House Republicans Work Tirelessly To Make Peoples’ Lives Worse... Why Does Anyone Vote For Them?

Make-believe Christian, MAGA Mike Johnson

A majority of Republican voters have been telling pollsters they don’t want cuts in Medicaid. This one survey from March for Kaiser shows that 24% of Republicans, 22% of Trump voters and 21% of rural Republicans want Medicaid spending increased, while 43% of Republicans, 43% of Trump voters and 44% of rural Republicans want Medicaid spending to stay where it is. Just 33% of Republicans, 36% of Trump voters and 35% of rural Republicans want to see spending on Medicaid decrease. (Among independent voters, just 14% want to see it decreased.)

Yesterday, Republican Members of Congress took a gamble that their voters don’t care enough to vote them out of office. Wonder why they would push through such a deeply unpopular and controversial agenda? Let’s game it out. First, many of them, even beyond those in safe gerrymandered districts, believe they can weather any political backlash because of how few Americans— especially their core voters— connect federal budget decisions with tangible outcomes in their own lives. Even among voters who support Medicaid, there is often a disconnect between federal policy and personal experience. If a constituent loses coverage, it’s more likely they’ll blame bureaucratic incompetence, a private insurer, or even a state-level decision rather than a congressional budget vote they never heard about or have forgotten about. This is especially true given how little media attention Medicaid receives and how grossly incompetent the DCCC is.

Second, there’s the strategic calculation that messaging— rather than policy— will determine reelection outcomes. Republican incumbents can frame their vote as a step toward “fiscal responsibility,” “reducing government waste,” or “restoring work requirements,” even as the practical effect is cutting healthcare. These talking points tend to resonate in right-wing media, and in safe red districts, that can be enough. Many Republicans count on their base absorbing the spin, not the specifics. They might say they support Medicaid but be convinced that the program has been “abused,” “bloated,” or is a “magnet for dependency.”

Third, many GOP lawmakers represent heavily gerrymandered districts where the real political threat is not from a Democrat, but from a more extreme Republican challenger in a primary. In that context, voting for a Trump-endorsed austerity budget isn’t a risk— it’s a litmus test. A vote against it could open them up to accusations of being a “RINO” or betraying the MAGA agenda. So even if some constituents are unhappy with the Medicaid cuts, the political incentive is to stay in Trump’s good graces and avoid being outflanked from the right.

Finally, some Republican members may genuinely believe the myth of the “undeserving poor.” Despite data showing that the majority of Medicaid recipients are children, disabled people, and low-income workers, conservative ideology continues to frame social programs as handouts to the lazy. From this perspective, cutting Medicaid is not only fiscally sound— it’s morally justified.

“Lawler,” wrote his top Democratic opponent Mike Sacks told us, “just voted to take health care away from thousands of his constituents here in NY-17. He said he wouldn’t. We didn’t believe him. He just proved us right. And yet Lawler’s already telling us that we should be grateful he raised the SALT cap as if we’ll all forget that in exchange he broke his promise not to cut Medicaid. But that was a false choice to further a budget whose bottom line he never questioned: steal from the poor to give to the rich. This budget sells out hardworking families in service of Trump and his billionaire buddies who bought Lawler his seat, too. It’s time to return policymaking to the people. Trump lost NY-17 in 2024, and in 2026, Lawler will too.” May I recommend you consider helping Mike Sacks replace Trump allies like Lawler by contributing what you can on this ActBlue page?

Emily Berge, president of the Eau Claire city council, and the progressive challenger to MAGA Republican Derrick Van Orden told us after the vote yesterday that “Actions speak louder than words and Van Orden's vote reveals his true priorities: tax cuts for the rich and cuts for everyone else. He talked a big game, but when it mattered, he sided with Trump's agenda. This isn't about politics; it's about values. Our community deserves a representative who fights for them, not against them. I believe in a budget that prioritizes healthcare, affordable housing, and good-paying jobs. That's the clear choice voters will have in November 2026, and it's why I'm confident we can win.”

