The Republicans’ Big Ugly Bill Is A Ticking Time Bomb— And They’re Standing Right On It

Now They Have To Sell The Unsellable: They Just Voted to Gut Medicaid In Their Home Districts

The party of Medicaid cuts & billionaire giveaways— contradictions about to explode in their own districts… by Nancy Ohanian

The Wall Street Journal titles a little off: Now Republicans Have To Sell Trump’s Megabill To Voters. Yes, it certainly is Trump’s Megabill… but it is their Big Ugly Megabill as well. It’s the Republican Party’s Megabill... other than Kentucky Republicans Rand Paul and Thomas Massie and Brian Fitzpatrick (PA). But, yeah, they have sell this abominable clusterfuck to the public now— including back home in the districts that will decide their fates in November, 2026.

This abomination, if you'll recall, was hard enough to sell to some of their own members! “They might have an even harder time,” wrote Aaron Zitner, Lindsay Wise and Natalie Andrews, “selling it to the public.” Polling indicates it’s the least popular major piece of legislation passed since the advent of polling and “some Republican lawmakers facing tough races next year represent the most Medicaid-reliant districts. They will have to defend the big cuts in the bill to Medicaid, the health-insurance program for low-income and disabled people, as well as to rural hospitals and to nutrition assistance, once known as food stamps. Those cuts help fund tax cuts in the bill that Trump called for during the 2024 campaign.”

These are the 10 districts held by Republicans, most dependent on Medicaid:

CA-22 (David Valadao): ~495,200 enrollees (64% of population)

KY-05 (Hal Rogers): ~397,800 enrollees

CA-23 (Jay Obernolte): ~355,400 enrollees (48% of population)

CA-01 (Doug LaMalfa): ~316,800 enrollees (43% of population)

LA-05 (Julia Letlow): ~312,600 enrollees

NY-11 (Nicole Malliotakis): ~304,100 enrollees

LA-03 (Clay Higgins): ~303,000 enrollees

WV-01 (Carol Miller): ~300,100 enrollees

LA-04 (MAGA Mike): 288,400 enrollees (31% of population)

WA-04 (Dan Newhouse): 278,000 enrollees (37% of population)

And these are the 10 districts held by Republicans, most dependent on food stamps:

CA-22 (David Valadao): ~27.9% of households receive SNAP

PA-08 (Rob Bresnahan): ~19% of households receive SNAP

TX-15 (Monica De La Cruz)

KY-05 (Hal Rogers)

LA-04 (MAGA Mike)

LA-05 (Julia Letlow)

CA-01 (Doug LaMalfa)

WV-01 (Carol Miller)

CA-23 (Jay Obernolte)

LA-03 (Clay Higgins)

OK, so obviously, the numbers show Valadao in the most trouble— highest Medicaid enrollment and highest food stamps usage. Valadao handled the passage terribly— denouncing it and saying he wouldn’t vote for it, loudly and publicly, because it would hurt his constituents… and then, when push came to shove,  voting for it anyway. On top of that, it’s a swing district where Biden beat Trump by 13 points and where Valadao, running against the worst imaginable Democrat, Rudy Salas, a grotesquely corrupt conservative, only managed to scrape by in both 2022 and 2024— 51.5% to 48.5% in 2022 and 53.4% to 46.6% in 2024. Unless the DCCC manages to insert a mirror image of Salas— which they are trying to do with right-of-center  Assemblywoman Jasmeet Bains— Valadao is finished. Progressive Democrat, Randy Villegas is running hard on cost of living issues and is likely to rout Valadao in Kern County, beat him in Kings and tie him in Tulare.

But on top of Valadao, Rob Bresnahan in northeast Pennsylvania and Monica De La Cruz in south Texas are in the most trouble, at least according to these numbers. Again, it will depend on who the Democrat is who runs, something the professional prognosticators never take into account.

