Although Donald Trump’s address to a turbulent and bitterly divided Congress on Tuesday night lasted as long a Premier League soccer match plus stoppage time, he scarcely touched on the issue of his administration’s plans for Medicaid.
The Democrats were quick to remind him of its presence, so much so that one veteran representative, Al Green, made history after he was removed from the chamber by the sergeant-at-arms for continually heckling the US president about the issue. “You don’t have a mandate to cut Medicaid,” Green shouted repeatedly at Trump, his voice drowned out by boos from the Republican side of house.
Green left the room, but the issue he raised will not go away quietly. On the eve of Trump’s address, a request for information was issued to the Congressional Budget Office (CBO) director Phillip Swagel by Pennsylvania Democrat congressman Brendan Boyle, a ranking member of the House budget committee, and Frank Pallone, his New Jersey party colleague who sits on the energy and commerce committee.
They sought clarity on the implications of cutting a planned $880 billion (€811 billion) over the next decade in the Republican budget resolution.
Their analysis of the response led to their conclusion that if Medicare, Medicaid and the Children’s Health Insurance Programme are, as promised, left untouched, then $381 billion becomes available and from that, only $135 billion can be targeted for potential cuts – far short of the $880 billion sought.
“This analysis from the non-partisan CBO confirms what we’ve been saying all along: Republicans are lying about their budget,” congressman Boyle said in a statement.
“Their plan would force the largest Medicaid cuts in American history – all to pay for more tax giveaways to billionaires. This is a complete betrayal of the middle class, and Democrats will keep fighting to stop them.
“The American people deserve to know just how much pain Republicans are willing to inflict on their own constituents to reward their billionaire donors.”
The issue gets to the heart of Trump’s spoken desire for “one big, beautiful bill” designed to achieve the ambition of chopping a total figure of $1.5 trillion in spending over the next decade.
Late last month, the framework for the budget bill narrowly passed through the House on a vote of 217-213. Every Democrat representative voted against it. Thomas Massie of Kentucky was the lone Republican to join them in voting it down, arguing that “even under the rosiest of scenarios” the framework will end up increasing the national federal debt by hundreds of billions a year.
“The only way they get to this magic thing where it’s not going to kill our country is that five years from now they imagine 2.5 per cent growth accumulates,” Massie said immediately after that vote.
People that are 200 years old are being sent cheques for social security – we are chasing that down
— Donald Trump
But Trump is adamant that the spending cuts can be achieved through the elimination of fraud and wasted spending, which has led to Elon Musk’s startling arrival on the Washington political scene.
Asked about the issue at his first cabinet meeting last month, the day after the budget resolution was passed, Trump replied: “I have said it so many times you shouldn’t be asking me that question ... We’re not gonna touch it. Now we are going to look for fraud. I’m sure you are okay with that – people who shouldn’t be on; people that are illegal aliens and others, and that’s with social security. When you see people that are 200 years old that are being sent cheques for social security – we are chasing that down and I’ve a feeling that Pam [Bondi, the attorney general] is going to do a very good job with that. But you’ve a lot of fraud. But, no, we’re not doing anything.”
Medicaid, has, since its inception during Lyndon Johnson’s administration, come to provide healthcare for 82 million Americans categorised as low-income. Within two decades, all states had joined the programme – Arizona was the last, in 1982.
The working people who built this country paid more into social security than millionaires and billionaires do
— Joe Biden, former US president
During his last state of the union address a year ago, Joe Biden, then president, had one of his more memorable moments by taking the Republican side of the House to task over the budget blueprint they had set out in the election year.
“If anyone here tries to cut social security, Medicare or raise the retirement age, I will stop you. The working people who built this country paid more into social security than millionaires and billionaires do. It’s not fair.”
The Republican budget plan allows for $4.5 trillion in tax cuts as well as increasing defence spending. And the basic maths and rationale as to how they will lower taxes while preserving public welfare programmes are coming under harsher scrutiny from the Democratic opposition.
Last month the Musk-created Department of Government Efficiency (DOGE) accessed the data systems for the Centers for Medicare and Medicaid Services, the beginning of its effort to identify the errant spending that has become central to the Trump administration’s fiscal policy. The Democrats are adamant it marks the beginning of the end for aid that tens of millions of Americans rely upon.
On Thursday, Tim Walz, Minnesota governor and Kamala Harris’s running mate in last year’s presidential election, said: “Donald Trump’s cuts to Medicaid will blow a massive hole in our state budget and leave thousands without care.
“There’s a storm coming from Washington.”
Republicans are adamant that all of this is just fearmongering from a Democratic movement that has lost its bearings and its message. Democrats are insistent that the Republican budget marks the beginning of the end of a crucial welfare health programme – and the beginning of a privatised replacement. Time will tell and the argument will grow louder.
