Making America Sick Again

With the introduction of its proposed budget, the Trump Administration has continued its effort to cut the ground out from under all but the wealthiest Americans–and especially from under the people who voted for Trump.

Fortunately, that budget displays the stunning ineptitude that is a hallmark of this Administration (Hey–what’s a two trillion dollar math mistake among friends..?) and is unlikely to pass.

We often hear exhortations to “follow the money,” or to “put your money where your mouth is.” Those phrases reflect an undeniable truth of human behavior: whatever our rhetoric, where we commit our resources shows our real priorities.  Trump’s budget not only makes his priorities painfully clear; it reflects his callous disregard for struggling Americans, including those who voted for him.

Time Magazine has detailed the consequences of the savage Medicaid cuts proposed by the Trump budget. Nearly one in four Americans–and 42 percent of Trump voters– rely on Medicaid. The budget assumes passage of the deeply unpopular Obamacare replacement passed by the House and currently pending in the Senate; that measure–which the CBO calculates would cost 23 million Americans their health insurance– cuts Medicaid funding by $839 billion over the next decade. The budget proposal reduces Medicaid by an additional $610 billion.

Those cuts endanger medical access for 74 million Americans.

Medicaid reaches far beyond able-bodied adults out of work, despite the proposal’s rhetoric. The elderly and disabled account for around 60% of Medicaid’s expenditures, with the disabled, including the mentally ill, accounting for a full 42% of spending.

The program is the country’s largest funder of long-term care expenses, covering 40% of the costs, as well as more than 60% of all nursing home residents. For Baby Boomers nearing or past retirement age, these funds are crucial: As MONEY has previously reported, nursing homes for the elderly cost an average of $80,000 annually, and those expenditures aren’t covered under Medicare, the health program for seniors over 65. In fact, because Medicaid absorbs high healthcare costs of people with expensive conditions like dementia, it has kept private insurance around 7% lower than they would be.

Slashing funds also disproportionately affects women and children: one-half of births in the U.S. are covered by Medicaid (that varies widely by state—in Louisiana, 65% of births are covered by Medicaid, according to the Kaiser Family Foundation). The Children’s Health Insurance Program, which covered more than 8.4 million children in 2015, would also see its budget significantly reduced, according to Joan Alker, Executive Director of the Georgetown Center for Children and Families. Medicaid also provides essential health coverage for low income women, particularly women (and children) of color.

And of course, the budget continues the Republican war on women and women’s health by defunding Planned Parenthood–effectively eliminating preventive care (pap tests, breast cancer screenings) for most poor women.

Pointing to the cruelty of this proposal is unlikely to move lawmakers for whom tax cuts for rich people are the highest priority, but you would think they might realize that such a wholesale assault on access to preventive care would wildly increase overall medical costs. (The old adage “penny wise, pound foolish, comes to mind.) Trump’s budget would throw people back to the tender mercies of the emergency room, return us to the days when medical costs and nursing home fees bankrupted families, and ensconce a system in which healthcare is simply a consumer good, available to those who can afford it and too bad for the rest of you.

Destroying Obamacare and slashing Medicaid aren’t even the end of the story: the proposed budget also “severely cuts funding for science and public health agencies, including a $1 billion cut to the National Cancer Institute.”

Notably, the National Institute of Health’s budget would be slashed from $31.8 billion to $26 billion. The Center for Disease Control and Prevention would face cuts of more than $1 billion, including a $222 million decrease in funding to the chronic disease prevention programs, which help people with conditions like diabetes, heart disease, and obesity.The National Science Foundation would face a decrease of $776 million.

Welcome to dystopia.


  1. The fact that none of this squares with Trump’s campaign promises and rhetoric should open his supporters eyes, but it probably won’t even register with them until they are personally faced with health or medical emergency.

  2. There appears to be no end to the savage greed of the republicans. We cannot just blame this all on trump. Members of Congress and the red governors and legislatures are all part of this hatred of their fellow citizens.

  3. Until a majority of Americans understand that profit has no place in health care we will continue to pay more for less and still be at the mercy of politicians and corporations for our well being.

