Trump's Great Healthcare Con

Not going to cut benefits -- Just churn out the beneficiaries

May 15-16

By Marc Cooper

In my last Coop Scoop post about a week ago, I described the Trump administration as a “patrimonial kleptocracy.” An organization modeled as a criminal syndicate.Given the putrid flood of events over the last few days, I will now triple down on that definition.

Donald Trump’s tour of Middle East dictatorships is perfectly consistent with a crime-family boss meeting with other, richer bosses, trying to cut as many self-serving financial deals as possible regardless of a difficult past. So what if MBS chopped up his critic, whips his oppoents or that Qatar has funded and sheltered Hamas. Nothing personal. Just business. And Trump can’t wait to kiss their asses. As they say: “These are friends of ours.”

The level of corruption we are witnessing now is staggering and unprecedented—and 100% conducted in broad daylight.

The corrupt despots, including Trump, are building and parlaying multi-billion dollar commercial agreements that have nothing to do with politics or foreign policy. They are all about enriching themselves, their families, and their subservient cronies.

Trump is the poor man in this assemblage, and it’s going to be tough-going to catch up with his petro-dollar partners. He’s definitely the junior partner. He merely has more button men than his wealthier associates., Watching him grovel to inherit the 13-year-old second-hand “flying palace” from the Emir of Qatar is as pathetic as it is infuriating (and I will guarantee you he’ll never get that plane anyway).

Not that Trump isn’t making out great anyway. He’s got at least five multi-billion dollar ventures in course with the Gulf dictatorships. The monarchs are also pumping big bucks into his scam crypto currencies. He’s a made guy.

And Trump has used his monetarily worthless $TRUMP meme coin as a device for literally anyone who buys enough of them to get VIP access to him and the White House. And his kid’s vaguely more legit crypto, at last report, allowed 58 people to make $1 million or more, while 750,000 sucker buyers have lost money.

But who cares about those losers? The Trump crime family, including his two older idiot sons, have made at least $3 billion in the last 3 months since Daddy’s elevation to American Capo.

I’m not going to dwell on this corruption in this post. There’s been excellent coverage of it. There’s also been plenty of complaining about it. And while protest against Trump is slowly building, it’s still grossly insufficient. There appears to be too much apathy, indifference, and nihilism among the American electorate for this, the most corrupt administration in history, to spark the popular upheaval it merits.

Yes, Trump’s polling stinks. But in the latest survey that covers the first 4 days of the Qatar plane affair, he’s actually up a point or two. If you are consulted by a pollster, it costs nothing to say you disapprove of Trump. That doesn’t mean you are going to do anything about it. You hang up the phone and go water the garden.

Also under-reported is that while Trump is in the terrible 30–40% range on almost every issue, the Democrats score an anemic 26% among those who say they agree with Democrats “on the issues.” And in simualted one against one match ups, Trump is winning.

But that doesn’t really worry the Democratic Party elite. They are busy writing “stiff letters” to House Speaker William Johnson—which assumes he can even read.

Here are two throwaway lines I will toss your way:

A) Kleptocracy is a feature of autocracy. B) Late-stage capitalism is not just an economic system—it also has severe cultural, social, and psychological aspects. Or better said, people in general, and the electorate in particular, are often as short-sighted, self-serving, and insensitive to anything except their own personal welfare as are their overlords.

Hence, too many shrugs about the world-class corruption taking place above their heads. God knows how many Americans wish they were running a billion-dollar scam of their own.

This outbreak of corruption is taking place—unbelievably—at the very same moment that MAGA is hard at work fashioning a budget that many moderate economists have labeled the largest transfer of money from the poor to the rich in world history.

Now that is something that just might evoke some stronger responses to the Trump regime. As he tries to conjure $4–6 trillion to extend the juicy tax cuts to the ultra-rich, the only pool of funding really available to him to raid remains Medicaid. The other three big pots are the untouchable Pentagon and the combined third rail of Medicare and Social Security—both of which even Trump is not quite stupid enough to cut, at least not with the midterms looming.

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THE GREAT MEDICAID CHURN

So that leaves only Medicaid and some similar programs available for him to plunder—the programs that serve the neediest of all—to pay for tax cuts for Jeff Bezos’s 500-foot yacht and Zuckerberg’s purchase of half of Hawaii. Medicaid is a ripe targets with 71 million Medicaid recipients (50% of births in the paradise of Georgia are Medicaid babies). More than 40 million Americans are on food stamps—that provides a whopping $50 a week to recipients. MAGA says it will shake down Medicaid for nearl $800b and Food Stamps for anotther $300b.

Going unsaid here is the completely failed work of Elon Musk. He had promised to deliber up to $2 trillion in savings. He ended up with, using suspect math, of dribbling out just $150b though his critics say he actually cost the government a slightly greater amount. But he did an A-1 jon of helping Trump capture a cornucopia of state agencies.

It is immoral, obscene, repulsive, and will be a stain on the country as a whole if these healthcare cuts come to pass in his “big beautiful” omnibus bill now up before the usually inert Congress. It will harden the image of Americans as an insensitive, uncaring people, interested exclusively in their God-given right to consume as much as they can and screw everybody else.

But wait, hasn’t Trump promised time and again he would not be “cutting” any medical care benefits? Yes—and technically, very technically—he will not be. His Republican stooges in Congress would like to get re-elected and they don’t want to go into the midterms with the blood of disabled grannies and hungry kids on their delicate, soft hands. Neither does Trump.

So, here in the middle of this essay, I have buried what should be the lead graphs. Trump and MAGA, looking to loot $800 billion from Medicaid and $300b from the food stamp program—SNAP—have backed down from earlier, more dangerous notions of simply cutting benefits. They will not cut the benefits. Instead, they will cut the recipients. Or better said, will have their underlimgs do the cutting.

