For decades, the Republican Party has been hellbent on cutting Medicaid and Medicare in addition to Social Security and other social safety net programs.
Its leaders have been obsessively driven by the idea of getting government out of health care—fantasizing about slashing programs—and handing it all over to their big donor buddies in the private sector looking to make even greater profits. The GOP rode on a wave of discontent with Big Government in the base of their party, confident that their voters were behind them.
The anti-government fervor and the distrust of institutions among GOP voters are still there—in many ways, they’re even greater than before—except in one particular area where it’s gone in the other direction, toward a trust in government: healthcare
And GOP leaders, moving to gut Medicaid, and clearly looking at Social Security and Medicare—with Elon Musk and his flunkies messing around with our private information—are soon going to painfully find out how much. Some GOP pollsters and MAGA blowhards are trying to get them to comprehend the new reality. But the GOP leadership is drunk on power, believing it's closer than ever to its goals and not paying attention to the flashing red lights.
In an illuminating piece, the Kaiser Family Foundation Health News reported on the disconnect last week—after Republicans in the House just barely voted (by one vote) on a budget resolution to allow for cuts to Medicaid by $880 billion—citing surveys and presenting interviews with MAGA voters.
Democrats have warned that the GOP’s actions will create a situation for them mirroring 2017, when the GOP unsuccessfully moved to kill Obamacare and lost the House in a massive blue wave. And actually, it appears things may be even worse for Republicans this time around. KKF Health News reporter Noam Levey interviewed GOP voters, who clearly show the shift in the base:
Government regulation of health care prices used to be heresy for most Republicans. GOP leaders fiercely opposed the 2010 Affordable Care Act, which included government limits on patients’ costs. More recently, the party fought legislation signed by former President Joe Biden to cap prescription drug prices.
But as Trump begins his second term, many of the voters who sent him back to the White House welcome more robust government action to rein in a health care system many Americans perceive as out of control, polls show.
Even Medicaid, the state-federal insurance program that Republican congressional leaders are eyeing to dramatically cut, is viewed favorably by many GOP voters, like Ashley Williamson.
Williamson, a 37-year-old Trump voter and an Eastern Tennessee resident with five children, explained that Medicaid was a lifeline when her mother-in-law needed nursing home care.
“We could not take care of her,” Williamson told Levey. “It stepped in. It made sure she was taken care of.”
She was one of several Republicans interviewed who voted for Trump who talked about the soaring costs of health care and how they want limits enforced by the government on co-pays, insurance costs and hospital costs—and they expect Trump to make it all happen, even though he and the GOP are light years from doing anything remotely like that.
The MAGA voters also want a cap on prescription drugs. That, of course, is something about which Joe Biden became the only president to have any success. Biden and Democratic lawmakers capped the cost of insulin for people on Medicare and gave Medicare the power to negotiate prices with drug companies, all while GOP leaders fought these measures.
Trump voters made their priorities clear to KKF:
Charles Milliken, a retired auto mechanic in West Virginia, who said he backed Trump because the country “needs a businessman, not a politician,” expects the new president to go even further.
“I think he’s going to put a cap on what insurance companies can charge, what doctors can charge, what hospitals can charge,” said Milliken, 51, who recently had a heart attack that left him with more than $6,000 in medical debt.
Milliken is in for a very rude awakening, if he hasn’t already been paying attention. Because, no, Trump will do none of that, and Republicans in Congress are also going in the other direction. And that is where the GOP’s radical agenda is going to implode on it.
Even Steve Bannon is sounding the alarm, warning against Medicaid cuts, saying, on his screechy podcast, “Medicaid, you got to be careful, because a lot of MAGA’s on Medicaid. I’m telling you, if you don’t think so, you are deeeeeead wrong.”
Trump’s own pollsters from his 2024 campaign are sending up red flares on healthcare too. Tony Fabrizio and Bob Ward, who conducted polling for Trump’s campaign, recently wrote a memo to GOP lawmakers, urging them to extend the subsidies in the Affordable Care Act. Those Obamacare tax credits will expire this year, and about 2.2 million people will lose health care if no action is taken.
