The Majority Report with Sam Seder - 3527 - How Zohran Mamdani Won; GOP’s Cruel Medicaid Cuts w/ Ryan Grim, Dr. Adam Gaffney

Episode Date: June 27, 2025

It’s Casual Friday and Sam is still hosting solo today as Emma continues to neglect the show for her “honeymoon”. Whatever. On the program today we listen to Sen Kirsten Gilibrand (D-NY) lose her mind and spew a stream of racist sewage out of her mouth towards Zohran Mamdani. Ryan Grim joins for a wrap up of the week’s news. Subscribe to Ryan’s newsletter here Drop Site News Dr Adam Gaffney joins us to discuss how proposed cuts to Medicaid will ultimately kill people. In the fun half we watch Sen Jon Ossoff (D-GA) expose VA Sec Collins for having no plan to execute the proposed $17-18 billion in cuts to medical services for the Veterans Affairs. Rep Liccardo (D-CA) exposes the Trump adminstration for dropping cases against those who have contributed to his slush fund. We also visit radical Mormon fundamentalist, Glen Beck as he uses tired 9/11 era Islamophobia to attack Zohran. All that and more, folks. Become a member at JoinTheMajorityReport.com: https://fans.fm/majority/join Follow us on TikTok here!: https://www.tiktok.com/@majorityreportfm Check us out on Twitch here!: https://www.twitch.tv/themajorityreport Find our Rumble stream here!: https://rumble.com/user/majorityreport Check out our alt YouTube channel here!: https://www.youtube.com/majorityreportlive Gift a Majority Report subscription here: https://fans.fm/majority/gift Subscribe to the ESVN YouTube channel here: https://www.youtube.com/esvnshow Subscribe to the AMQuickie newsletter here: https://am-quickie.ghost.io/ Join the Majority Report Discord! https://majoritydiscord.com/ Get all your MR merch at our store: https://shop.majorityreportradio.com/ Get the free Majority Report App!: https://majority.fm/app Go to https://JustCoffee.coop and use coupon code majority to get 10% off your purchase! Check out today's sponsors: NUTRAFOL: Get $10 off your first month’s subscription + free shipping at Nutrafol.com when you use promo code TMR10 SUNSET LAKE: Use the code LEFTISBEST to save 20% at SunsetLakeCBD.com  on all their farm fresh CBD products for people and pets. Follow the Majority Report crew on Twitter: @SamSeder @EmmaVigeland @MattLech Check out Matt’s show, Left Reckoning, on Youtube, and subscribe on Patreon! https://www.patreon.com/leftreckoning Check out Matt Binder’s YouTube channel: https://www.youtube.com/mattbinder Subscribe to Brandon’s show The Discourse on Patreon! https://www.patreon.com/ExpandTheDiscourse Check out Ava Raiza’s music here! https://avaraiza.bandcamp.com/ The Majority Report with Sam Seder – https://majorityreportradio.com/

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Check them out. Sunsetlake sabadeh.com. Use the code left is best and get 20% off. Now time for the show. The majority report with Sam Cedar, where every day is casual Friday. That means Monday is casual Monday. Tuesday, casual Tuesday.

Wednesday, casual hump day. Thursday, casual thurs. That's what we call it. And Friday, casual Shabbat. The Majority Report with Sam Cedar. It is Friday. June 27th, 2025. My name is Sam Cedar.

This is the five-time award-winning majority report. We are broadcasting live steps from the industrially ravaged Gowanus Canal in the heartland of America, downtown Brooklyn, USA. On the program today. Ryan Grimm. What is it? Oh, yeah, drop site and counterpoint's host and frequent guests on the show. He was live in the Mamdani election party. Also on the program today, Dr. Adam Gaffney, pulmonary ICU doctor,

healthcare researcher at the Cambridge Health Justice Lab. They just released a study that shows the devastating impact on human life that this bill the Republicans are trying to pass will reek meanwhile speaking of reeking

Supreme Court dropped a couple of rulings today in fact the last of their term the two biggest they have limited nationwide injunctions and to undermine birthright citizenship

Another ruling also allows religion to supersede all other rights in many respects by allowing parents to withdraw children from classes that in any way include books, that in any way mention anybody who's lesbian, gay, by transqueer. back in the Senate the parliamentarian continues to strip from the Republican fat cat bill the worst of it still remains John Thune may have to keep Republican senators working over the weekend as they struggle

to tear health care away from millions and give millions back to rich people New York State Senator Christian Gillibrand goes full Islamophob

in wake of the Mamdani win Trump's DOJ pressuring the UVA president to resign because of yes DEI Bob Kennedy's

anti-vax board votes to remove the Marisol from the flu vaccine even though it's not in most of the flu vaccines in this country, but it will probably make that vaccine out of reach for some poor people. IDF soldiers tell Haretz that they were ordered to shoot unarmed Palestinians waiting for Gaza food aid. U.S. economy shrunk more in Q1 than previously announced as tariff evasion drove our GDP down

and finally rest in peace Bill Moyers one of the truly great journalists of several eras dies at age 91. All this

and more on today's majority report. Welcome ladies and gentlemen. Thanks so much for joining us Emma is still on her honeymoon

