The Christian right wing wants to take money from the poor and give it to the rich — just what Jesus would do. Right?

This article discusses the “religious” right’s planned efforts to reduce federal debt by cutting healthcare for low-income individuals and the disabled, while diverting funds to wealthy individuals.

Is taking from the poor and giving to the rich what Jesus would do?

Revealed: The GOP’s ‘draconian’ strategy to cut Medicaid as Trump returns
REUTERS/Anna Rose Layden
Phil Galewitz, KFF Health News, January 13, 2025

Under President Joe Biden, Medicaid enrollment hit a record high, and the uninsured rate reached a record low.

Donald Trump’s return to the White House and a GOP-controlled Senate and House of Representatives are expected to change that.

Republicans in Washington say they plan to use funding cuts and regulatory changes to dramatically shrink Medicaid, the nearly $900-billion-a-year government health insurance program that, along with the related Children’s Health Insurance Program, serves about 79 million mostly low-income or disabled Americans.

The proposals include rolling back the Affordable Care Act’s expansion of Medicaid, which over the last 11 years added about 20 million low-income adultsto its rolls.

Trump has said he wants to drastically cut government spending, which may be necessary for Republicans to extend 2017 tax cuts that expire at the end of this year.

There are two problems with this notion:

1. There is no need to cut federal spending. Our Monetarily Sovereign federal government cannot run short of dollars. It has the unlimited ability to create new dollars, simply by touching computer keys. The federal debt never is a burden on the government or on taxpayers.
2. The Trump tax cuts primarily benefit the rich. Trump literally wishes to take from the poor and give to the rich.

The Republicans plan to take healthcare dollars from the poor or disabled and give those dollars to the rich.

Trump made little mention of Medicaid during the 2024 campaign. The first Trump administration approved work requirements in several states, though only Arkansas implemented theirs before a federal judge said it violated the law.

The “work requirements” rule assumes the poor or disabled are malingerers, who would rather stay home and live in poverty  than work. It is the sneering, superior attitude of those who have much toward those who have little.

House Budget Committee Chair Jodey Arrington (R-Texas) told KFF Health News that Medicaid and other federal entitlement programs need major changes to help cut the federal debt. “Without them, we will watch this country sadly enter into fiscal collapse.”

Conservatives have been preaching this false narrative about fiscal collapse since 1940. (See: “Historical BULLSHIT. Claims the Federal Debt Is a “Ticking Time Bomb”: From Sept. 26, 1940 to October 10, 2024″)

In 1940, the federal debt was $40 billion. Eightyfive years later, has risen to $35 trillion, and the economy is healthier than ever. No “fiscal collapse” in sight.

Rep. Chip Roy (R-Texas), a member of the Budget Committee, said Congress needs to explore cutting federal spending on Medicaid.

“You need wholesale reform on the health care front, which can include undoing a lot of the damage being done by the ACA and Obamacare,” Roy said. “Frankly, we could end up providing better service if we do it the right way.”

For eight years, Republican party has promised a “better” version of ACA. They use the word “reform” to describe cutting benefits.

Trump has long talked about making the ACA less expensive, but the question is less expensive for whom?

Trump’s past proposals would certainly have made the ACA less expensive for the federal government, but with the trade-off of higher out-of-pocket premiums for people, more uninsured, and higher spending and greater risk for states.

Advocates for poor people fear GOP funding cuts will leave more Americans without insurance, making it harder for them to get care.

Of course it will. Ironically, the poor voted for Trump.

“Medicaid is an obvious target for huge cuts,” said Joan Alker, executive director of Georgetown University’s Center for Children and Families. “An existential fight about Medicaid’s future likely lies ahead.”

Medicaid, which turns 60 in July, is nearing the end of a disruptive period, after COVID pandemic-era coverage protections expired in 2023 and all enrollees had to prove they still qualified.

