Republicans vote to take healthcare away from upwards of 10 million people to pay for a fraction of upper-class and corporate tax cuts

The latest iteration of Republican immorality:

The bill makes major changes to reduce the cost of the health insurance program for the poor and disabled. The centerpiece of those efforts is a strict work requirement for childless adults without disabilities, which would require beneficiaries to document 80 hours of monthly work, or prove they qualified for an exception, or else risk losing their benefits. Those new rules would have to take effect by the end of 2026, after the next midterm election, though states could opt to adopt them sooner.

House leaders moved up the implementation date, originally slated for 2029, at the behest of fiscal hawks who demanded larger cuts. But the new timetable may be hard for some states to hit.

More immediately, the legislation would make it easier for states to cancel people’s coverage by allowing them to increase paperwork requirements and drop those who don’t respond to requests to verify their income or residency. It also would require states to impose co-payments for a wide array of medical services for adults on Medicaid who live above the poverty line, a policy some Democrats described as a “sick tax.”

Another provision would reduce Medicaid funding to states that use their own tax revenues to provide health coverage to undocumented immigrants, a change that could affect financing for 12 mostly Democratic-controlled states. The legislation would bar Medicaid from providing funding to Planned Parenthood as long as the organization continued to provide abortions, and would bar Medicaid from covering gender affirming health care to any beneficiaries. And the bill would limit strategies that states have developed to tax medical providers and pay them higher prices for Medicaid services.

Before the last-minute changes, the Congressional Budget Office estimated that the Medicaid changes would cause 7.6 million more Americans to be uninsured at the end of a decade, while reducing federal spending on health care by more than $800 billion. That estimate will be updated as the office continues to analyze the final bill text.

All these changes are going to push that 7.6 million up substantially. The new paperwork requirements in particular will allow Republican states who were forced to take the Medicaid expansion by the voters or Democratic governors to deny people coverage with red tape. The direction of travel has indeed been set! (And I guarantee that if Josh Hawley’s vote means anything he’ll provide it.)

The bottom line is that there has been no party realignment, despite some changing demographics within the coalitions. Trump is just an orthodox-innovator in the Reagan regime, and the theory that the Republican coalition become more socioeconomically diverse would moderate their ecomomic policy is transparently wrong:

This is not heterodoxy. It's very normal, if unusually crude and economically illiterate, Republican fiscal policymaking pic.twitter.com/z2ULp3kuMr— dylan matthews (@dylanmatt) May 21, 2025

But Steve Bannon’s podcast something something.