How long is this thing going to last? Four months ago. It's it, I mean, it's been four days, right? I mean, in terms of news, which is how I measure things, it's been but four months. Actually, no. I mean, she couldn't have. It is hard to imagine a week where there would have been more news. She, of course, had going to be gone.

for another week because you know it's her honeymoon but even still whatever um we have seen a wide a array of a wide array of um uh responses to zohran momdani really spanking Andrew Cuomo in the Democratic primary for mayor now just an update Cuomo has decided that

there is not going to be he is not going to give up his ballot access the deadline passed I think yesterday that does not mean that he's going to run but it does sound like he's going to see

how much money he can get to run. They are scrambling big time. I'm sure you guys yesterday spoke about the Bill Ackerman, Ackman. Yep, segment one. Insane rant on I've had, I've been getting

up in the middle of the night, like a three, and I know I shouldn't go on Twitter, but like I still, because of the whole Zoron thing like I do, and I saw him, he had tweeted at one in the morning, and it was literally something that he must have been writing all day. And it ended with, we're going to do a writing candidate.

And I will tell you, the level of insanity associated with something like that is enormous. And just on top of the fact, like, dude, you're literally saying that you're going to try and buy this election. This is all stuff that you should never have written down for publishing. You mean, you should never do any of what you're talking about. And you shouldn't be you, but I understand that you are. But you should not be tweeting that out like that. It is in your absolute worst interest, which allows me to believe that honestly, he's just, he's just crazy. We, I know you've gone over yesterday a wide array of the right wing bigotry that was unleashed.

And it's almost as if they, it is what I call everything bagel bigotry. and uh they don't know which which element of the bagel of the everything on the bagel that they want to focus in on and i understand um folks like hakeem jeffreys and uh and and chuck schumer you know giving sort of half-hearted not so i congratulate or, you know, recognition because, of course, their donors are very concerned about Mom Donnie, probably more from a taxation standpoint. And also, broadly speaking, they all know that things like this create broader implications in our body politic.

It's not just New York City they're worried about. it's not just the added two percent if i make over a million dollars you know the twenty thousand dollars for a millionaire is just you know people like 20 thousand dollars if you have a million dollars but it's not it's not that big of a deal um they uh they are concerned about it spreading and it giving people hope and um they are they it's the precedent they're concerned about but i have to say that with all of that as jaded as i am i was shocked to hear the audio of christian jillibrand on w nyc and i'll tell you something like um i heard about this seconds after it was on air from total normies

who texted me and were like you cannot believe all Jews incidentally too I mean yeah actually I heard it from three people within like 10 minutes who listened to Brian Lear

which I now okay back in the day at Air America at one point I was on against him in which case it was not appropriate to listen but they all texted me some variation of you cannot believe what Christian Gillibrand just did on Brian Lear's show. It was bizarre, insane, bigoted nuts, I think, were the, some variation of those.

Here is, now understand, Brian Lear's show, it's a local show, but it's New York City, so it's quite large. Bigger than most and probably national shows, even maybe, for some. he takes phone calls when he has guests on he takes phone calls and they ask the guest question and you will always get a wide array of guess so the issue here is not so much i'm not so surprised about the caller and i'm not so surprised about the caller you know sort of like presenting a series of lies or exaggerations or uh manipulations that lear can't address and And to be clear, Lear was not a mom-dani guy in the run-up to the election. But I don't know.

I think he was almost worried about getting sued at this point. But listen to not just the caller, that's almost less relevant. It is less relevant. Listen to Christian Gillibrand. This is her speaking, incidentally, hot off the heels of her midwifing, the genius. act i mean she was i don't know if she was the author but she was certainly one of the co-sponsors the genius act is a crypto bill that is going to be i guarantee you i don't know that i'll still be around maybe i'll be down to one a week uh at that point but in five 10 15 years

we're going to have a financial meltdown and it's going to be because of this among other things, probably, but that genius bill. But this is just completely insane. Hi, good morning. Thank you for taking my call in question. I want to ask two very pertinent questions about the threat facing the Jewish community, unfortunately from Zora Mamdani. There was a bill that I was reading about that, unfortunately,

he wants to target synagogues and Jewish institutions, which donate to nonprofits, which are medical institutions like United Hattala, and Magan devote David Addam, which is like the Jewish Red Cross. So how do we make sure that Jewish institutions are protected from his plans to punish and fine our institutions which fundraise the medical nonprofits, which do work both here in the United States and in Israel and other countries in the world? And also, how can we hold Mr. Mandani accountable for his glorifying Association of Hamas and other terror bombings of the Intifada in 1990s, where over 1,000 Jewish Israelis were killed to his revisionist Holocaust knowledge to the Warsaw Ghetto uprising where Jews were mass exterminated and faced threats? He compared when Jews were killed to when Jews fought back against Nazis. It's quite despicable. I'm sorry. Gabe, thank you for your call. There's a lot in there, Senator, some of which may be inaccurate. So I don't know, you know, I can't fact-check everything in real time, but do you know any of that to be inaccurate or accurate, including the original premise that he would somehow target synagogues if they were contributing to groups like Hatsola ambulance services in a way that he could hurt the synagogues?

