“I love the poorly educated,” President Trump declared during the 2016 campaign. His intense support for the “big, beautiful” 4.5 trillion tax-and-spending bill now before Congress shows that he has a unique way of demonstrating his affection
Republicans are on the verge of enacting Trump’s upwardly distributive fiscal policy measure, which has become an extreme test of the loyalty of his more downscale MAGA supporters, who not only oppose the bill but stand to bear the brunt of its negative consequences.
In its current form, which is changing by the hour, the measure, known popularly as B.B.B., would provide the upper classes, including Trump’s allies and donor base — corporations and the rich — with tax cuts worth approximately $4.45 trillion over 10 years. The measure would offset the cost with the largest reductions in safety net programs in recent decades, if not all time, for those on the lower tiers of the income distribution.
This pared back social spending would adversely affect a large bloc of rural and exurban Republicans who played a crucial role in putting their party in control of the House and Senate and Trump in the White House.
“You can very safely say,” Bobby Kogan, senior director of federal budget policy at the liberal Center for American Progress, told The Washington Post, that “this is the biggest cut to programs for low-income Americans ever.”
Many of the details of the legislation remain in flux as the Senate continues to vote on amendments. If the Senate approves the legislation, the House and Senate will still have to come to agreement on a final version for the measure to become law.
The Trump tax-and-spending bill comes in the wake of one of the most significant developments in American politics over the past quarter century: the Republican Party, once the representative of Wall Street and Main Street, has become the party of low-income white America while remaining committed to the trickle-down economic policies of the 1980s.
“The ongoing shift of the class profile of the two parties has radically changed the character of Republican and Democratic areas of the country,” Jacob Hacker, a political scientist at Yale, wrote by email. “Districts represented by Republican members of Congress — as well as counties that supported Trump in the last election — are poorer, more rural, less dense, have fewer college graduates, and are more likely to be in areas scarred by deindustrialization.”
The effect of Trump’s One Big Beautiful Bill, Hacker argued,
Will be to throw millions of Americans off Medicaid and greatly worsen the rural health crisis. The effects will be most devastating for older Americans in areas where Medicaid is the main health insurance lifeline for working families — that is, for Republicans’ base supporters.
Both Steve Bannon and Josh Hawley have made clear that Medicaid is now a core part of the social contract on which needy Republicans rely. The number of Republican-majority counties disproportionally dependent on just the federal programs Trump and fellow Republicans plan to cut has grown by leaps and bounds.
The economic transformation of the Republican electorate is perhaps best illustrated in a September 2024 Wall Street Journal article based in part on data compiled by the Economic Innovation Group, a nonpartisan nonprofit that promotes policies spurring economic growth.
The article documents that the number of Republican-majority counties dependent on the federal government for at least 25 percent of local government expenditures increased from 186 in 2000 to 1,746 in 2020 (an uptick of 838.7 percent). In contrast, the number of Democratic- majority counties dependent on federal payments for 25 percent of their budgets over the same period grew from 131 to 240 (an uptick of 83.2 percent).
In a June 12 report to Democratic House Congressional leaders, “Distributional Effects of H.R. 1, the One Big Beautiful Bill Act,” the Congressional Budget Office found that Americans falling into the bottom 30 percent of the income distribution — which now includes many white Republicans — will experience a net loss of income if the Trump bill passes.
The loss would be most severe for those at the very bottom, according to the report:
Resources for households in the lowest decile of the income distribution would decrease by about $1,600 per year (in 2025 dollars) compared with their projected income in C.B.O.’s base line projections. That amounts to 3.9 percent of their income. Those projected decreases are mainly attributable to reductions in in-kind transfers, such as Medicaid and SNAP (food stamps).
Michael Shepherd, a professor in the Health Management & Policy Department of the School of Public Health at the University of Michigan, wrote by email: “I think it is fair to say the ‘big, beautiful bill’ will in multiple ways be a massive blow to the working-class and rural voters who have become core to Trump’s base.”
Rural Americans, Shepherd wrote,
are several percentage points more likely to be enrolled in Medicaid than nonrural Americans. And older rural Americans are much more likely to be ‘dual eligible’ recipients of both Medicaid and Medicare. As a result, the cuts are more likely to enact harm on Trump voters.
Overall, it is rural communities in states won by Trump, like Kentucky, North Carolina, and Ohio (all of which also have two Republican senators), and Trump-majority rural communities nationwide, that will suffer the most from these cuts.
In addition, Shepherd continued,
Nearly 300 rural hospitals face closure in the next couple of years even without the cuts. In Texas, for example, nearly 70 hospitals are on the brink. In Georgia, nearly two dozen in the same boat. Nearly all of these are in Trump majority counties and Republican congressional districts.
