As President Donald Trump’s “big, beautiful bill” heads to the Senate, Republicans are trying their hardest to sell voters on the prospect of deep cuts to Medicaid and other social safety net programs in order to fund tax breaks for the ultra-wealthy. The process has involved plenty of bold-faced lying to constituents.
Republicans’ current reconciliation bill will kick an estimated 15 million Americans off of their health care coverage by 2034. The expected coverage rollback will primarily be fueled by increased requirements for Medicaid recipients, as well as changes made to Affordable Care Act marketplace policies and the failure of the bill to renew tax benefits for ACA plan purchasers.
Last month, Trump told reporters that he and Republicans were “not doing any cutting of anything meaningful. The only thing we’re cutting is waste, fraud and abuse. With Medicaid, waste, fraud and abuse. There’s tremendous waste, fraud and abuse.”
In a Sunday interview with CNN, Trump’s director of the Office of Management and Budget, Russell Vought, claimed that “no one will lose coverage as a result of this bill,” and accused backlash to the legislation of being “astroturfed.”
“This bill will proserve and protect the programs, the social safety net,” Vought added.
In reality, the bill cuts spending on Medicaid by at least $600 billion over the next 10 years. What Republicans say are measures to curb “waste, fraud, and abuse” in the program are largely administrative hurdles intended to bog down potential recipients in paperwork and red tape in order to complicate enrollment in the programs.
Vought’s statements to CNN represent Republicans’ latest strategy to combat increased hostility from voters over unpopular cuts to popular programs. As members of the GOP move to market the legislative package to constituents, their unified message has been that the legislation somehow protects Medicaid, and that any American who loses their health care coverage doesn’t deserve it, and even that they would only be giving it up voluntarily.
Rep. Anna Paulina Luna (R-Fla.) accused Democrats of using “fear tactics- not the truth- when they speak to the American public.”
“Chuck Schumer claims Republicans want to dismantle Social Security, Medicare, and Medicaid, but the reality is we’re working to safeguard these programs,” she wrote on X.
Rep. Mike Lawler (R-N.Y.) told the New York Post last month that the bill “worked to protect critical services like Medicaid,” while eliminating those who were “gaming the system.”
In a separate tweet, Lawler wrote that the reconciliation package “strengthens Medicaid for seniors, single parents, and the I/DD community by eliminating waste, fraud, and abuse,” by eliminating coverage for “illegal immigrants” (who were already ineligible for most Medicaid programs), eliminating “scam artists” from the program, and instituting “work requirements for able-bodied adults without dependents.”
What Republicans like Lawler avoid acknowledging is that the vast majority of able-bodied adults on Medicaid already do work. Over 60 percent of recipients work either full or part time, where as the remainder largely do not work because they are disabled, ill, a primary caregiver, or a student.
Several other Republicans, including Reps. Zach Nunn (R-Iowa), Tom Kean Jr. (R-N.J.), Ryan Mackenzie (R-Pa.), and Rob Wittman (R-Va.) all used some version of the phrase “protecting Medicaid” in public statements defending the legislation.
Rep. Don Bacon (R-Neb.) wrote on X that Republicans had “protected Medicaid for those who need it,” adding that “work requirements for able bodied adults w/out children helps get 4.8 million back into work force & on employer provided insurance.”
It’s a fancy way of saying that 4.8 million people would be forced out of the program, according to estimates from the nonpartisan Congressional Budget Office.
On Sunday, House Speaker Mike Johnson told NBC News’ Meet the Press that concerns about individuals losing coverage were overblown. “The people who are complaining that these people are going to lose their coverage because they can’t fulfill the paperwork, this is minor enforcement of this policy, and it follows common sense,” the speaker said.
“4.8 million people will not lose their Medicaid unless they choose to do so,” Johnson added, insisting that “the American people are not buying” Democrats’ messaging around the bill.
But even as House Republicans make their pitch to increasingly angry voters, they’re being undermined by some of their colleagues in the Senate. Sen. Josh Hawley (R-Mo.) has called the legislation’s attacks against Medicaid “politically suicidal,” and Sen. Rand Paul (R-Ky.) told CBS News on Sunday that the cuts are “a bad strategy” to deal with GOP concerns about the national debt. (The deficit will increase, not decrease, as a result of the legislation.)
But perhaps the clearest acknowledgement of how awful the legislation is came from one senator who didn’t even bother denying that the bill would have potentially awful consequences for Medicaid recipients. On Friday, during a town hall even in her home state of Iowa, an attendee yelled out “people will die” as Sen. Joni Ernst (R-Iowa) defended the “big, beautiful,” bill.
Ernst simply paused, and told the audience, “Well, we all are going to die.” If Republicans get their way, many people will be dying a lot sooner than they hoped.
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