Bulwark Takes - Republicans Broke Rural Healthcare—Then Blamed Democrats

Episode Date: October 5, 2025

Sam Stein and Will Saletan take on Mike Johnson’s ‘Meet the Press’ appearance where he repeatedly lied about the shutdown being over undocumented immigrants receiving free healthcare, struggled to answer on Trump’s call to use the military against citizens, and said the unprecedented federal firings during the shutdown are completely up to Russ Vought. Read Jonathan Cohn's article for The Bulwark: https://open.substack.com/pub/thebulwark/p/government-shutdown-emergency-medical-care-illegal-immigrants

Hey, it's Will Salatan from The Bullwork. I'm here with my buddy, Sam Stein. We're here to talk about what was going on the Sunday shows this weekend. And the answer is Mike Johnson, the speaker of the house. He was on Meet the Press and doing his usual shutdown spin, except he threw a little bit of a curveball today. So Sam and I are going to talk about that. What'd you think was the curveball? I've been watching this guy, Sam, for two weeks, and he's been doing the same boring shutdown spin. The same thing about illegal aliens this, illegal aliens that. And then today came the curveball. So he's on with Kristen Welker, and he starts out with the standard spin. So we're going to start out with that. This is the first thing that Johnson said to Kristen Welker about the Republican position on the shutdown and why he says,

the Democrats are, in his view, shutting down the government. Because we got illegal aliens and able-bodied young men without dependents off of Medicaid. They were never planned to be there in the first place. And what the Democrats are demanding right now to keep the government open is we put them all back on there. I've heard spin before. That one didn't personally strike me as outrageous spin, although I know it's not actually factual. But what stood out to you? So, all right, this is Johnson's standard span.

And he always says, you know, if you go to page 57, of the Democrats' CR, we'll find this thing, blah, blah, blah, blah. There's like 71, but maybe, whatever. Yeah, no, he's got like a, it's page 57, 21, clause 41. Yeah, it's like a, let's lawyer game, right? So, and he always says, like, go read it, right? And the point is, Sam, you're never supposed to actually go read it. Because if you go read it, you'll find out, yeah, of course.

I mean, so I've read it. Did you? No, screw that. No, I've read it. So that's Johnson's game, right? He's going to say page 57. It's all on my website. and you're not supposed. So if you go and look, there is nothing in there about Democrats

demanding anything for illegal aliens. And the Democrats have said, it's already illegal. All right, they've already said that. What there is, just so people know this, it's a paragraph. It's a paragraph that says we want to repeal a bunch of Republican cuts to health care. Right. And, okay, so what's in the Republican cuts to health care? Some tiny fraction of them have to do with enforcement mechanisms to make sure that people who are here illegally can't get health care. And Sam, it's only about the enforcement mechanisms. It's already totally illegal. So for Johnson to say that Democrats are demanding

to put illegal aliens on health care is just a flat out lie. Right. And he went on and he does this a couple in a couple different points. So at another point in the interview, he's talking about, well, you know, we're trying to fix health care because it's so problematic and premiums are too high and you got the idea.

It's like, and the Democrats, they want to get rid of, you know, this great fund for rural hospitals. They want to claw back $50 billion that we put in for rural hospitals to prop them up. Again, it's the same exact logic that he's using, which is the Democrats are undoing what is a rural hospital bailout fund. But the only reason the rural hospital bailout fund is in law

is because Republicans had to put it into law because they had killed rural hospitals with their Medicaid cuts. So by undoing the one big, beautiful bill, Democrats are taking away the Medicaid cuts that Trump put in place, but they're also taking away the need for a rural hospital bailout fund. But of course, Johnson doesn't want to elaborate it on it. For him, it's just their harming rural hospitals. It's a nice sleight of hand.

Right. Sam, can correct me? Wasn't the rural hospital fund that the Republican, that was all CYA, right? The Republicans were gutting health care. Yes. And so this is like, okay, we'll throw a little, a tiny bit of money to compensate it for the problem. And to be clear about this. The process was this. The House didn't even pass the rural hospital bailout fund in their version of the one big, beautiful bill.

