumers.
• Sister Simone Campbell, NETWORK Advocates for Catholic Social Justice: Our test for any ACA replacement bill is simple: Does the bill protect access to quality, affordable, equitable healthcare for vulnerable communities? After reviewing the House GOP replacement bill, the answer is a resounding no. Instead of providing greater health security, the bill increases costs for older and sicker patients and drastically cuts the Medicaid program, all while providing huge tax cuts to wealthy corporations and individuals. This is not the faithful way forward and must be rejected. 
• Young Invincibles: House Republicans introduced a bill to repeal and replace the ACA, which would have devastating effects on millions of young adults, a group which has seen the greatest health care gains under the ACA: in the past six years, Millennial uninsurance rates have dropped from 29 percent to 16 percent.
• Planned Parenthood: One in five women in America has relied on Planned Parenthood, and their health care shouldn't get caught up in congressional Republicans' extreme agenda. This proposal would deny millions of women access to cancer screenings, birth control, and STD testing and treatment.