  4. Nancy: “There appears to be no end to the savage greed of the republicans.”

    Marvel at the shitzpah of GOPs who come to the microphones and telecameras and whine like welfare queens about a budget that does not slash “entitlements” enough. Of course they must chant this mantra in order to constipate the airwaves thereby precluding space for sane discussion about the need for more revenue through tax reform.
    The latest rant is about corporations that will take away their jobs, jobs, jobs and go to other countries for more favorable tax rates. It’s the “fear of insecurity mantra”. Believe it??
    And for the rest of us….”No bread? Let them eat cake!”

  5. Democrates have to reconsider their strategy about politics, political power and how to reach and motivate voters. That republicans aim for a small government, 19 century confederate style is no news. The way Fox News manipulates facts is also well known, where is the moral counterbalance?
    I hope the good thing about Trump is he urges all men of good will and reason, to think about the meaning of life and the basis of civilization: we are our brothers keeper.
    Listen on YouTube to the speech of the mayor of New Orleans on the occasion of the removal of the statue of general Lee and after that the Fox News comment.

  6. Although it is now clear where 45’s loyalties lie, his supporters still won’t care. He’ll keep going out and lying to them and they will eat it up. Fortunately for them, this budget won’t pass. Unfortunately, much of this budget is the Republican dream come true and the appropriations bills will reflect large parts of it.

  7. Republican candidate charged with assault after ‘body-slamming’ Guardian reporter. Audio of Greg Gianforte attacking Ben Jacobs corroborated by Fox News journalists in the room, who described candidate ‘slamming him to the ground’ Gianforte grabbed Jacobs by the neck with both hands and slammed him into the ground behind him. Faith, Keith and I watched in disbelief as Gianforte then began punching the reporter. As Gianforte moved on top of Jacobs, he began yelling something to the effect of, “I’m sick and tired of this!”

    Now for the spin: “It’s unfortunate that this aggressive behavior from a liberal journalist created this scene at our campaign volunteer BBQ.”
    It seems rather evident the Trump Budget, the Ryan-Trump Healthcare Plan is a giant body slam to the 99%.

  8. Louie, he should have been arrested for assault and forced to post bail until a hearing is held. Anyone else would have been arrested. This is SO wrong! It will be even more wrong if the citizens elect him, yet I wouldn’t be surprised.

  9. Mississippi state representative Karl Oliver wrote on Facebook that people who supported the removal of Confederate memorials “should be LYNCHED”. “If the, and I use this term extremely loosely, ‘leadership’ of Louisiana wishes to, in a Nazi-ish fashion, burn books or destroy historical monuments of OUR HISTORY, they should be LYNCHED!” Oliver wrote in a Facebook post Saturday evening.

    Oliver has a defender: “He’s a true Southern gentleman and a Christian, and he’s speaking his convictions,” Harrison said. “And most everybody here, they wanted him elected because he would stand on his convictions.”
    It seems obvious to me the glorification in monuments of the Confederate generals and politicians, that fighting for slavery was a righteous cause. You do not erect monuments to the villains of history. The racist attitudes that we all know lingered on but was subject to “code words” has now emerged from the swamp.

  10. Learning of the Trump budget brings to mind the question, ” have Republicans given up on ..of the people, by the people, and for the people?” It certainly looks that way, as they sure have given up on the American Dream applying to ALL Americans.

  11. The fundamental question is “What is government for?” Is it only to further enrich the already rich or does it have some responsibility to its citizens in general with programs like SNAP and Medicare? Are South Bend, Indianapolis, Evansville et al. to look like Calcutta with the starving, dead and dying people on the sidewalks?
    It is the poor and middle class members who serve in our military to protect the tangible and intellectual properties of the rich and corporate class; when are those so protected going to protect the poor and middle class who provide such protection? A march on Memorial Day with waving flags is no substitute for fair sharing of the economy’s income and living wages for all, and indeed I am beginning to think that such outpouring of patriotism is designed to deflect our attention from such economic abuse. I am ready to now reverse Kennedy’s famous speech and instead ask “what our country can do for us” which, per Republican policy, is nothing.

  12. Bravo Gerald Stinson, bravo!!

    I have been fortunate to have worked directly with the special needs community for nearly two decades in regard to support issues via my position at Riley Hospital for Children at IU Health. What I am seeing is a concerted plan by the Republicans in the Congress and Trump’s screwball OMB Director to directly attack these folks and their children as they basically attack the rest of us through the imposition of this cruel and heartless budget proposal. They will destroy the always tenuous financial situations these folks all have to deal with on top of the very obvious emotional combat they also have to face daily. All of the rest of us will face the same kind of hardships if what these total fools propose to do comes to pass by us standing back and do nothing.