That was not Mike Johnson's party. It was when it went to the Senate, and a bunch of Senate Republicans were like, okay, we're hearing from a lot of rural hospital officials and CEOs saying, if you pass this, we're going to, like, have to close because reimbursements aren't going to go, you know, bottom down. We need a bailout fund. And so the Senate put it in their version, which then went back to the House and the House passed.

So Mike Johnson never even wanted this thing or never a push for this thing until he got to force upon him. But now, of course, it's, you know, if Democrats dare touch it. Right. They're monsters, right. Sam, is there any universe in which the Republicans are more in favor of funding rural health care than the Democrats are? I mean, it just seems like it's flat on false. No, I mean, they would say this bailout fund is proof of it, but no.

I mean, Democrats want to actually undo the Medicaid cuts. They want to make sure that reimbursement, and this gets into the illegal immigration stuff, too, which they, which is kind of right-haring. But emergency Medicaid, they want to make sure that those funds are there for hospitals to cover people who show up in the emergency room. So by, you know, any stretch. the imagination is ridiculous to say that Democrats are more in favor of harm and rural health care than Republicans. Factually, it's just not true. Statistically, it's not true. But we're in this place where, of course, Mike Johnson's got to go on and spin what it can. Right, right. Okay, so Kristen Welker comes back at Mike Johnson to correct him about the illegal aliens thing and what

the Democratic position is. Here's what she said and here's how he responds. Right now, undocumented immigrants are not eligible for federal health care programs. Democrats, as you heard, say they're not trying to change that. But one of their demands would restore Medicaid funding for hospitals to give emergency care, including two undocumented immigrants. Are you suggesting Mr. Speaker, that ER

doctors check people's immigration status before they render emergency care? No. Again, it's another red herring. What the Democrats are demanding is that illegal aliens that care for them in an emergency room should be reimbursed at a higher rate. To the hospitals? To the hospitals. Then

American citizens, young, pregnant, They want to pay more for illegal aliens than a U.S. citizens, and we are against that. Yeah, so that's what I was talking about, which is you have this pool of money, emergency Medicaid, which covers people who show up at the ER, make sure the hospitals don't go bankrupt because, you know, there is a law, a Reagan-air law, and I encourage people to read Jonathan Cohen's newsletter, the breakdown, because the Sunday evening newsletter is on this law. But under the law, if you operate an emergency room, you do not turn away people who show up for critical care. You give them care because it is morally the right thing to do.

And on top of that, although it might bankrupt the hospital, the federal government will come in and help alleviate some of the costs. That's called Emergency Medicaid. Mike Johnson and J.D. Vance and everyone else is using that to say, well, this is, you know, funds for illegals to get health care. It's not. It's funds for hospitals to stay solvent when they abide by the Reagan-ARA law to give anyone emergency care. Right. So a few things about this clip. first of all, I've been watching

Mike Johnson for two weeks. This is the first time that he has made this claim about higher reimbursement rate for illegal aliens. That's like that brand new thing. Yeah, I didn't notice that too. I had not heard that one before. Right. It's brand new. So, why would it be brand new? The answer is, of course,

he didn't say it because it ain't true and it's like the pitcher going deep into his bag, you know, because his pitches aren't working so he's throwing one he hasn't thrown before. He's got the Vaseline on there. He's just Rebbing on the bomb? If Johnson really believed this, he would have been saying it all week, Sam.

So second thing, he admits to her. She says, do you want to check? Do you want the hospitals to check before they give the emergency care? He says, no, no, no, no, no. So basically, Sam, he's admitting they don't know. Hospital doesn't know if the person they treated was here legally or not. So this claim- I think it's actually more than that.