5 other Republicans who are in the greatest jeopardy of losing their seats over the vote are Alaska’s Nick Begich, where a third of his constituents are enrolled in Medicaid; Juan Ciscomani in southeast Arizona; Jeff Hurd in Colorado; Ken Calvert in southern California; and Dan Newhouse in central Washington. In fact, here are another 10 potential dead ducks (unless Suzan DelBene and her inept DCCC screw up, a better than 50-50 chance):

IA-01 (Mariannette Miller-Meeks): Approximately 19% of the population is enrolled in Medicaid.

CO-08 (Gave Evans): Approximately 20% of the population is enrolled in Medicaid.

PA-07 (Ryan Mackenzie): Approximately 22% of the population is enrolled in Medicaid.

PA-10 (Scott Perry): Approximately 20% of the population is enrolled in Medicaid.

WI-03 (Derrick Van Orden): Approximately 24% of the population is enrolled in Medicaid.

MI-07 (Tom Barrett): Approximately 21% of the population is enrolled in Medicaid.

IA-03 (Zach Nunn): Approximately 20% of the population is enrolled in Medicaid.

VA-02 (Jen Kiggans): Approximately 19% of the population is enrolled in Medicaid.

NY-17 (Mike Lawler): Approximately 20% of the population is enrolled in Medicaid.

WI-01 (Bryan Steil): Approximately 21% of the population is enrolled in Medicaid.

Westchester/Rockland County progressive Mike Sacks is one Democrat who knows how to communicate complicated ideas very directly to voters who may be just partially paying attention. Yesterday he told us that “Lawler’s self-cultivated reputation as a moderate was always as much of a lie as his promises to protect Medicaid before showing once again with this vote that he’s just MAGA Mike. If he was a real moderate, he would fought for his district and voted against ripping healthcare away from 32,216 people here in NY-17 and food assistance from 18,264 of our households. Instead, he tied himself to the mast of Trump’s tyrannical ship of state, and the voters they’ve hurt are going to sink them both for their lies and cruelty.” 

Although the out-of-district establishment is heavily pushing the Blue Dog who lost to Derrick Van Orden last year, local progressives are totally behind Eau Claire City Council President Emily Berge in the primary. This morning she told us that “Derrick Van Orden faced a clear choice: vote to provide healthcare and food for his constituents and other Americans, or vote to give more money to billionaires and large corporations. He chose to prioritize billionaires and corporations, cutting essential healthcare and food programs. I have learned while serving in local government that a budget is a moral document, and Derrick Van Orden's morals are clear with his vote. We need leaders who will stand up for the 99%, not the top 1%. This isn't a hard choice, and I'll pick the 99% every time.”

In PA-07, the DCCC is pushing a Republican carpetbagger who just switched party ID to run, Ryan Crosswell, instead of Lehigh County controller Mark Pinsley, a can-do progressive. Crosswell has no idea how to speak like a Democrat, let alone a progressive, because he isn’t one. Maybe he should learn how to be one and run for office in a decade or two. Meanwhile, Pinsley could be conducting masterclasses in how Democratic candidates should be addressing the Big Ugly Bill:

“We need a moment to mourn, not just because this bill passed, but because we’re not getting Medicaid back. It will be years before we have the Senate, the House and the presidency. So take the moment to grieve.

“But realize while we grieve, they’re strategizing. Right now, Republicans are workshopping the right words, the right headlines, the right lies to sell this betrayal to their voters. And they will sell it, because those voters want to believe. They need to believe in their savior.

“And when Republicans talk about ‘work requirements,’ don’t be fooled. That polls well, sure. But that’s not what they did. They also cut funding for the helpers, the caseworkers, the aides, the ones who guide people like my brother, who lives with a leaning disability, through the paperwork. he can not fill it out himself  My sister and I help him  but even we need help, this is govt paperwork after all  the whole goal is to make it hard to fill out.

“And remember: Medicaid doesn’t hand people money. It pays doctors. Hospitals. Providers. Directly. The people who have Medicaid don’t get money directly.

