There’s a new and important problem facing Republicans as they seek to hammer Medicaid yet again, as I explained at New York:
In the long Paul Ryan era of Republican budget-cutting efforts (when Ryan was House Budget Committee chairman and then House Speaker), Medicaid was always on the chopping block. And when the program became a key element of Democratic efforts to expand health-care coverage in the Affordable Care Act sponsored by Republicans’ top enemy, Barack Obama, Medicaid’s status as the program tea-party Republicans wanted to kill most rose into the stratosphere. No wonder that the last time the GOP had a governing trifecta, in 2017, there was no single “big beautiful bill” to implement Trump’s entire agenda, but instead an initial drive to “repeal and replace Obamacare” along with measures to deeply and permanently cut Medicaid. Rolling back health coverage for those people was Job One.
So now that Trump has returned to office with another trifecta in Congress, an alleged mandate, and a big head of steam that has overcome every inhibition based on politics, the law, or the Constitution, you’d figure that among the massive federal cuts being pursued through every avenue imaginable, deep Medicaid cuts would be the ultimate no-brainer for Republicans. Indeed, the budgetary arithmetic of Trump’s agenda all but demands big Medicaid “savings,” which is why the House budget resolution being implemented right now calls for cuts in the neighborhood of $600–$800 billion. And it’s clear that the very powerful House Freedom Caucus, thought to be especially near and dear to the president’s heart, is rabid for big Medicaid cuts.
To be sure, the extremely narrow GOP margin in the House means that so-called “moderate” Republicans (really just Republicans in marginal districts) who are chary of big Medicaid cuts are one source of intraparty pushback on this subject. But the shocking and arguably more important dynamic is that some of Trump’s most intense MAGA backers are pushing back too. OG Trump adviser Stephen Bannon issued a warning in February, as The New Republic’s Edith Olmsted reported:
“Steve Bannon, former architect of the MAGA movement turned podcaster, warned that Republicans making cuts to Medicaid would affect members of Donald Trump’s fan club.
“On the Thursday episode of War Room, while gushing over massive government spending cuts, Bannon warned that cutting Medicaid specifically would prove unpopular among the working-class members of Trump’s base, who make up some of the 80 million people who get their health care through that program.
“’Medicaid, you got to be careful, because a lot of MAGA’s on Medicaid. I’m telling you, if you don’t think so, you are deeeeeead wrong,’ Bannon said. ‘Medicaid is going to be a complicated one. Just can’t take a meat ax to it, although I would love to.’”
Bannon didn’t comment on the irony that it was the hated Obamacare that extended Medicaid eligibility deep into the MAGA ranks (with voters in deep-red Idaho, Missouri, Nebraska, Oklahoma, and Utah insisting on taking advantage of it), making it a dangerous target for GOP cuts. But in any event, particularly given Trump’s occasional promises that he’d leave Medicaid alone (which didn’t keep him from supporting the deep 2017 cuts), there existed some MAGA sentiment for finding “savings” elsewhere.
The volume of this sentiment went up sharply when one of the flavor-of-the-year right-wing “influencers,” Trump buddy Laura Loomer (reportedly fresh from laying waste to the National Security Council staff) went after a conservative think-tanker who was advising HFC types on how to savage Medicaid, per Politico:
“In a social media post Monday, Loomer called Brian Blase, the president of Paragon Health Institute, a ‘RINO Saboteur’ for helping draft a letter circulated by 20 House conservatives that advocated for deep cuts to Medicaid in the GOP’s domestic policy megabill.
“’In a shocking betrayal of President Donald Trump’s unwavering commitment to America’s working-class families, and his promise to protect Medicaid, [Brian Blase] … is spearheading a dangerous campaign to undermine the Republican Party’s midterm prospects,’ Loomer said on X.”
Loomer’s blast at Blase was clearly a shot across the bow of the House Freedom Caucus and other Republicans who are lusting for Medicaid cuts and/or are focused on deficit reduction as a major goal. She called Medicaid “a program critical to the heartland voters who propelled Donald Trump to his election victories” and warned that Medicaid cuts could badly damage Republicans in the 2026 midterms.
The perpetually shrewd health-care analyst Jonathan Cohn thinks MAGA ambivalence about Medicaid cuts could be a game-changer. After citing data from Trump’s own pollster showing support for Medicaid among Trump supporters, Cohn noted this could have an impact in Congress:
“Trump himself has said he is going to protect Medicaid — although, as is always the case, it’s hard to know exactly what he means, how seriously he means it, or how much thought he has even given to the matter.
“But Trump’s own uncertainty here is telling, just like the pushback to Medicaid cuts from the likes of Loomer. Together they are a sign of just how much the politics around government health care programs has changed in the last few years — and why this piece of Trump’s big, beautiful bill is proving so tough to pass.”
It wouldn’t be that surprising if there’s a thunderbolt from the White House on this subject before the House budget reconciliation bill is finalized. If there isn’t, nervous House Republicans may be forced to read his ever-changing mind.
The parts of the memo that are really important need to be highlighted. It could use an executive summary. Otherwise the more original arguments (even if they are rethreads) get obscured by the more well known ones that have been debated endlessly.
