Polls show Democrats down in the dumps at their lowest approval level in decades, but we Republicans are having an identity crisis of our own, and you can see it in the tug of war over President Trump’s “one big, beautiful bill.” The nub of the conflict: Will Republicans be a majority party of working people, or a permanent minority speaking only for the C suite?
Mr. Trump has promised working-class tax cuts and protection for working-class social insurance, such as Medicaid. But now a noisy contingent of corporatist Republicans — call it the party’s Wall Street wing — is urging Congress to ignore all that and get back to the old-time religion: corporate giveaways, preferences for capital and deep cuts to social insurance.
This wing of the party wants Republicans to build our big, beautiful bill around slashing health insurance for the working poor. But that argument is both morally wrong and politically suicidal.
Let’s begin with the facts of the matter. Medicaid is a federal program that provides health care to low-income Americans in partnership with state governments. Today it serves over 70 million Americans, including well over one million residents of Missouri, the state I represent.
As for Missouri, it is one of 40 Medicaid expansion states — because our voters wanted it that way. In 2020, the same year Mr. Trump carried the Missouri popular vote by a decisive margin, voters mandated that the state expand Medicaid coverage to working-class individuals unable to afford health care elsewhere. Voters went so far as to inscribe that expansion in our state constitution. Now some 21 percent of Missourians benefit from Medicaid or CHIP, the companion insurance program for lower-income children. And many of our rural hospitals and health providers depend on the funding from these programs to keep their doors open.
All of which means this: If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It’s that simple. And that pattern will replicate in states across the country.
One of my constituents, a married mother of five, contacted me to explain why Medicaid is vital to her 8-year-old daughter, who depends on a feeding tube to survive. Formula, pump rentals, feeding extensions and other treatments cost $1,500 a month; prescriptions nearly double that cost. These expenses aren’t covered by private insurance. The mother wrote to me, “Without Medicaid, we would lose everything — our home, our vehicles, and eventually, our daughter.”
Congress should be doing everything possible to aid these working families, to make their health care better and more affordable. We should cap prescription drug costs, as I have recently proposed. We should give every family in America with children a hefty tax cut. What we should not do is eliminate their health care.
Mr. Trump himself has been crystal clear on this point. Since taking office he has repeatedly rejected calls for Medicaid benefit cuts. Just the other week, he said, “We are doing absolutely nothing to hurt Medicare, Medicaid or Social Security. Nothing at all.”
And for good reason. The president understands who his voters are. Recent polling shows that 64 percent of Republicans hold a favorable view of Medicaid. About one in six have personally been on the program. Meanwhile, more than 80 percent of Americans oppose significant cuts to Medicaid and over half — half — have a personal or family connection to the Medicaid program.
It’s safe to say the Trump coalition was not pulling the lever for Medicaid cuts in November. Mike Johnson, the House speaker, finally woke up to this fact last week, when he withdrew his support from one of the most aggressive reductions to Medicaid on the table. But many of my House and Senate colleagues keep pushing for substantial cuts, and the House will begin to hash out its differences in negotiations this week.
My colleagues have cited the editorial board of The Wall Street Journal, which has been pushing that line for months, including in a recent editorial that inveighed against my opposition to Medicaid benefit cuts. But following The Journal’s prescriptions would represent the end of any chance of us becoming a working-class party.
Republicans need to open their eyes: Our voters support social insurance programs. More than that, our voters depend on those programs. And there’s a reason for this that Republicans would do well to ponder. Our economy is increasingly unfriendly to working people and their families.
For the better part of 50 years, working wages have been flat in real terms. Working people cannot afford to get married when they want to, have the number of children they want to or raise those children as they would like. These days, they can barely afford to put a roof over their kids’ heads, to say nothing of health care.
Both Democrats and Republicans share the blame for this state of affairs, which is one big reason Mr. Trump got elected. He promised to shake up the status quo. Republicans in Congress should pay attention. Our voters not only want us to protect the social insurance they need to get by; they also want us to fight for a better life — for a better economy with the kinds of jobs and wages that allow working people to get married and start families, to buy homes and have a stake in their towns and neighborhoods.
That’s the promise of American life. If Republicans want to be a working-class party — if we want to be a majority party — we must ignore calls to cut Medicaid and start delivering on America’s promise for America’s working people.
Josh Hawley is a Republican senator from Missouri.
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