The unwinding’s disruptions could pale in comparison to what happens in the next four years, said Matt Salo, former executive director and founder of the National Association of Medicaid Directors. “What we are going to see is an even bigger seismic shift in who Medicaid covers and how it operates,” he said.

But Salo said any efforts to shrink the program will face pushback.

“A lot of powerful entities — state governments, managed-care organizations, long-term care providers, and everyone under the sun who wants to do well by doing good — wants to see Medicaid work efficiently and be adequately funded,” he said. “And they will be highly motivated to push back on something they see as draconian cuts, because it could affect their business model.”

The GOP is looking at several tactics to reduce the size of Medicaid: Shifting to block grants. Switching to annual block grants could lower federal funding for states to operate the program while giving states more discretion over how to spend the money.

There is no magic to block grants. Money for Medicaid must come from somewhere. The federal government, being Monetarily Sovereign, has the infinite ability to create dollars without levying taxes.

The monetarily non-sovereign states do not have this power. Who should pay, the infinitely rich federal government or the perpetually strapped states?

If giving block grants saves the federal government money, what will the states do? Answer: Cut Medicaid. They will have no options because they will have less money to work with.

Currently, the government matches a certain percentage of state spending each year with no cap. Republican presidents since Ronald Reagan have sought to block-grant Medicaid with no success.

Arrington said he favors ending the open-ended federal funding to states and replacing it with a set annual amount based on how many people each state has in the program.

The sole purposes are to force the states and state taxpayers to pay more, and ultimately, to force the poor and disabled to receive less care.

The poor or disabled either will have to do without health care, or somehow buy coverage from private insurance companies, owned and managed by the rich. Either way, the rich win and the poor lose — the perfect Republican formula.

Cutting ACA Medicaid funding.

The ACA provided financing to cover, through Medicaid, Americans with incomes up to 138% of the federal poverty level, or $20,783 for an individual last year.

The federal government pays 90% of the cost for adults covered through the law’s Medicaid expansion, which 40 states and Washington, D.C., have adopted.

Even with the federal government paying 90% of the cost, ten Republican states have opted out of the ACA expansion. In the 10 states that didn’t expand Medicaid, 1.6M can’t afford health insurance. The majority of residents in this coverage gap are people of color, an analysis found.

Opting out has cost the states billions of dollars, not only in federal dollars, but in savings:

1. Expanding eligibility allows states to cut spending in other parts of their Medicaid programs.
2. It allows states to cut spending outside of Medicaid — particularly on state-funded health services for the uninsured.
3. Finally, expansion may increase state revenues due to taxes related to Medicaid expansion or taxes on the increased economic activity it triggers.

A report from the Commonwealth Fund estimated that states not expanding Medicaid could collectively have lost out on more than $7 billion in 2020 alone.

Nine of those ten states voted for Trump in the past election. The lesson: You get what you vote for.

During the first Trump term, federal courts ruled that Medicaid law doesn’t allow coverage to be conditioned on enrollees’ working or seeking jobs.

But the GOP may try again. “If we can get strict work requirements on able-bodied adults, that can be a huge cost savings by itself,” Rep. Tom McClintock (R-Calif.) told KFF Health News.

Because most Medicaid enrollees already work, go to school, or serve as caregivers, critics say such a requirement would simply add red tape to obtaining coverage, with little impact on employment.

If the GOP’s plans to shrink Medicaid are realized, Democrats and health experts say low-income people forced to buy private insurance would face challenges paying monthly premiums and the large copayments and deductibles common to commercial plans that typically don’t exist in Medicaid.

He said the GOP will look to scale back Medicaid to its “traditional” populations of children, pregnant women, and people with disabilities. “We need to rebalance the program that most people think is underperforming,” he said.

Most Americans, including large majorities of both Republicans and Democrats, view the program favorably, according to polls.

“Rebalance” is another GOP synonym for “cut benefits for the needy and create new benefits for the wealthy.”

Rodger Malcolm Mitchell

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