“The words that come out of the mouths of Republicans: Lies. And they want to believe those lies, because they make cruelty sound like responsibility.

“Ryan MacKenzie and the others didn’t just pass a bill. They gave more money to ICE, the brownshirts of this moment, who are now being funded at a higher rate than the Marines. ICE is not about safety. It’s about power. It’s about people who want to harass Black and brown families because it makes them feel superior.  Just think about that. There are people right now who want to take a job with ICE. People who want to harass Black and brown families. Not to protect the country. Not to enforce the law. But to feel superior. That’s what this bill funds. That’s who this bill empowers.

“So when they tell you they ‘cut taxes on tips,’ tell them the truth: they gave the biggest tax cuts to the rich. Everything else is camouflage.

“They will come to you with half-truth after half-truth. Just keep repeating the full truth: they stole from the poor and the middle class to give to the rich. And they’ll do it again unless we stop them.” 

That’s how Democrats need to talk to the voters about the train wreck the GOP just passed. Before the vote, Trump’s own pollster warned that “If a Republican candidate [in a competitive district] voted to cut Medicaid to pay for tax cuts, they would lose by 21 points.” Zitner, Wise and Andrew wrote that “After a March survey, the firm warned that cutting Medicaid ‘could spell political peril for Republicans.’ Trump himself has acknowledged the risk, saying the target is waste and abuse, not services. ‘We’re not cutting Medicaid,’ he has said.”

Control of Congress in next year’s elections could turn in part on how voters come to see the bill. As the two parties prepare to spend millions of dollars to shape their impressions, Republicans have some advantages: Voters might be skeptical of the package, but many know little about it, suggesting they are open to persuasion. And some of its elements are popular.

While only 27% of adults in a Pew Research survey said the bill would give them even a little help, surveys also show that some tax provisions, such as Trump’s signature proposals to end federal taxes on tips and overtime, draw overwhelming support.

Medicaid is popular: About one in five Americans get health coverage through the program. But so are provisions of the bill that require many beneficiaries to show that they are working, looking for work or in training programs to retain Medicaid benefits. The bill also directs new spending to the military and to immigration enforcement, which were top Trump priorities. Those are all messaging opportunities for the GOP.

… One challenge for the GOP is that relatively few people benefit from provisions such as “no tax on tips,” while the broadest-based tax provision—the continuation of tax cuts enacted in 2017— doesn’t create a change that most voters can feel. The 2017 tax cuts were due to end this year, and Republicans will now ask for credit for leaving the lowered marginal rates in place.

“For the most part, these are not actual tax reductions from what people have been paying for seven or eight years,” Buck said. “There’s a bit of a risk that they are overpromising tax cuts that are not going to materialize” for most people.

Alaska’s 2026 Senate race is already showing the calculations the two parties are making.

… Democrats are telling voters that the Medicaid changes put rural hospitals, many of which are on weak financial footing, at further risk. “Rural hospitals will be forced to close, all to pay for tax cuts for billionaires,” says an ad the Democratic Senate PAC is running against GOP Sen. Joni Ernst in Iowa.

Ernst said the GOP bill actually “strengthens the integrity of Medicaid,” echoing her party’s assertion that the work requirement and other changes help focus the program on the most pressing needs. Senate Republicans fortified the fund intended to help rural hospitals weather the Medicaid cuts, but, overall, the bill calls for substantial reductions, analysis by the Kaiser Family Foundation shows.

Republicans, in turn, are saying that Democrats voted to raise taxes by voting against the bill. “He’s voting yes for higher taxes,” says a Republican ad against Democratic Sen. Jon Ossoff of Georgia, which ran just before the Senate approved the bill.

The GOP hopes voters will feel concrete benefits from the bill quickly. They have front-loaded the tax cuts in the bill while delaying the benefit cuts. Ending federal taxes on tips for many workers takes place this year, while the Medicaid work requirement kicks in later on.