I just don't want to give out information that's false, but I also don't want to shrink from information that's true. well um the caller is exactly the new york constituents that i've spoken to that are alarmed um they are alarmed by past public statements they are alarmed by past positions um particularly references to global jihad um this is a very serious issue because people that glorify the slaughter of jews cause for a second create fear in our that's her first lie he didn't say we should engage in global jihad Like, you're a U.S. senator. And, and incidentally, this is obviously sped up a little bit. So, like, this wasn't, you know, she misspoke, I guess.

She's being very fast and loose. Global jihad. Okay. Past positions, particularly references to global jihad. This is a very serious issue because people, that glorify the slaughter of Jews, create fear in our communities. The global...

Pause for a second. People that glorify the slaughter of Jews create fear in our communities. Who is glorifying the slaughter of Jews? What, who is that she's talking? She's talking about

Zoran Mamdani. Is she claiming he's glorifying the slaughter of Jews? Maybe Christian Gillibrand. she'd call Bradlander. Maybe Christian, is her name Christian, Jilliebren, or is it Kristen?

I think it's Kristen. Maybe she should check in with a Jew before she starts claiming that Mamdani is glorifying the slaughter of Jews. Unbelievable. This is a very serious issue because people that glorify the slaughter of Jews create fear in our communities. the global intifada is a statement that means destroy and destroy Israel and kill all the Jews. Pause it for a second. That is also a lie. It doesn't mean either one of those things.

Like, in no possible way does it mean kill all the Jews. It doesn't really mean destroy Israel either. But like, that's like, that's like three. steps away if you wanted to sort of like really you know fudge it a little bit you could get to destroy israel or destroy the ethno state as opposed to you know uh like a political revolution but in no one's even fever dreams does it mean kill all the jews or any jews you're the kind of things that if Mr. Mamdani is elected our mayor will need to assure all New Yorkers that he will protect all Jews and protect the House of Worship and protect funding for not-for-profits that meet the need of these communities. Pause it.

Maybe she doesn't get over-the-air television, and maybe she hasn't heard of Colbert. But, like, in addition to him doing this on the campaign over and over again, he was on with Bradlander, being extremely explicit about this and bradlander saying like in fact not only we're going to have uh you know to have a uh a jew and a muslim going around campaigning together is as new york as it gets um and incidentally those not-for-profits that meet the needs of these communities the needs uh the community that she's referring to maybe she doesn't know are illegal settlements in the West Bank that were illegal under Joe Biden. Now, Israel has said that they're legal.

Now, they're still illegal under what has been everybody's past policy, including Bidens, maybe short of Donald Trump's, and certainly international law. You'll have to do as our mayor. He would certainly say that he has committed to protecting all Jews in New York as mayor of New York. Do you dispute, do you— Pause it for a second. Now, Lear says this in a sideways way. He should have probably—he said, well, he has committed.

It's not that he would say that. He has committed. Now, you may not believe him. He could be a secret sleeper cell. But he not only would say that he said that, he has said that. good do you do you doubt that well i one of the issues i did talk to him yesterday was exactly this issue and he

has agreed to work with me on this and to protect all residents okay positive this is where uh christian gillowbrand seems to have a repeat repeat offender uh despicable problem if you read the jane mayor story about al frankin she came out and called for his resignation when it was already clear that he was going to do that

and her coming out and saying like she's going to take credit for him to protect all say no he's been saying from day one go ahead this is something I care deeply about and so I will be an advocate on these are things that I think are important to New York

you know what else she was an advocate on it seems to me sexual harassment in the military and I'm trying to think who it was that Zoron Mandani was running against Oh, yes, a serial sexual harasser.

Go ahead. They get on these issues. These are things that I think are important to New Yorkers. And I will work with him when he gets elected if he gets elected to make sure everyone is protected. I also, on the federal level, work to get resources for all our religious sites in the state and in the city. I lead the letter for funding for – I lead the letter for the funding to protect synagogue. and churches and temples and places of worship across our city and state. Oh, wait a second.

I'm trying to think of all the three big religions in the state. Christianity, they go to churches, and Jews go to temples, although sometimes you call it synagogues. Hindus go to temple. That about covers it. I feel like, oh, mosques. Oh, I have to. look at that up in the dictionary. It's funny. It's funny how global jihad comes right to mind, but mosque, I forget the name of it. For the funding to protect synagogues and churches

and temples and places of worship across our city and state. And these are things that he has assured me in my one conversation that he will protect everyone. But I understand why people are concerned because of past statements. And so this is just an issue that I will work with him on, for sure. I just feel compelled to say, we can find no evidence that he has supported Hamas. or has supported violent jihad, as that caller was asserting. Can you? Again, Brian, I don't have all the data information, and I've never sat down with Mr. Mamdani.

So I've asked to have that meeting. I'm going to have that meeting. We will talk through all these things. He can tell me his views of the world. Oh, pause. Oh, I hope we, can we get a live stream of you asking him if he's in favor of Hamas and violent jihad? This is just unbelievable. I, if she doesn't get primaried, I will be shocked.