These are the key insights (imo):
1. The political views of white workers were dramatically transformed by Donald Trump’s election in
2016. It is vital to understand the change that has occurred. … Since Trump’s campaign and election in 2016, however, circumstances have profoundly changed –and changed in a way that has shifted the political terrain dramatically against the Democrats. The difference can be stated simply: when white construction workers now sit around for lunch and the conversation turns to politics, Trump now completely defines and shapes the conversation. Every discussion quickly becomes framed in terms of what they agree with or disagree with about what Trump has done and said. They may have a range of opinions about specific policies and issues, but it is always Trump and his actions that defines the terms of the debate. (p.22-23 -talk about burying the lede-)
2. A key difference between the modern white working class conception and the traditional radical
view is that white working people do not visualize a single dominant “ruling class” or “power elite”
above them but rather see three different and distinct groups, none of which totally dominates
society but each of which in one way or another mistreats them and holds them in contempt. … The first group is the political class…The second group is the “Wall Street” financial elite…The final group is the “liberal” elite (p.24)
3. It is notable that none of the key distinctions indicated above between extremists and cultural traditionalists involve opinions on specific political issues. Instead, they deal with differences in basic social values like tolerance, compassion, empathy and open-mindedness and personal characteristics like psychological rigidity and obsessiveness. While these characteristics are resistant to change, they clearly divide the white working class into distinct sectors that are more and less persuadable. (p.6)
4. White workers in the groups very un-self-consciously expressed an old-fashioned “I have a dream”
philosophy about race – a philosophy that is now often viewed by progressives as naïve. … This feeling is expressed most clearly in disgust with “political correctness,” which they see as an attempt to impose upon them values with which they do not agree. Unlike conservatives, a number of participants in the groups admitted that over the years, they had gradually come to recognize that the biased cultural attitudes regarding African Americans that they’d held in the past were wrong and needed to change.
(p.11-12)
5. Progressives cannot assume that they can detach white workers’ displays of tolerance (of which they approve) from these workers’ cultural traditionalism (of which progressives do not approve and wish they would discard). Culturally Traditional white workers’ basic mental frameworks cannot be taken apart and reassembled at will. (A) progressive Democratic candidate who tries to run a campaign based on an elegantly detailed agenda of issues and policies but who cannot communicate a personal connection and emotional identification with the culture of the voters he or she seeks to represent will rarely succeed. (p.13-14)
6. (T)hey described politicians not simply as sometimes individually corrupt but as part of an inherently and irredeemably corrupt system that requires politicians to sell themselves to special-interest contributors to get elected, and who inevitably use their position to become wealthy. They further perceive all politicians as living in an insular and elite artificial world of wealth and influence-peddling.
They noted, in fact, that this perception was so strong that it represented “a new form of class consciousness.” (N)ever vote for the Democratic politicians who promise to enact them. The mystery disappears when it is understood that white working people tend to see Democrats as just as corrupted by the political system as Republicans are. (p.16-17)
7. Measures that Democrats themselves consider entirely altruistic policies to help not only the poor and needy but white working-class people as well are seen by white workers as cynical electoral bribery to buy mostly minority votes. (p.17)
8. When conservatives express broad generalizations about “welfare queens and Cadillacs,” it is
reasonable for progressives to dismiss such statements as urban legends that mask simple prejudice. But the anecdotes offered in the focus groups were entirely different; they were highly detailed and specific stories of people-white people-who the participants knew personally, and who were frequently their own white neighbors and relatives. It was, in fact, precisely the very clear, detailed, and vivid personal knowledge they demonstrated about such people taking advantage of the system that formed the basis for their intense anger. (p.18)
9. This same distinction between fairness and unfairness also appeared in the participants’ attitudes toward the wealthy. On the one hand, there was no antagonism for people who become wealthy through business success, and virtually no support for abstract “income redistribution” or punitively taxing the rich as a matter of basic social justice. But at the same time, there was a deep anger at the way the wealthy manipulated the system to pay lower taxes than ordinary workers or otherwise game the system to their advantage. There was also a feeling that the rich had become increasingly separated from and indifferent to those below. (p.18)
10. The participants supplemented these general views with specific ideas: that candidates should
live on their government salary and reject all other income, and that they should come from and
live in the very same community that elected them. … It is important to notice that this distinctive, personal-character-based set of criteria describe a candidate who is profoundly different from many of the “blue dog” Democrats that progressives quite reasonably scorn. Such candidates pander to conservative hot-button issues to win votes, while at the same time do not seriously defend workers’ economic interests but rather take money from special interests and make no effort to reduce the influence of big money in politics. (p.19)
I haven’t read the entire paper. But I totally agree with the premise. I have family in Ohio – white working class. They are not fire breathing extremists. They just feel that they work hard and play by the rules but just can’t get ahead. They feel that the system is stacked against them and no one cares. Culturally they are more aligned with the GOP but that’s not really what motivates them. They vote for the GOP in hopes that they will shake things up. Things like free college tuition or cancelling student debt has no relevance. At the same time, I’m not really sure what can be done to help in this global, knowledge based economy.
Levison’s argument is sound. I fear it will fall on deaf ears.
It has the advantage of not being as belligerent as many of Teixeira’s recent posts.