Donald Trump’s Agenda Will Hurt His Base. Will They Notice?

Republicans just did something wildly unpopular, but they’re counting on Americans being too checked out to notice—and thus, to blame them for it. The passage of last week’s Big, Beautiful Bill was “backloaded” with “a lot of the Medicaid and [Affordable Care Act] cuts,” as Larry Levitt, the executive vice president for health policy of the nonprofit health research group KFF, put it to Axios. Republicans added work requirements to Medicaid and did other creative math tactics in order to cut nearly $1 trillion from the program, which could lead to almost 12 million people losing coverage, according to the Congressional Budget Office. But, Levitt noted, there “will be few tangible effects in health care from this bill before the midterms.”

How convenient! Cutting Obamacare has long been a GOP dream, something Donald Trump tried to do during his first term—and would have if it wasn’t for John McCain’s famous thumbs down, which saved the Affordable Care Act and enraged much of his party. This time, Trump managed to achieve his goal—without having to put the actual legislation to a vote. With everything tucked into the BBB, there just weren’t enough votes to sink Trump’s signature legislation. North Carolina senator Thom Tillis didn’t go along with the program, warning his fellow senators they were about to “make a mistake on health care and betray a promise” and that the legislation would “hurt people who are eligible and qualified for Medicaid.” A few days before the vote—which required a JD Vance tiebreaker—Tillis announced he wouldn’t seek reelection next year, exiting the stage like other Republicans who have dared to cross Trump.

Something significant happened between Trump’s first term and his second that made it possible to sneak a skinny Obamacare reform through Congress. Trump is now more unfettered and untethered, and his administration lacks the “grown-ups” in the room that had kept him somewhat in check the previous go-round. “Promises made, promises kept,” the White House likes to say, even as some big promises remain unfulfilled.

Republicans were able to sell the bill to their constituents despite the fact that red states would be especially hurt by Medicaid cuts. To convince people that they should give away their own stuff, they framed the cuts as happening to other people, such as “illegals” who are supposedly enjoying government services that citizens are somehow unable to avail themselves of. Trump has long fueled grievances to gain power, and in this case, the GOP is also tapping into people’s envy, a sense that someone else is getting something for nothing, and that the way to fix everything is to root out “waste, fraud, and abuse.”

“Republicans have duped some people into believing it’s only illegal immigrants who’ll lose health care under [the bill] but that’s not true,” Matthew Yglesias noted. “That’s why Vance is so desperate to [dismiss] ‘minutia’ about the Medicaid provisions as ‘immaterial’—he doesn’t [want] you to know.” Or there was Speaker Mike Johnson, who insisted on CNN that “we are not cutting Medicaid,” while expanding the definition of fraud. “You’re talking about 4.8 million able-bodied workers, young men, for example, who are on Medicaid. They are choosing not to work,” Johnson said. “That is called fraud.” Providing health care to people who aren’t working isn’t fraud, it’s just a legislative choice.

Over on Newsmax, Louisiana Republican Steve Scalise tried to argue that the GOP was cutting Medicaid to preserve it. By “getting rid of a lot of waste, fraud, and abuse,” Scalise suggested, “the truly disabled and needy will be able to get better access to Medicaid.” Because now, he continued, “the 35-year-old who’s sitting at his mom’s basement playing video games is going to have to go get a job again.”

During his time in the White House, Joe Biden wasn’t able to get credit for some of his legislative wins, but he was blamed for inflation. Will Republicans, who now control the government, get blamed for not only cutting Medicaid, but rolling back many of the clean energy initiatives passed in 2022? Under the GOP bill, many “projects will very likely be abandoned,” writes Steven Rattner. “Most Republican legislators are supporting this despite the fact that a vast majority of these investments have taken place in Republican congressional districts.”

Republicans might be banking on Democrats being too despondent to fight back and their own voters not realizing how they’ll be hurt until after the midterms. And getting consequential legislation like this through Congress will only empower them to keep going. Senator Ron Johnson said yesterday that when it comes to Medicaid cuts, he expects his party will get “a second bite of the apple.”