If she's using it primaried, I may just spare my run against Schumer and run against her. Oh, oh, did I say that? Get the Kirsten out. Someone's going to get to rejillo branded. I don't know. We've got to work on the, um, uh, going to work on the on the slogan we will win we will win it's unbelievable that it's unbelievable she needs to issue an apology multiple apologies well her comsperson said she misspoke so

not enough to apologize for it but she misspoke oh i'm sorry was this uh she misspoke was this was this was this was this a special episode of the brian lear show not on in the uh late morning but rather at like 3 a.m. on a Friday night. Folks, a while back, oh, let's hear a word from our sponsor, shall we? A while back, I noticed I was a little thing on top of my head. And I didn't want to take anything that was drug-based. And we actually had Neutralfall in the office,

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Thank you for me. Thank you. I don't know. Thank you. we are back sam cedar on the majority report it is a pleasure to welcome back to the program ryan grim the uh founder and or co-founder of the site drop site um which you can find on substact we'll put a link to that and also the co-host of counterpoints um on the uh breaking point For this exact reason, we are actually, like, phasing out the name counterpoints because it's just so confusing.

Counterpoints on the breaking points channel. So it's just all going to be breaking points now. So we'll just have four co-hosts of breaking points, but like two a day. Interesting. Yeah. All right. Well, we will win. We just broke some news, did we?

You did. There you go. Okay, there we go. uh ama vigland on her honeymoon um it's already been four days i don't know what she's doing but um uh uh uh there's a couple stories i want to talk about um but let's obviously start with the big big one um you literally wrote the book about uh winning a campaign uh when they have money but we have people. The name of your book,

I'm not sure if you recall, the first one was they have money, we have people. Yeah, there you go. And, you know, underpinning that is that you also do need a little bit of money,

not just people. And New York City's matching funds, you know, I don't know if it necessarily made this possible because as, you know, Mom Donnie was turning money away, but without the match getting him into the kind of

credibility, liability range, maybe he doesn't get that amount of small dollars because people don't want to just give to anybody who is going to get 3%. Absolutely. And you can't manage 50,000 volunteers unless you have some paid staff. Exactly. And you can't like organize that number of volunteers without some paid staff and some people. They might show up once and then it's a disastrous experience. You know, nobody's got a clipboard for you. They don't tell you what to do. It's hot out.

And you're like, well, I tried. So to make it a fulfilling and enriching and useful experience for these volunteers, you have to have it well structured and organized to get them to not just come back, but then to recruit their friends. So yeah, you do need money too. So. And which he had. All right.

So let's, I mean, you know, track this for us. I know that you interviewed Mamdani like seven months, like maybe around January, I think. We just looked. It was November the first. November. Okay. And what, give me your sense of, like, how this tracked over the campaign. I mean, we interviewed him in January, and I noticed, like, about a month or two ago that the title was still like, is he going to beat Adams? And, you know, we're like, oh, we should change that. Now, of course, it's back in play, because Adams had dropped out. But, like, what, how do you know, what happens? happened here? I mean, what, what, what, what, what do you, uh, attribute this to? That's, that's interesting. You know, he had to, he had to get past a threshold of support, which means he had to start raising enough money that he'd get, start getting his name out there.

And with the, and he did that very early, and thanks to these matching funds, you know, up to $250. It's matched like six times or something. So he had, you know, by, you know, by, early January, a significant amount of money to start spending on, you know, social media ads and to, and to put together a team that could then produce these really well done, you know, social videos that were getting out there. And he hit the, he hit the podcast circuit, you know, pretty hard. So, you know, you can, you can reach kind of a threshold amount of, of people who were, like, very plugged, because they're very plugged into politics. Like, right. In fact, outside of the campaign headquarters on Tuesday night,

I met a woman who was going to an exercise class. She was wearing a Zoran shirt. And she said, hey, I love breaking points, and I love the majority report. Like, I was, I was, I was, I was, she said both. Yes, she watched a majority report. In that order? Okay.

Well, breaking points is in the morning. Majority reports in the afternoon. Okay, that tracks. That tracks. Yes. And she said, like, you know, She constantly wanted to watch these programs to get updates on Zoron, but she'd been watching it for a long time. So that's the kind of person that's going to then volunteer for the campaign.