Republicans are taking lessons from Trump’s first term, when the party pushed a big tax cut through Congress but gained little political benefit. The bill remained unpopular, and Republicans lost more than 40 House seats in the 2018 election.

“People didn’t know what was in the bill. All they heard was that this is for the wealthy and corporations,” said Dave Winston, a Republican strategist who advises House and Senate GOP leadership.

Winston says Republicans can build support for the legislation by showing, with specificity, how it affects individual tax bills. He cautions that Republicans are making a mistake by casting the bill as the largest tax-cut ever, language the White House and GOP leaders have employed but which Winston thinks voters dismiss as hyperbole.

Instead, Winston says Republicans should focus on the fact that about 90% of people take the standard deduction, which was due to fall from $30,000 to $16,000 next year for a couple if the bill hadn’t passed, exposing more of their income to taxes.

“If you walk them through the math of what they’re going to face in 2026 without the bill, that’s the single most persuasive argument,” he said. 

Yeah, sure… people just love being walked through the math. On Saturday, conservative NY Times columnist Ross Douthat showed how worried he is about conservatives being prisoners of their own tax cuts. “Aside from hype artists and White House spokespeople,” he wrote, “it’s hard to find true enthusiasm for the sweeping new policy law, even among Republicans who voted for its passage. But because almost all Republicans did vote for it, with even the supposed deficit hard-liners mostly falling into line, the strongest remaining critiques are coming from the center and the left, with a special focus on the legislation’s cuts to Medicaid. Given Trump’s promises to protect that program and the importance of Medicaid for many voters in his coalition, that’s the place of greatest political vulnerability and the likeliest source of short-term blowback.”

But he wanted to put that aside and fret that “The future of American dynamism depends on preventing our commitments to retirees from crushing youthful entrepreneurship and family formation. But the new legislation goes in the opposite direction. Instead of means-testing entitlements, it offers temporary tax deductions to seniors, pandering to gerontocracy rather than resisting it.” And he wants congressional conservatives to make that what the debate it about. Conservatives have always lost that debate in the past. In fact, every time Republicans have tried to go after Social Security, Medicare or Medicaid, they’ve paid a political price. George W. Bush’s attempt to partially privatize Social Security in 2005 collapsed under massive public backlash. Paul Ryan’s budget blueprints— rife with deep cuts to Medicare— became electoral liabilities for every Republican forced to defend them. Even Trump, who toyed with entitlement cuts early in his first term, quickly pivoted to promising he’d protect them once he realized how wildly unpopular the idea was. The American public, across party lines, consistently rejects the idea that economic “dynamism” should come at the expense of retirement security— and no amount of think tank hand-wringing or Times or Journal op-ed agonizing has ever changed that.

What Douthat won't (or can’t) bring himself to confront is that the GOP’s entire economic identity is now a tangle of contradictions— populist rhetoric layered over oligarch-friendly policies that benefit neither the working class nor the “youthful entrepreneurs” he claims to champion. The tax bill he half-heartedly critiques was engineered precisely to serve the donor class, with a few shiny scraps tossed to seniors for political cover. He’s nostalgic for a party that could champion “dynamism” without alienating its base or its billionaires, but that party never really existed. The modern GOP isn't trapped by tax cuts— it’s defined by them, and by the cynical politics of resentment that distract from who actually profits. Douthat may prefer a conservatism of ideas, but he’s writing eulogies for a movement that sold itself, long ago, for capital gains and culture war clicks.

In fact, Douthat wrote that “Just about the only notable right-wing media figure to question these priorities was Steve Bannon, and he was absolutely right… It is a political impossibility to push through the entitlement reforms that the wisest Republicans would support, which would necessarily reduce benefits for some middle-class retirees, without asking affluent taxpayers to share some of the pain. And it is coalition-shrinking folly for the GOP to persistently cut programs that benefit its own voters while always lightening burdens on wealthier voters who are trending toward the Democrats.”