He's saying, yes, I am comfortable with taxpayer funds going, to certain health care functions and needs for undocumented immigrants or illegal immigrants. That's what this law says. You cannot check status. You have to administer care. He's saying, I don't want to change that. And if you don't want to change that, that means definitionally you are okay with illegal immigrants getting taxpayer-funded care because they are not paying the hospital for that.

The taxpayers are footing the bill. And unless you want to change that law, that's that. Right. But because he isn't changing that, because the hospital doesn't know whether the person they treated was here illegally or not, his next line, his argument that we just said, there's new argument that they're reimbursing at a higher rate for the illegal person is just false on its face because the hospital literally does not know. They can't ask for a higher rate. Maybe he's saying, maybe I'm trying to get into that. Maybe he's saying, well, they're not going to be on Medicaid or they're not going to have insurance in our likelihood. so it's going to cost more. I don't know. It's like really hard to follow logic.

Maybe that's it. I can tell you that because I've talked to Jonathan Cohn about this and Jonathan's going to explain more in his newsletter about it. But here's the short version of it. Maybe because, you know, Jonathan Cohn is the nicest, fairest human being in the universe. He bends over backwards to try to construe. It's too much, that's too much. He should be meaner.

So his version of it is, maybe they're saying there's a thing called Medicaid expansion that gets reimbursed under. or a slightly higher rate. And maybe they're saying that. But Sam, they do not know whether the person on the Medicaid expansion was illegal or illegal. So there's just no way to know. Bullshit from Johnson. Well, at one point I was trying to push back.

You're talking about people who are here legally but are not citizens. And it just got muddied at that point. To pay for health care for illegals, we're not doing that. What you reference refers to lawfully present people who are here, immigrants, DACA recipients. Let me move on because we are running out of time. So what I was going to say is the stuff out of the health care was kind of interesting, but his spin about the D.C., sending the Army in or the National Guard into the cities, that was the good stuff.

Like, that was when it got really good. Right. So here it is. Welker plays the clip of Trump at Quantico, talking about sending the military, basically, the guys in the room, into D.C. and other cities. And here's how Johnson responds. It seems that the ones that are run by the radical left Democrats, what they've done to San Francisco, Chicago, New York, Los Angeles.

They're very unsafe places, and we're going to straighten them out one by one. And this is going to be a major part for some of the people in this room. That's a war, too. It's a war from within. Do you support the American military being used to fight American citizens? That's not what the president just said there. That's a mischaracterization of what he said. There is a war on crime.

There is a war on crime. And I will use as an example A, what's happened here in the District of Columbia. we're much safer. Everyone on your staff could walk from their cars to the studio this morning. Why? Because there are National Guard troops

patrol in the streets. Before this, it was a literal war zone. This is one of the most dangerous cities in America. So what kills me about this is, you know, we think authoritarianism comes to America. It must be some big, grand, scary moment.

And it's not necessarily that. A lot of what happens is somebody does something extraordinary, which is Trump saying, I'm going to do something totally extraordinary. I'm going to send the National Guard and the military into these American cities because there's a war within.

And there ought to be an extraordinary reaction to that. There ought to be an uprising in Congress, people saying, what the hell are you talking about? And instead, what we get is this very ordinary statement from Mike Johnson. Well, the president says he's going to do this thing, and I'm a Republican too. So I'm just going to come up with an excuse. And Sam, you and I know this is totally normal in a normal context for the speaker to say,

well, the president's going to do this, so I support him. But when the president's doing something like that, this, you've got to speak out. Instead, Johnson says there is a literal war going on in D.C. A literal. He used the word literal, which was unbelievable to me. A literal war zone. I mean, it's like, it's so shameless and so ridiculous. There's one line. And I'm just, I'm just going to speak from personal experience. He says, quote, everyone on your staff could walk from their cars to the studio this morning. Why? Because there are National Guard troops patrolling the streets. Okay. Just so people understand.

studio where he is, is about, I don't know, two blocks from Union Station, the train station. It is shared by Fox News, the same building. It is totally fine to walk. I've walked there on Sunday morning multiple times for TV news hits, not on Meet the Press, but on other TV shows. There is no way that I, it's just, what he's talking about doesn't exist. It's not reality. Staffers for Meet the Press and NBC have walked there. every weekend for years, totally fine. The National Guard troops aren't even patrolling the streets around there. They're not there. They're not there. They're in like the National Mall. They're elsewhere. They're just not there. They're in Union Station, but it's ridiculous. It's a total lie.