Pamela Herd and Donald Moynihan are University of Michigan professors of public policy who penned an OpEd, Republicans Will Use Paperwork to Kick Americans Off Health Care, that the NY Times published moments after the GOP passed the draconian Medicaid cuts as a centerpiece of their Austerity budget. They addressed how these Republicans plan to hoodwink their voters about the damages their votes will now cause. “To control the political damage,” wrote Herd and Moynihan, “Republicans are pursuing a strategy to reduce benefits, while pretending otherwise. They’ve mostly abandoned transparent cuts, such as eligibility changes or spending reductions to states, because it’s easy for voters to understand that damage. Instead, Republicans are opting for opaque cuts, which will shed millions of eligible beneficiaries by overwhelming them with pointless paperwork and other needlessly complicated administrative requirements.”

The bill “reverses what has been a quiet revolution in Medicaid— making it easier for people who are eligible to obtain benefits. Over the past 15 years, reforms have included simplifying applications, eliminating confusing paperwork and automating processes, especially when it comes to renewing benefits. Surveys show that the public supports such service improvements. In short, America has not only expanded who is eligible for Medicaid, but also made it easier for eligible people to get benefits. The eligibility expansions, which led to large increases in enrollment and spending, were so effective because they were paired with burden reductions. For example, allowing children to stay continuously on Medicaid for 12 months, rather than six months, may have halved the number of eligible children who erroneously lose coverage. During the Trump administration, some states added new barriers, which caused a nearly 6 percent loss in coverage among children within six months. Democrats learned that addressing these easily overlooked administrative burdens was essential to ensure that more Americans have health insurance. Republicans learned a different lesson. Precisely because they’re overlooked, administrative burdens are an excellent political tool to accomplish unpopular policy goals. Consequently, Republicans are proposing to increase burdens to ensure large coverage loss among the eligible… [W]hen Arkansas adopted work requirements in 2018, nearly all of the people who lost coverage had met the requirements. They simply couldn’t manage the paperwork to prove it.”

The bill gets rid of rules the Biden administration promulgated to make it “easier for people to navigate Medicaid’s eligibility and renewal processes. The mixture of reforms would have ensured that millions of people who were eligible for benefits, including disabled people, actually received them.” Trump’s big beautiful bill will put a quick end to that. It will “also require more beneficiaries to renew their coverage twice a year. Since the passage of Obamacare, most people have had to repeat this process only annually. Not only would the twice-a-year requirement cost people a lot of additional time and effort, many eligible people would lose coverage during this process. By some estimates, one-third of people who lose Medicaid quickly regain it, signaling they lost it because of procedural mistakes rather than becoming ineligible. That is why recent reforms have lengthened periods between renewals.” And we all know how Republicans just hate bureaucracy and extra paperwork, right?

Another new burden would require beneficiaries to pay when they go to the doctor. Co-pays reduce health care use, but do not produce cost savings. One study found that even a $12.50 co-pay discouraged women from getting a mammogram. Moreover, there’s evidence that some of the people needing health care the most are among the most likely not to get it.

Finally, congressional Republicans want to create incentives for states to add even more administrative burdens. They’re planning to increase penalties for states that make enrollment errors, which would encourage them to add excessive documentation requirements. Given that the vast majority of fraud and wasteful spending is perpetrated by private health insurers that contract with Medicaid or health care providers,  the effect would be to push eligible people off the program more than it reduces any erroneous payments.

Republicans claim that such burdens serve virtuous policy goals, like reducing fraud and welfare dependency. But if millions of people are going to lose access to health insurance, let’s at least be honest about how this is likely to play out and why Republicans are pushing this agenda. The push to make public health insurance less accessible is driven not by concerns about what best serves the public. Instead, the most vulnerable will be made worse off, all to fund a tax cut that most benefits the rich.