So because of this independent media pipeline, you can actually reach them. And then at some point, I think the public woke up to the fact that Andrew Cuomo was seriously trying to have another act as mayor of New York City. so then needed to start paying attention to this election and to see who the viable opponents were and by the time people were paying attention Mom Donnie was viable

and had a message that resonated with people which is that the city is unaffordable. You have to make several million dollars a year. You tell me in New York City for that not to resonate with you. Oh, without a doubt. I mean, I mean, the city's incredibly expensive um and it does resonate across a very wide spectrum of what you know um people would

be surprised i think if you live in other you know in smaller cities just like how wide how uh that that resonates i i i had people the day after the election uh approach me about child care uh and they're like, you know, we're spending, you know, $40,000 a year on child care. Right. And now, look, there's obviously cheaper child care, but I don't know that you get it cheaper than like $15,000. I mean, I was in a co-op 10 year, 12 years ago for nursery school, you know, and that was 12 years ago, it was around that amount of money, but you could save money by a co-op,

but it helps just the idea of being seen in that way by a candidate. I think. But let's, I just want to, like, this is, what's fascinating to me is that it feels like the Cuomo campaign and the entire Democratic establishment that was so upset the day after, whether that was like in the CNBC crew, I mean, obviously, let's put the right to aside for a moment. It is amazing to me because we have seen starting with the Howard Dean campaign, which was. in 2004, that there's a shift in the dynamic of how campaigns are run. And the reason why the primary is in June in New York State is because it was a incumbent or a big-name protection racket. Right. They have the machine.

Cuomo knew from day one he was going to get his whatever, 350,000 votes that are going to come from the the machine that has been built right and they just assume nobody can get a higher number than that so if we put it in the summer uh you know people won't come out they don't realize that this alternative mechanism to at least get a jump start i mean look mom donnie is a great candidate uh you know and um not everybody could do that um but they don't realize there's a A mechanism, there's a counter machine that exists now that didn't exist, let's say 30 years ago. Yeah, AOC found that exact kind of crack because it was right around the exact same time that her primary was scheduled against Joe Crowley. 40,000 people voted in that primary.

This is a district that represents a roughly 700,000 people. So, you know, Zoran had, what, 50,000 volunteers? volunteers. She needed like 16,000 votes total to knock off one of the most powerful Democrats in the entire country. It's sort of, yeah, it's like a Death Star situation where somebody like put a little like flaw in the blueprint that, okay, this will work unless you can excite people and get them out to the polls. And Democrats, it could not imagine a world in which voters could get excited to go to the polls and vote for somebody other than the party machine pack that was being put up. And that lack of imagination has now cost them across the board.

Like DSA's like elected a ton of people. Yeah. To the assembly, the Senate. You know, after 2018, Mamdani was elected in this 2020 wave. I actually met, do you remember Adnan Gabra Gorgeous who was the second candidate running against Elwood Engel? Yes. Yes. Yes. Yes. I interviewed him as well at that time, and he dropped out in support of Jabal Bowman. Of Jabal Moment, yeah. And that was actually a crucial moment because he dropped out and endorsed Bowman, and then it was just a day or two later that Elliot Engel went to this Black Lives Matter rally. I'm only here because I'm being contested, yeah.

And he was only there, I think, because he now had only one opponent and thought he might lose. But anyway, Gabbergorges was at Zoran's party. he organized the East African voters for for Mom Dani. And he told me that when he was running in that 2020 race, in September 2019, he went to the AOC Bernie rally, which is right nearby in Astoria, you know, just canvassing trying to, you know, raise money, get signatures, meet voters.

And he said he saw this kid and hustling outside of the Bernie Sanders AOC rally. And the kid had some magnetism to him. And so he went over and watched him for a while and watched him speak to people. And he's like, he's like blown away. He's like he's the only candidate I gave money to. Like he came there to like get signatures, shake hands, make raise money. He ended up giving this like 26 year old Zoran Mamdani $5 for his, for his campaign and stayed in touch with him after that. And he, you know, Mom Donnie that year knocked off a longtime assembly member.

And Mom Donny and the other DSA members, you know, formed this block. in Albany, which caused real problems for Cuomo, and I argued, like, helped kind of push him out. Like, he may have been able to withstand his different scandals, if not for this genuinely oppositional block that was against him in Albany. And so this has been building for a long time, and the city just never, the city Democrats never moved the primary. You could move them together, like have everything in September, or you can have everything And although, you know, having it in September, if you know, really screwed them with George Santos because they had all of these guys elected in like September and then they had no time to like be like, oh, by the way, this one's a con artist.

Yeah, I mean, that's the, it's a dilemma. And I should also say that this primary garnered, as far as I can tell, I don't know the exact numbers, but close to 20 to 25 percent more voters. than the last mayoral primary. It was well over a million. And the other dynamic, I think, is that progressives were smarter about how you win. I mean, one of the stories was AOC. You know, people were waiting on her endorsement. She ended up endorsing very, you know, in timing wise, almost the same time she had in the prior race.

And from my perspective, I don't know if this is what they're thinking. thinking was it made a lot of sense because people don't know that this a campaign is happening you want to do a close so that it's like an action item right you don't you don't want like hey make sure you buy my book in six months uh when it comes out no you want people to be able to act but one of the stories i read was that like her she and her team wanted to see a coalition you know like some type of like cohesive strategy by all the progressives as to how you're going to be Cuomo. And I don't know. Do you know much about that story? Yeah. Yes. And also, yeah, yeah, that is the case. And Brennan and C.

of who's a UAW official who organized the UAW's endorsement of both Mamdani and Lander. They came in very early. And they pushed those two very hard. They said, look, you guys need to be together. Like this needs to be, you need to cross endorse. Like, you're not going to be able to beat Cuomo alone. And AOC felt the same way. And I, you know, there's, who knows, counterfactuals, et cetera, but I think it's true. Like, I think Brad Landers support for, you know, for Mamdani was essential to get him, to just fortifying him through some of the tough moments. But then also, Mom Dany's team was telling me that their early polling had them winning something like 60, 40 of Landers voters. after the endorsement, that moved up considerably to like closer to 80, 20 or something,

which is really unusual, which shows like, because usually candidates can't actually move their own voters to somebody else. The voters like, yeah, I like you, but after, if you're not going to win, I'm going to choose for myself. It's rare, actually. And, you know, AOC can do it. Bernie can do it. A few people can do it because they become a heuristic in people's minds.