On Sunday, Fabrizio, ramped up the urgent message, telling The Washington Post, “It is popular and it would be good politics for the House and Senate GOP to embrace it.” But Trump and GOP leaders in the House and Senate made it clear months ago that they’re going to allow those tax credits to expire.
It’s notable that Trump’s own pollsters are being so public, clearly afraid of what the data shows and trying to convince the GOP to listen. Bob Ward of Fabrizio Ward told KKF’s Levey that many GOP voters are rethinking their embrace of free markets over government, after years in which many millions of Americans have been saddled with medical debt.
“I think most people look at this and say the market is broken, and that’s why they’re willing for someone, anyone, to step in,” he said. “The deck is stacked against folks.”
Yep, it’s pretty damn rich, since Democrats have been saying that for decades while Republicans have been trying to kill the safety net—and they’re still trying, oblivious to what their own voters now believe.
In a national survey that Fabrizio Ward collaborated on with Democratic polling firm Hart Research just after the 2024 election, MAGA voters were less likely to blame the federal government than insurance companies and the pharmaceutical industry for high health care costs. Three quarters of them want the government to impose caps on hospital costs.
In a recent poll by KKF, half of Trump supporters backed continuing Biden’s achievement in having Medicare negotiate with drug companies. Price caps are in fact huge for MAGA, according to researchers KFF’s Levey interviewed, even though the leadership of the GOP has actively fought against limiting the free market. Republican pollster Mike Perry conducted focus groups on the issue, which Levey was able to observe.
Perry, who’s convened dozens of focus groups with voters about health care in recent years, said the support for government price caps is all the more remarkable since regulating medical prices isn’t at the top of most politicians’ agenda. “It seems to be like a groundswell,” he said. “They’ve come to this decision on their own, rather than any policymakers leading them there, that something needs to be done.”
Other forms of government regulation, such as limits on medical debt collections, are even more popular.
About 8 in 10 Republicans backed a $2,300 cap on how much patients could be required to pay annually for medical debt, according to a 2023 survey by Perry’s polling firm, PerryUndem. And 9 in 10 favored a cap on interest rates charged on medical debt.
“These are what I would consider no-brainers, from a political perspective,” Ward said.
And that’s just MAGA and GOP voters. When you widen out to independents and Democrats, the vast majority of Americans, as a January AP poll showed, want more funding for Medicare, Medicaid and Social Security, not less.
Trump himself possibly perceives there is a third rail here (though that knowledge hasn’t stopped him from stepping on it in the past many times). He keeps saying they “won’t touch” Medicaid.
But the budget bill the House just passed only allows the $880 billion—which are to pay for Trump’s tax cuts for the wealthy—to come from money the Energy and Commerce Committee oversees, which is Medicare and Medicaid and some smaller health programs, like the Children’s Health Insurance Program. The GOP claims the money is only going to come from “waste, fraud and abuse” that they’ll expose but which they’ve yet to find.
The U.S. Government Accountability Office, the nonpartisan Congressional watchdog, in a study last year found that there may be about $100 billion in waste in both Medicaid and Medicare combined, which is little over 10% of the money the GOP needs—if they find even that. So it’s clear they’re going to have to cut programs to pay for the tax cuts of millionaires and billionaires, and Medicaid is what they’ve been focused on.
Democrats have been loudly warning about what will happen, and they’re planning, as they did in 2017, to hit the GOP hard, with political ads already running in some parts of the country. Republicans in swing districts are publicly expressing their fears, even though they voted for the legislation because Trump had a gun to their heads, threatening to primary them.
But the GOP’s leaders don’t get that, unlike at any time in the past—even in 2018, during the midterms in which they got clobbered over their unsuccessful assault on Obamacare—there is a huge gulf between them and their own voters on healthcare.
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