Republicans love to rail against “big government” and the tyranny of red tape— at least when it affects corporations, small businesses and the wealthy. But when it comes to the lives of ordinary Americans, especially the poor, the sick or anyone living paycheck to paycheck, suddenly they can’t create enough bureaucratic hurdles. They’re not interested in shrinking government so much as repurposing and weaponizing it: transforming it into a punitive machine that treats basic rights and public services as privileges to be earned through constant documentation, re-verification and surveillance, what Herd and Moynihan have written about as “administrative burdens.” These are not accidental inefficiencies— the’re deliberate strategies to obstruct access to public benefits while preserving plausible deniability. The GOP may avoid overtly slashing eligibility for Medicaid or food assistance, but they can achieve the same result by forcing people to navigate confusing paperwork, reapply constantly, or jump through hoops until they give up. This is cruelty by design, made even more insidious by the fact that it hides behind a bureaucratic veil.

So why does anyone vote for them? Partly, because the consequences are often obscured— buried in fine print or felt most acutely by the politically marginalized. And partly, because Republicans have mastered the art of deflection: convincing their base that these punitive policies are aimed at some undeserving “other,” not them. But sooner or later, the burden lands on everyone who isn’t rich enough to be above it. The Republican Party isn’t working to make our lives better. They're working tirelessly to make them harder— and they’ve figured out how to do it without most of us even noticing… until it’s too late. Sure they hate the kind of bureaucracy that could slow down a corporate merger, environmental pillaging, or billionaire tax evasion but when it comes to poor and working-class Americans trying to access health care, food assistance, or unemployment benefits, suddenly the GOP becomes a fan of forms, filings, and endless documentation. Paperwork becomes a weapon. Bureaucracy transforms into a wall and suffering becomes policy, hiding their inhuman cuts behind layers of red tape— sabotage by design.

Iowa progressive Democrat, Travis Terrell, wasn’t surprised that his MAGA opponent, Mariannette Miller-Meeks voted to kick so many Iowans off Medicaid. He calls it “class genocide,” noting that the bill “rips the safety net out from under working people, includes immediate Medicaid cuts while putting Medicare in extreme danger by blowing a hole in the deficit that could trigger billions in automatic cuts, all to funnel the largest redistribution of wealth in history straight to the billionaire class.”

Terrell is telling voters in southeast Iowa that “Ottumwa Regional Health Center, the hospital I was born in, is a for-profit hospital in a low-income city. It runs on thin margins. Cuts like these will push hospitals like that to the brink. This isn’t hypothetical, it’s personal. When I was an infant, I developed a life-threatening infection. The doctor at my hometown hospital called the University of Iowa for a transfer, but was told I wouldn’t survive the flight. A university surgeon stayed on the phone and talked my hometown doctor through a procedure that saved my life. If that hospital hadn’t existed, my mom would’ve watched her baby die in her arms. When my brother was born sick, the only reason he survived was because that hospital had recently built a pediatric ICU. When my dad had a stroke, that hospital stabilized him before he was transferred for further treatment. Without it, he wouldn’t have made it.”

He reminded voters that a “congresswoman who lives in that same city, Mariannette Miller-Meeks, is celebrating the passage of a bill that could kill that hospital, that could kill her neighbors. She knows exactly what’s at stake, and she’s cheering it on. Right now, there are four hospitals in this district— her district— that are in severe danger of closing because of her choices. And if those hospitals close, young families will be forced to leave Iowa just to protect the safety of their children. Ottumwa’s already aging workforce will be crippled— because how do you build a future in a place where the people in power are sinking the ship and setting fire to the lifeboats? I won’t stand by and watch families like mine be forced to flee the states they were born in. I won’t let people die in the backseats of their cars because they couldn’t reach care in time. I will take the seat of the woman who is poisoning the well of our shared hometown in Iowa and our distict— and I will fight like hell to make sure monstrosities like this never happen again. We need to do everything we can to stop this, in the streets, in the courthouses, in every damn place we still have power left to use. Our lives depend on it.”