As it stands, over 20 percent of the typical rural hospital budget comes from Medicaid. Cuts of the size included in the B.B.B. will lead to closures in the coming years at alarmingly high rates. About 80 percent of rural hospital closures over the last decade have been in the states that did not expand Medicaid.
With the attacks on expansion states in the B.B.B., it is reasonable to assume that rural hospitals in expansion states will face the problems currently being faced in non-expansion states. In other words, the problem facing rural communities in the ten states that didn’t expand will become a nationwide problem.
Shepherd’s conclusion: “Everywhere one looks in this bill, you can find provisions that will make life considerably harder and more expensive for the rural and working-class voters and communities who have recently joined the Republican fold.”
In the view of some experts, the adverse distributional consequences of the Big Beautiful Bill are emblematic of broader policies adopted by Trump and congressional Republicans.
Noam Lupu, a political scientist at Vanderbilt, wrote by email: “I think there’s a more general puzzle here: that Republican policies seem disproportionately to hurt smaller communities and Democratic policies seem disproportionately to help them — even though majorities in these communities vote for Republicans.”
To support his case, Lupu cited an April 17 Center on Budget and Policy Priorities study by Brendan Duke and Gbenga Ajilore, “Republican Agenda’s ‘Triple Threat’ to Low- and Moderate-Income Family Well-Being.”
“The Trump administration and Republican majorities in both houses of Congress,” Duke and Ajilore write, “are advancing a policy agenda that deeply threatens millions of families’ ability to afford the basics by making it harder for them to secure health coverage, buy groceries, or afford everyday goods — all while pursuing expensive tax cuts that are skewed toward the wealthy.”
In addition to the Trump tax and spending measure, Duke and Ajilore write, the overall Trump agenda
includes an executive action agenda that unlawfully stops funding for public services and investments, hollows out and politicizes the civil service, and undermines basic governance. It also includes sweeping tariffs — the highest in more than a century and eight times higher than they were last year — that will cost low- and moderate-income families hundreds if not thousands of dollars, more than offsetting whatever modest tax cuts they may receive from tax legislation.
Expanding the analysis to include the executive action agenda and tariffs, Duke and Ajilore contend, shows a much larger share of the population losing income than the studies that focused on the Big, Beautiful Bill alone. According to the Center on Budget and Policy Priorities’ calculation of the annual dollar change in household income in 2026, the top 1 percent would gain $25,500, the top 20 percent $500; the fourth highest quintile would lose $1,410 per household; the middle quintile would lose $1,610; the second lowest quintile would lose $1,720 and the bottom quintile, $2,270.
A separate Jan. 30 study published by the budget center, “President Trump, Congressional Republican Proposals Would Shift Large Costs to States, Inflict Widespread Harm,” by Wesley Tharpe and Meg Wiehe, found that of the 10 states most dependent on federal money in their budgets, eight were red states and two were blue.
What explains this disregard?
Lupu wrote that he generally agrees with the thesis offered in a chapter written by Hacker, Paul Pierson and Sam Zacher in the book “Unequal Democracies: Public Policy, Responsiveness and Redistribution in an Era of Rising Economic Inequality.”
“They have what I think is a very convincing argument about the institutional and party organizational explanations for this phenomenon,” Lupu wrote, adding that
They would say that there are organized interests with very strong preferences about budget cutting that are part of the Republican coalition and then there are voters in the coalition who stand to lose from these cuts. But with American party politics having become so nationalized and polarized, the party organization became more likely to listen to the intense organized interests because the voters don’t really have anywhere else to go.
That’s effectively what we’re seeing with this bill.
Lupu argued that the current Republican policies on taxes, spending and tariffs represent a dangerous gamble.
“Parties that take their voters for granted eventually do get punished,” Lupu wrote. “I do think a party that consistently hurts its own supporters will eventually lose them.”
KFF, formerly the Kaiser Family Foundation, has been closely tracking provisions of the Big Beautiful Bill. In an email, Drew Altman, president and chief executive, noted that “the Medicaid and ACA (Obamacare) cuts will disproportionately affect MAGA supporters,” adding that:
It looks like Republicans are handing Democrats their golden issue but it’s not a slam dunk. Whether MAGA supporters blame Trump and Republicans for the cuts, however, will depend a lot on whether Democrats succeed in holding them responsible. Many of the cuts are wonky and clothed as popular measures like promoting work. They will be implemented piecemeal over time, and many could look to voters like they are coming at them from their governor, their marketplace or insurance plan.
Altman drew my attention to two of his recent analyses published on the KFF website.