Like, okay, Bernie supports this person, then I don't need to look into them. he's he's looked into it it's fine but there's not a lot of people that can do that but lander for his voters in new york was able was able to do that and so that was really he created a permission structure i think for a lot of jewish support to say like okay uh i trust land elizabeth warren level support like yes yes college graduates speaking of that the colbert uh or uh late show thing do you know anything about the sort of like what went in into that interview, because I was very surprised to see Stephen Colbert asked that question, particularly in the context of which he did.

It was sort of like almost the first question. But it also struck me like, that is a great question to ask, that it's not inconceivable that that was put on the agenda by the candidates, because you are reaching exactly the demographic you want that Cuomo has been reaching with relentless ads. if you want a chance to address that ad, that would have been the time and place to do it and sitting next to Bradlander would have been the way to do it.

I don't know enough to say whether or not that was orchestrated or organized. I have heard that it was rocky, like that there was more even to the story that behind the scenes, there was even some kind of aggression from around that whole situation, which I'm still trying to report out. So I don't have all the details yet. So I think that there, but I think there could be multiple things happening at the same time. I think there could be some kind of Colbert factions or whatever, you know, inside his staff or something that really wanted like an ambush type of, like we're going to nail this guy situation.

But then you're right that actually it plays to, you know, Lander and Mamdani's advantage. Because not only does it look weird because it's like there aren't these guys running for mayor? Like what is going on here? and then really you're going to be attacking this guy when the two of them agree for the most part about this issue and he supports him and vice versa like so it does really take the teeth out of out of it i think it was very helpful for uh mom dony i think it was very helpful if there were some colbert staffers who thought that they were going to um you know hurt mom donnie with that it shows that that's why they're in comedy you know and not well i mean But Colbert, in my experience, and I haven't, you know, I haven't had a conversation with him in over, you know, probably 10 years, I was surprised by that question, just knowing, you know, what his politics were, at least. I was rather surprised. But, all right, let's look down the road a little bit. We don't know who Mom Donnie's going to be running against.

It could be like, you know, sort of the ghost of Andrew Cuomo, because he's still going to stay on the ballot, which if I'm on Donnie, you know, and Cuomo still he's still hemming and hiding, having his name on the ballot is not a bad thing. Because if he's not going to put any effort into it, which, you know, it sort of feels like it's only going to cut into Adams. And it just makes it harder for, you know, Bill Ackman to know who he's going to pay. I also think, you know, do you have a guess on who Ackman's candidate may be? Because I have one, and I'll say mine first, just so that you don't trump me. Okay. Listen to the words, I'm going to say. Mayor Seinfeld.

I almost tweeted that yesterday. I didn't want to tweet it into being, though. No, I know. So now that you've done it, it's your fault. He did use the word young, and maybe compared to Larry David, Seinfeld's young. Yeah. Although Larry David's been old for like 55 years. Yes, that's true.

I don't know. Now, Larry David ran. Now, he'd have to move from L.A., right? Right, right. Everybody loves Larry David. That's a real contest. That's that guy, Pete, what's his name, the guy from Sari Night Live? Pete Davidson.

I honestly think that's what he's thinking in his head. I thought he was thinking Richie Torres. Yeah. It's true. He's not joking. Matt's laughing because it is that like... No, I genuinely think that's the name. Because also if you think of what Jerry Seinfeld, I love it.

If you read his entire pitch, like that whole post is so worth reading. It's Ackman begging somebody to run and making the kids. for why you should run. And his arguments are so self, just playing right to the person's self-interest. It's a short campaign. It's not even that much of a lift. You don't even have to campaign that hard. You don't have to fundraise. I'm going to raise all the money for you. You're not expected to win. So if you don't, if you lose, it's not actually going to hurt you that much. And you're going to make connections to donors who are then going to be supportive of you for the rest of your career. He's just explicitly saying all this.

stuff, which is like nice of him to do in public, because you can, like, you can imagine him sitting down in a boardroom somewhere and explaining all this to Richie Torres, but it's like nice to hear him just say it out loud. And then he says, I would say the person's name, but the fact that I'm a Trump supporter, you know, would then tarnish him. So if I just do this and recruit him publicly and then spend all of my, all of his money, then it somehow isn't tarnished. But yeah, that's the case that, and he's always telling Richie Torres, what do you have to lose? It's four months of your life. And then you get connections with us billionaires for the rest of your life. I didn't realize how insane Bill Ackman was. I mean, this is, I mean, he is a

crazy person. It is not so glad that he's in public, though. I think this is, I think this is publicly known. But in 2004, I was writing a blog that was supposed to be a personal blog by a New York Times reporter and it was back at the time where you know people of a certain age could get this wrong and think that the blog was only available to their friends because it was like locked to their friends and so it was just all this sort of catty stuff um and it's like does this guy think that nobody like was he trying to sort of like get a huge thread of of people going like either, you know,