MAGA has defaulted to a less transparent, downright diabolical scheme to skim the trillions they seek. They are not going to cut monthly checks. They are just going to make it more onerous, more burdensome, and, for some people, just impossible to do the reporting and paperwork to either enroll in or stay on Medicaid.

Estimates are that this will “churn” out as many as 10 million recipients just from Medicaid. And, by the way, having reported on this and other welfare programs for over 40 years, “churn” is always a desired goal of plan administrators and is openly talked about and celebrated in program management meetings. The more needy you can churn out, the more efficient the program.

The plan now being favored by the Republican House would impose an 80-hour-a-month obligation on “able-bodied” single Medicaid recipients to either work, formally study, or formally volunteer to remain eligible. The ill, the disabled, and caregivers for others would be exempt.

A majority of Americans, of course, support this measure. It sounds tough—and that’s what the despised poor leeches deserve, right? (Note: I prefer the words “poor,” “hungry,” or “homeless” over the oh-so-delicate terms like “underserved,” “food insecure,” and “those experiencing homelessness.” For the Right, these are bloodless euphemisms that deny the existence of a political-economic system that leaves 65% of Americans with less than $400 to meet an emergency. For the Left, they are politically correct, self-virtuous ways to describe people who are just plain f**ing poor and/or hungry or have been abandoned by society to live on the streets. Please do not use these terms—they make me experience great scorn).*

Making people work for their measly handouts sounds tough and fair somehow. But it is also a ruse. Study after study—somebody in Congress must have read one—shows that something like 95% of Medicaid recipients already meet these conditions.

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I reported on this sort of scheme in the early 1980s when L.A. County imposed similar obligations on its last-ditch general relief programs. And it was a colossal failure. Actually, it was a great success in churning recipients into homelessness. Nobody could decide what “able-bodied” meant. Many recipients couldn’t pay for transportation to seek a job. And the self-reporting was complicated for this impoverished population and unreliable to document. But one single error in the reporting would cause a six-month suspension of benefits.

The case of Medicaid is somewhat different. As noted above, almost everybody already meets the requirements. But the new MAGA plan would escalate the complicated paperwork required to be filed by recipients and would increase reporting from once a year to every six months.

We are dealing with the most vulnerable slice of the population, and frankly, a lot of them are not great at paperwork. The elderly among them do not have the computer skills to do it all correctly—especially in the ass-backwards, impoverished red states, many of which have sketchy internet access and reliability. “Hey Granny, you just have to reboot, clear your browser cache, and use your Google account to log in.”

Loren Adler, associate director of the Brookings Institution’s Center on Health Policy, told ace healthcare reporter Jonathan Cohn at The Bulwark this week:

“A lot of this is really just about erecting barriers to enrollment and re-enrollment, and then, more broadly, just narrowing eligibility.”

Narrowing it enough that estimates of those who will be churned out range from 7–10 million recipients. And Trump will be able to say, “We didn’t cut off anybody—just as I promised.”

Many rural medical facilities and doctors are also highly dependent on Medicaid recipients for payment. Fewer recipients will mean many more rural clinics and hospitals laying off staff or closing their doors. But no worry—in our New America they will easily find jobs screwing little screws into the imaginary iPhones that will never be made in America.

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STARVING THE FOOD STAMPS

Then there are 40 million Americans on food stamps—euphemistically now known as SNAP. The subterfuge here is again not for the federal government to cut anybody off (though, once again, estimates say millions more may lose assistance).

Since before World War II, when the program started, the federal government has paid 100% of the benefits. It still will under the Trump/MAGA plan. So once again, Trump sticks to his promise that the Feds will not cut anybody off. Instead, he will force the states to take the political hit.

Republicans in Congress are now looking to force states to pay for 5 to 25 percent of SNAP beneficiary funding. Experts warn this could force state governments to remove individuals from the food assistance program, leave local budgets with massive shortfalls, and hurt the food producers and retailers that serve them.

Currently, the U.S. government pays 50% of the administrative costs of the program, and the states pay the other half. The proposed “reform” would immediately raise the state burden to 75% of the administrative toll—a figure that could bust the budget of several poor states.

This would inevitably lead to states being forced to do the wet work of Trump’s gang. And remember—the fewer recipients, the less the federal government will have to shell out.

Elaine Waxman, a senior fellow at the public policy think tank Urban Institute, told The Washington Post that forcing states to pick up more of the funding

“fundamentally reshapes the program… States will do different things depending on their positioning, but I don’t see any scenario where they’re able to avoid significantly cutting SNAP.”

“And that might be benefits, it might be severely restricting eligibility. … So there will clearly be far fewer people, I think, receiving SNAP.”

And she’s right. Independent analyses project that up to 3.5 million SNAP recipients will be churned out each month. And that doesn’t even include their 4 million “food insecure” children.

Some of these details might change as the Big Beautiful Bill goes through Congress, with a finish date of July 4th. But one thing is for sure: the tax giveaway will go though. And it will be funded by shaking down the poor. And, if not, it will simply be added to Trump’s already record deficits so our children can burden the cost with long-term austerity.

The continuation of the tax cut for the ultra-wealthy is shameful enough. To pay for it by taking away health and food support for the poorest among us will be one more moral stain on our legacy. I’m hoping—against hope—that this filthy funding transfer just might arouse a greater portion of the population than a hand-me-down “flying palace” for Boss Trump.”

They have no decency. They have no compassion. They have no humanity. They are our enemy and they must by taken down.+++

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