On June 10, Altman wrote:
Nearly half (45 percent) of the people who get their health coverage in the ACA Marketplaces and in the individual market — about 10 million Americans — are MAGA supporters or non-MAGA Republicans. What that means is that the policy changes and cuts being made by Republicans to the marketplaces will directly affect their own voters.
However, Altman continued,
The biggest change will actually come from inaction: If Republicans don’t extend the enhanced ACA tax credits this year, the premiums people pay will increase by more than 75 percent on average and result in an additional four million people losing coverage.
All told, the combined impact of the reconciliation changes and the tax credits expiring would result in at least a one-third reduction in Marketplace enrollment. Red states that didn’t expand Medicaid will be hit especially hard. For example, 2.2 million people in Florida are expected to lose health coverage from the changes to the ACA and 1.7 million in Texas.
In a separate June 18 report, Altman cited KFF polling showing that many voters are unaware of the effects of the Trump legislation. When told of the consequences, the already weak support drops precipitously:
We asked respondents if they had a favorable or unfavorable view of the B.B.B. and then asked two “what if you knew” follow-up questions. Public support for the legislation drops 14 percentage points from 35 percent favorable/64 percent unfavorable to 21 percent favorable/79 percent unfavorable after hearing that the legislation would decrease funding for local hospitals, and three-fourths of the public (74 percent) hold an unfavorable view of the legislation after hearing that the bill would increase the number of people without health insurance by about 10 million.
One of the driving forces behind the growth of the downscale Republican constituency and the emerging economic division between red and blue America is the polarization of voters by education that began in the 1990s as college-educated voters became more liberal and Democratic, while non-college voters, especially whites, became more conservative and Republican.
This process rapidly accelerated in the wake of the 2008-9 Great Recession as blue counties across the nation recovered and returned to steady growth while red counties on average stagnated or declined.
Mark Muro, a senior fellow at the Brookings Institution, has documented this process in a series of articles.
In a 2019 report, “America Has Two Economies — and They’re Diverging Fast,” Muro and Jacob Whiton showed that in 2008 median household income in congressional districts represented by Republicans ($55,000) was still higher than it was in Democratic districts $54,000). By 2017, however, income in blue districts rose to $61,000 while in red districts it fell to $53,000.
The same divergent trends could be seen on virtually every measure including GDP growth, educational attainment and population increase.
“Democratic districts,” Muro wrote,
have grown significantly more dynamic in the last decade. Overall, ‘blue’ territories have seen their productivity climb from $118,000 per worker in 2008 to $139,000 in 2018 as recent demographic changes and electoral sorting ensured they became better educated and more urban. Republican-district productivity, by contrast, remains stuck at about $110,000.
In July 2024, the Economic Innovation Group reported a similar sharp acceleration in the economic gap between red and blue counties, beginning in 2008. That year, according to the group’s report, 67 percent of the nation’s “left-behind counties” — defined as “counties that experienced less than half the national population and median household income growth rate” — voted Republican while 33 percent voted Democratic.
By 2020, counties that voted Republican made up 83 percent of the left-behind, while 13 percent of Democratic voting counties qualified as left behind.
By 2024, Muro and his Brookings colleagues found that “President Donald Trump’s winning base in 2,633 counties represents 86 percent of the nation’s total counties but just 38 percent of the nation’s GDP. Conversely, Vice President Kamala Harris’s losing base of 427 much higher-output counties represents 62 percent of the GDP.”
Trump is fully aware of the public hostility to the measure. His own pollster, Tony Fabrizio, conducted a survey for the Modern Medicaid Alliance that found: “Voters Overwhelmingly Oppose Cutting Medicaid to Pay for Tax Cuts — An Unpopular Move with Swing Voters, Republican Base.”
In their report to the alliance, Fabrizio and his two partners, Bob and John Ward, wrote:
There is no appetite across the political spectrum for cutting Medicaid to pay for tax cuts. Medicaid is well-liked by most voters, in large part due to the broad impact it has across the electorate and the high level of importance voters place on as many Americans as possible having health insurance. Opposition is high to cutting the program generally and is especially high for cutting funding for CHIP and the help Medicaid provides seniors.
This once again raises the question of why Trump is so determined to thwart and deprive the men and women who elected him to the presidency not once but twice.
The answer is that the Big, Beautiful Bill reveals Trump’s true colors. He is more committed to surreptitiously gambling on lavish tax cuts for the rich, including himself and his friends, than he is in cementing a populist coalition that could carry the Republican Party to victory in 2026, 2028 and beyond.
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Thomas B. Edsall has been a contributor to the Times Opinion section since 2011. His column on strategic and demographic trends in American politics appears every Tuesday. He previously covered politics for The Washington Post.
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