Richie Torres should run or, oh, that's a great idea. But like, anybody with half a brain realizes you cannot do a writing candidacy to win a general mayor, mayoral election in New York City. Yeah, and is Richie,

does it have a T, R-I-T, is it R-I-C? Like, is it Richard? Like, so, yeah, a lot of confusion there. Yes, in that post, he said, then if you have names, please post them below, and then I'll create a poll so that my fingerprints are not on this. But we know it's him.

Like, we know. This is not a WhatsApp group, man. That's what I'm saying. It's like he thought that he was just doing this on his own signal channel or something, and nobody else was reading it, and that he would not get a million responses that were all mocking him. It reminds me of this great Saturday Live skit in 2016

where Trump is like, I don't use insecure email. I use this private messaging app called Twitter. And the moderator's like, Twitter, that's public. He's like, and I'm still in the election. That's public. Somebody was also doing that like,

wasn't that Chris DeLilla thing where? Oh, yeah, Snapchat. We get access those later. You can take pictures? Wait, well. All right. Last question on this. What happens with, like, we have,

Mamdani needs to implement his stuff. He's going to need to win in Albany if he wins the mayoral. And they're going to fight. Not only they're going to fight to keep him from being mayor, but if he becomes mayor, they're going to try and make it the worst, you know, mayor, mayor, mayor, in the history of New York. I mean, they're just going to, tooth and nail.

But it seems to me that Kathy Hogle has a problem. She does. Because Anthony, Antonio Delgado, her lieutenant governor, is already trying to run to her left. And she's been trying to sort of edge over there. And now, like, is she going to want to be seen as the one who's blocking Mom Dani from achieving, like, if I'm on Dani, on day one, I go up to Albany.

Like I say, thank you for inaugurating me, and then I just go up to Albany and start to do the, because I got about a year and a half to get this done, it seems to me. So aside from, like, all the implications that could be nationally of, like, where it's going to push Democrats, and maybe we can talk about that in, you know,

in later weeks. But for Hockel, this could really push Hockel to the left because she could be looking at Lawler, you know, I mean, that's a general election question, but if she moves to the right, Delgado could as she moves to the right, Delgado

could end up being between her and Mom Dani. And so, this is a very tenuous place for her, and she has never struck me as that bright of a politician. No. No, and also, Mom Dani and Delgado, both former rappers, right?

I mean, I don't know if there's a rapper like a code or what not. I used to get feet, more likely to see. No, but yeah, so what he needs. So that's where his experience actually is helpful. Like he does know Albany. If his movement can get primary challengers out in the field, like starting immediately for this, for the next cycle.

And you have, you know, end up WFP out there as well, challenging 10 to 20 assembly members and, you know, five to ten state senators who were wobbly on on these questions and mom done he doesn't endorse at first you you know you hold that you know the endorsement is the bullet and the gun that you hold back if the if these state senators and assembly members pressure hokel to let mom dony just do the things he said he was going to do when he ran like which is not a radical ask and frankly the things that he wants to do are not in it and as radical as people are make it like there are municipally owned uh grocery stores there are free buses

there are you know rent control's been done before um you know by multiple administrations you know none of this stuff is you know pie in the sky um it's you know this is not radicalism this is new deal democratism on some level it just and people voted for it so like let them do it and so and then if albany comes through then you know they can know Mamdani can disappoint all his supporters and not endorse the kind of challengers to these incumbents and even endorse the incumbents if the incumbents allow him to execute on his agenda. And, you know, Hockel then the more pressure there is in Albany from the assembly and the Senate, the more pressure there is on Hockel to do it to do it as well because then she really is the one standing in the way with Delgado over here, you know, like you said, taking up that space. it does seem like it's not insurmountable. Like the New York Times is just like,

oh, he can't do this. He requires Albany and Hockel says forget it. But it's not that simple. No. And I think she's doing a soft forget it so that if there is a candidate to run against him in the fall, that that's how they're going to run on.

Like his program's already dead in the water. But she's going to be singing a different song uh you know we saw her uh on congestion pricing she's not she is not adept at this right uh i mean i don't know what else to say she is not adept at this all right uh ryan i'm going to let you go because i know you got stuff here but one final thing um there was a p there was an uh a big investigative uh story in harrats um i mean drop site news is um has been incredibly um not only consistent, but relentless and insightful in its reporting on what's going on in Gaza. We had Jeremy Ska-Hall on, I don't know, a couple of weeks ago talking about the interviews that he had done with Hamas.