    The American people, all of us, simply cannot allow this to be done to us, period. We cannot be just spectators and roll over and accept what these cretins want to do to us. We have to get them out of office at the earliest opportunity and also take to task the shadowy cash cows, like the Koch brothers, that want to impose this terribly draconian future on all of us, as if they have thee right to do such a thing. Voting is obviously at the core of this but if it ends up requiring more than that in terms of public action then we need to be willing to step up to this incredible challenge to what this country is supposed to stand for and what our elected leaders are supposed to be done for us and bring it down and stop these wretched ideas and those that push them down as well. Enough is enough!!!

  13. People get sick and have accidents, probably more so poor people than wealthy people. People have families they will take care of no matter what they have to do.

    Most of us start off adult life poor but with prospects.

    Of course wealthy people really don’t need insurance. At some level of wealth the least expensive option is self funded health care unless you can get someone else to pay for it which is most often the case for them.

    So the Republican coup is attempting to deprive only those who need it something that they will get one way or another.

    ACA got those people to pay as much as they could afford for their health care.

    If the accounting was accurate, which it never is, the Republican proposal saves nobody anything yet creates extreme emotional resentment among probably a majority of the country’s population.

    If it survives it moves the country much closer to an unstable third world banana republic.

  14. Daleb’s comment at the top today is IMO, unfortunately, exactly right.

    It appears to me a large number of those who voted for Trump, and who will be hurt the most by his “proposed” cuts to Medicaid in his budget and by the TrumpCare repeal of Obamacare, aren’t paying attention to and are in total denial about the fact they are the ones who are going to be screwed by him and the Republican junta in Congress. In fact, it appears many avid Trumpites are currently doubling down on their support of the Great Orange Buffoon-In-Chief in response to the media’s and the rest of the country’s criticism and revulsion at what he and his Republican fellow travelers are trying to do mainly TO THEM: “Just give him a chance.” “Get over it, you lost the election.” Etc.

    It seems to me their continued support and seemingly incredulous belief Trump wants to and will help them is likely rooted in the same universal human emotional reaction and results in the same response that telling your intelligent, college educated, employed at a good job daughter that her live-in, high school dropout, chronically unemployed, sponging off her, drug abuser, emotionally abusive “boyfriend” is a loser and she should dump him does. Those who read the newspaper advice columns know that type of parental criticism and harping usually results in the daughter jumping to the defense of and sticking with her loser boyfriend until she reaches that same conclusion on her own; usually as the result of something truly bad happening.

    As Daleb points out, I think many of the Trump supporters only will — if ever — reach that conclusion for themselves until they are faced with the actual reality that they, and millions of others in this Country, no longer have medical insurance or Medicaid assistance for themselves or their families. Not to speak of all the other havoc that passage of Trump’s Budget would cause.

    If that is the case, perversely, the best thing Trump and the Republicans in Congress could do at this point to enhance the prospects for the Democrats regaining control of both the House and Senate in the 2018 Congressional elections would be for them to actually pass the present TrumpCare bill and Trump’s proposed budget as is. The ensuing “train wreck, although not a guarantee given the gerrymandering creating so many “safe” Republican Congressional districts — would greatly increase the odds the Democrats could regain control of both the House and Senate in 2018. And for better or worse for the Democrats’ prospects in 2018, that’s why the some of the somewhat more rational (I use the word advisedly) Republicans in the Senate have treated the House’s Trumpcare bill as radioactive toxic waste, and will likely do the much same with Trump’s proposed budget.

  15. This is one more bit of proof that Trump got elected by out lying both his Republican and Democratic opponents.

    What does this say about future elections and America’s global reputation?

  16. Thank you for making the point that making poor people sicker and without insurance makes insurance more expensive for everyone else. Cost-shifting to the insured is what every hospital does to pay the bills for the emergency room patients who have no other options and show up when their symptoms are more severe and costly to remedy. It’s the most costly and least effective way to dispense health care. When will we ever learn?

  17. One explanation for this callous disregard of the voting block that put them in office is that they don’t expect to be held accountable for their actions next election. How to reverse that expectation?

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