Greg Sargent: This is The Daily Blast from The New Republic, produced and presented by the DSR network. I’m your host, Greg Sargent.
Michael Linden: Thank you very much for having me, Greg.
JD Vance (audio voiceover): We know what the president United States made a promise, a sacred promise, that the only people who are going to lose access to health care are illegal aliens who shouldn’t be in this country to begin with. Because I happen to believe that Medicaid belongs to American workers and American families. I happen to believe that when you are struggling in this country, we’re generous people and we want to help you. But we want to help the people who have the legal right to be in the United States of America. So it’s not about kicking people off the health care. It’s about kicking illegal aliens the hell out of this country so that we can preserve health care for the American families who need it.
Linden: Yes. And it’s important to understand that what the vice president said was completely false, just straight=up false. The bill cuts, as you said, $1 trillion from Medicaid. It does so in a couple of very specific ways. The most important ones are it imposes new requirements for existing recipients on how to make themselves eligible every six months based on a whole set of new requirements, new paperwork. That’s going to kick millions of eligible Americans off the bill. It also limits the ways that states can finance Medicaid. Medicaid is a federal and state partnership. Both the states and federal government put money into Medicaid. This bill actually makes it harder for states to do that and shifts more of the costs onto states at the same time.
Sargent: We will get to that in a second. I want to talk about the rural hospitals component of this. A big part of this bill is going to be the impact it has on those. They’re already in very rough shape. Let’s recap what some local newscasts are saying. One in Kentucky says that 35 hospitals could close. One in Mississippi says the bill’s cuts are putting 11 nursing homes at risk of closing. One in Louisiana says cuts to food stamp programs feeding half a million poor families are facing cuts. In Texas, more rural hospitals are at risk of closing. There’s just tons more like that. Can you give us the overview of why that particular thing is happening and what the human toll of that is really going to be going forward?
Sargent: And in rural America in particular, right? Can you talk a little bit about why that’s important? One of the big reasons rural America is suffering right now is the state of their rural hospitals. So this goes directly to the jugular here on something that’s already making life hard in these places and makes it worse, doesn’t it? People are going to die, right?
Sargent: So in his speech JD Vance addresses the bills threats to rural hospitals. Listen to this.
Sargent: Note again the ugly demagoguery about undocumented immigrants. He’s actually saying pretty much straight out, Hey, Trump voters, don’t think about what you’re hearing about this bill’s impact on you. Think instead about how many undocumented immigrants are going to get hurt. It’s just beyond disgusting. Your thoughts on that part of it?
Sargent: Let’s talk about the distributive consequences because I think that’s what you’re getting at there. The benefits such as they are that will go to working people will be in the form of pretty minuscule tax cut, which gets extended for those people. But at the same time, the bill cuts taxes enormously for people at the very top of the income spectrum. And then on top of that, if you put together all the features—the health care cuts, the cuts to food stamps and other safety net programs, plus the array of tax cuts mostly benefiting the wealthy—what you get overall is a large redistribution of wealth upward. Can you talk about that?
And that is, by the way, the way that most Americans see it. And it is the reason why JD Vance is out there lying about the bill, because they know this is a massive vulnerability for them. This is the worst thing that could happen for them: that the American people understand that they’ve been betrayed.
Reporter (audio voiceover): There was a nonpartisan Congressional Budget Office report that came out last week showing that the bottom 10 percent, the poorest Americans, would lose about $1,200 a year on their income while the top 10 percent would add about $13,000 annually to their income. Can you justify for those poorest Americans those differences?
Sargent: This is the thing. They can’t paper over the basic distributive consequences of this bill. They can’t paper over what the purpose of the bill actually is. And I think the almost desperate sounding floating of weird tropes about undocumented immigrants really gets at the core of that. They really, really need an argument to distract their own voters from what this bill is actually going to do to them.
Sargent: That’s such a good point, especially this idea that you get this enormous amount of money from just cutting benefits to a few undocumented immigrants. That’s what really shows how insultingly stupid the lies are here.
It’s very difficult to understand why Donald Trump and JD Vance and the Republican Party decided after an election that was all about the cost of living—and where, as you said, they won working-class people by some metrics—they would decide to directly attack those same people and raise their costs in the service of tax cuts for billionaires. But that is what they did. And it is the long-standing Republican policy of cutting taxes for rich people and paying for it by making everybody else pay more. The so-called populist wing of the Republican Party was nowhere to be seen in this particular fight. And I think they’re going to pay the price for it.
Linden: Absolutely. I think what you’re going to see is a combination of both of those things where Democrats will point to every failure of the health care system that we are about to see over the next year and attribute it, correctly in my view, to this bill. At the end of the day, this was a health care reform bill. Dr. Oz said it: They bought it, they broke it, they own it. And so if the American people are unhappy with the cost of health care over the next year, if they lose their coverage, if their hospital closes, if a clinic shuts down or has fewer hours, all of that is attributable to the Republican tax scam. Plus, we have an incredibly unpopular set of tax policies that overwhelmingly help the rich when everybody else is feeling really strapped. So you put those two things together, and that’s got to be the core argument over the next year.
They have a huge vulnerability. So Democrats do need to keep talking about it. The biggest challenge that we have—we know this—is that most Americans have busy lives and they’re just trying to make it one day at a time. And they need to hear about this bill. The dots need to be connected.
Linden: Right. So as soon as this fall, 20 million people who get their health insurance through the exchanges are going to see higher premiums because this bill made changes to the Affordable Care Act and deliberately allowed an expansion of the tax credits for that health insurance to expire. So 20 million Americans are going to see their premiums go up this fall as they renew their health care for next year. So that’s a pretty big impact right away. That’s just your costs go up. Hospitals and clinics, as you’ve already said, are going to start closing even in advance of those Medicaid changes. These are businesses that have to look several years in the future. They’re not looking just in the next three days. They’re looking next three months, three years. So that’s going to start happening. And there are going to be effects on the health care system that we can’t predict. You pull $ 1 trillion out of the health care system, people are going to make changes that we can’t exactly predict now. So I think there’s going to be a lot of upheaval.
Sargent: A lot will be on Democrats here to make sure aloof voters are focused on that.
Sargent: Well, that’s exactly the most important component of this that has to be nailed down. And Senator Jon Ossoff of Georgia actually took a stab at saying something like this before JD Vance’s speech. Listen to this.
Sargent: That was pretty strong stuff, Michael. What do you think? It seems almost like that’s a pretty good template for how to do this.
Sargent: Well, Democrats have a very good argument. Now they just have to make it. Michael Linden, fascinating stuff, man. Thanks so much for coming on.
Linden: Thank you.
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