Related Articles
If President Donald Trump’s tax bill becomes law, millions of people are expected to lose access to Medicaid, the government insurance program for low-income and disabled Americans.
House Speaker Mike Johnson (R-La.) doesn’t feel bad for them — and has argued, in fact, that stripping their health care is the “moral” thing to do. Johnson’s message to these millions of people on Tuesday was to insult them. “For heaven’s sake, do something constructive,” he said at a press conference on Capitol Hill, arguing the legislation simply brings “common sense” to the Medicaid program.
Trump’s “Big Beautiful Bill” would authorize another round of tax cuts for the rich — and it would be financed, in part, with sweeping cuts to Medicaid.
Some of these savings would be achieved by imposing work requirements on all supposedly “able-bodied” adults on Medicaid under the age of 65, demanding they either work or volunteer at least 20 hours a week. Medicaid contains strict income caps mandating that recipients earn little money — so the new work requirements are effectively a demand that recipients toil in low-wage jobs in order to maintain their health insurance.
According to the nonpartisan Congressional Budget Office, the legislation will force 10.3 million people off Medicaid, primarily due to the new work requirements.
“If you’re going to be on the public wagon and you’re able, you should try to help pull it,” Johnson said Tuesday. “All we did was put in there, as you all know, a 20-hour work requirement per week,” he continued, expressing shock that anyone might quibble with this. “Give me a break. They’re complaining about that. You either have to be working, you have to be looking for a job, in a job training program, or volunteering in your community. For heaven’s sake, do something constructive.”
In reality, many people on Medicaid cannot work but have not been approved for disability payments; they would lose coverage under the legislation. The same goes for people on Medicaid who act as caregivers for relatives or friends. But these are not the only people likely to lose coverage under the bill. Most people on Medicaid already do, in fact, work — and they, too, could lose their insurance as a result of the bill’s passage.
That’s because the work requirements would add more red tape and paperwork demands to a program that already sees eligible beneficiaries frequently lose their coverage for administrative reasons. When states conduct checks on people’s income levels — to ensure they remain poor enough to qualify — the process often results in people losing coverage if they fail to respond to a piece of mail or phone call, not because they are suddenly ineligible.
The Big Beautiful Bill additionally attempts to ensure that people who lose coverage due to the work requirements cannot afford to buy individual health insurance plans on their state marketplaces. The bill would make these people ineligible for subsidized coverage; given that these plans often have expensive premiums, they would likely become uninsured.
Johnson on Tuesday reiterated his past talking point that Republicans “are not cutting Medicaid,” but rather “strengthening the program for the people who are the most vulnerable populations who really rely upon that.”
That is, however, not the point of the Big Beautiful Bill, which would redistribute even more wealth from the poor to the very wealthiest Americans. The point is to make sure America’s meager safety net barely exists at all.