He knows it. He's lying. And to do it like that shamelessly is just like, you know, to your point, like, yes, everyone expects a House Speaker to back the president of their own party. But to do it, in this kind of like, lame, clearly, you know, disingenuous way, it's just a bad look. Yeah. Okay. So I agree with you. And I've had a similar experience of like, I ride the D.C. Metro. There's like, I arrive at the Dupon Circle Metro.

There's a bunch of guardsmen there. What are they doing? Hanging out, yapping with each other, right? No, it's crazy. There's no security at all that they're providing, right? But, but like on a very serious note, people don't know this about Mike Johnson. Mike Johnson is a constitutional lawyer. He, like, spent his career defending religious liberty, right?

So he should be like the guy most tuned into, if a Democratic president was going to send in troops against the will of the mayor and the governor, which is, like, unprecedented, you would, Mike Johnson would be the first guy to say, those are jackbooted thugs. That is the, that, and, and it's happening. And instead of a United Congress saying, this is completely out of bounds, they just roll. over. And so basically, everything that Trump does to roll back the norms of the rule of law and democracy, the Republican Party just rolls over and accepts it. And this is an example of it. I'll just, I'll just end on this note because you're right. But there's also like this

kind of interesting, there's a way he does that is interesting to me. So there's another point in the interview where Welker asks him about firing federal employees during the shutdown. She's like, look, this never has happened before. Yes, they've been furloughed, but never during any prior shutdown has the administration gone and actually fired federal employees, little on thousands of them? Like, do you support that? President Trump, the White House, says it's preparing to potentially lay off, actually lay off thousands of federal workers.

That's never been done before in a shutdown. Do you support laying off thousands of federal workers as a part of this shutdown? We haven't seen the details yet about what's happening, but it is a regrettable situation that the president does not want. The president asked Chuck Schumer and Hakeem Jeffries in the Oval Office. about a week ago. Please don't do this. Please keep the government open and we'll work out all these issues that we have plenty of time to work out. What do you want to see, though? Do you want to see thousands of federal workers laid off? No, I want Chuck Schumer to do the right thing that he's done

throughout his 30-plus year career in Congress and vote to keep the government open. And you know, he kind of took a little while to answer it. But if you read between the lines, he eventually was like, no, but you have to expect Russ Fatt to do what he wants to, Russ Voight to do what he wants to do. It's never happened before. We see furloughs. We don't see furloughs. We don't see layoffs, though.

In a situation like this where the Senate Democrats have decided to turn the keys to the kingdom over to the White House, they have to make tough decisions. Russ Vote runs the Office of Management and Budget. He has to now look at all of the federal government, recognizing that the funding streams have been turned off and determine what are essential programs, policies, and personnel. And it's like it just encapsulates everything. He won't speak out, even though we know that he had posted. he won't say he disagrees with it, at least not forcefully. He just basically is a rubber

stamp. And he's like, well, they're going to do what they're going to do. And I'm powerless. You're like second in line for the presidency. And so, you know, therefore, whatever, I'll come on, meet the press and I'll talk. But I won't bring the house back in because what good will do? And I won't speak up against the president because what good would it do? And I, you know, I won't say what I know is unconstitution because what good would it do? And he's basically seated all the power of what is one of the most powerful positions in the country. to Trump. Yep. Depressing. Depressing as usual, authoritarian comes to an America and the speaker of the House rolls over for it. Sam, thanks for doing this. See you next time. Thanks, well.