And this story about, it's almost been, we've seen it. But we didn't see what, you know, just how depraved it was, that there were orders, standing orders, to shoot Palestinians coming for food aid. Right. Right. We've heard it from Palestinian witnesses. We've heard it from the medics and the doctors and the nurses at the hospitals who've treated the victims. We've seen videos of it, but what we hadn't gotten yet and what Horat's delivered is inside reporting. from, you know, the soldiers themselves who are participating in these massacres.

And, you know, Israel is such a small country. You know, imagine a, you know, it's a country the size of, say, Maryland. And so, you know, I grew up in Maryland. If Maryland was at war, like, I would know a whole bunch of the people who were at war. And so the journalists in Israel are better sourced than our kind of journalists

because we've got a military of millions. And so if a group of people of Marines commits a massacre somewhere, like chances that I'm going to know one of those Marines is not very high. Whereas in Israel, they're going to, like, these people are friends. They're texting. They know each other. And they're like, you have no idea what we're doing out here.

Well, we do have some idea because we're hearing it from the doctors. We're hearing it from Palestinian witnesses. What's going on? And the soldiers are telling them. We're being ordered to shoot at civilians. I had, when I first saw this, and I think I talked about this on breaking points, saying it looked like squid games like an actual real-life squid games and to see in harrets the soldiers themselves call it the israeli version of red light green light like it's

depraved on just an utterly incomprehensible level every time that these massacres occur almost every time the idf says we're going to investigate this we've we heard that there were warning shots were fired we're going to investigate this they never investigated what arest shows is that if you do investigate even even without the authorities that a military has to investigate itself you can uncover what's going on here and the iCC comes into play when a government refuses to prosecute war crimes like that's the condition under which the iCC has jurisdiction and so the only argument in israel has for prosecuting some soldiers during that you know for that rapins today telom prison that was called on video the argument was if we don't do this it gives the iCC jurisdiction is even even that argument is falling flat it seems it it i mean it just seems like they do not care and you know the like there has been clear evidence of this like you say from the perspective of

of Palestinians and from doctors, and it's not like the people in Israel, in Israeli government, or in the Israeli military don't see these things. It is a willful blindness, it seems to me. You know, Mom Donnie shared that Harette's article today. Oh, he did? Well, that's part of the global jihad that Kristen Gillibrand was talking about, spreading Haaret's articles. That's right.

Um, ha, a ratz. Somebody just corrected me on the, I am. It's like, do people not watch this show? He pronounced Ryan Grimm right today, so give him some credit. I did. I was like, do we have the Ryan Grin on again? Ryan, thank you so much for joining us. I really wanted to talk to you, uh, because of all the reporting you did in,

you're and now you have like a trilogy i thought i was done with this uh because ryan has written two books that are sort of um historical what do a diptic yeah there you go um volume one and two volume one and two um uh having traced uh oc's uh campaign and that concept and and this is a concept that is growing and like i say you know like i think this is we're seeing that this is the that sort of like the the the you really can track it to the dean campaign in terms of their their ability we've got people traces it back there yeah yeah um thanks so much for coming on really appreciate it know you're on vacation that is pleasure well dedicated look at that uh thank you i appreciate it um we will put those links in the youtube and podcast description all right we're going to take a quick

break. And when we come back, we're going to be talking to Dr. Adam Gaffney. He is a pulmonary and ICU doctor. He is also a healthcare researcher at the Cambridge Health Justice Lab. They put out a report on the projected effects of the proposed cuts in federal Medicaid, and essentially how it's going to kill people. And this is all in that supposed big, beautiful bill. We'll be right back after this. Thank you for me. Thank you.

And so. Yeah. And you're I'm I'm going to be able to be. Yeah. And so much.

And so. And so. We are back, Sam Cedar. We are back, Sam Cedar. On the Majority Report, it is a pleasure to well. Welcome to the program, Dr. Adam Gaffney, pulmonary, ICU doctor, and ICU doctor, I should say, and a health care research at the Cambridge Health Justice Lab of Harvard Medical School. And one of the authors of a report on the cuts that are outlined in the house, and presumably the, the Senate bill of Medicaid and its implications to people, essentially.

Dr. Welcome to the program. Thanks so much for having me on. Walk us through what, there's a couple of different sort of provisions that will cut Medicaid. And I want to get that in a second, but just give us a sense of like how much reliance is there on Medicaid for people to get health care and for hospitals to be able to provide health care? Yeah, so look, Medicaid was set up in 1965, and since then it has grown a huge amount.

You know, we set up as a program for low-income Americans over time, or Affordable Care Act, other provisions have expanded it. So today, more than 70 million low-income Americans depend upon Medicaid. as they are a primary source of health coverage. So that's a huge number. And from the provider's side, you know, I work in a safety net hospital. So many or maybe most of my patients rely on Medicaid, many hospitals in, you know, that focus on disadvantaged communities that treat patients from lower income backgrounds

rely hugely on Medicaid. It's, you know, given the lack of a universal health care system in our country, it's kind of like the foundation of the health care safety net. And so that's kind of the role it plays in our society. Well, in terms of that growth, the ACA expanded eligibility to Medicaid up to was 130% or 140% of poverty. 138. In all but I think at this point 11 states in the kind of.

country. So that added millions to it. Again, if you're making 138% of poverty, you're not wealthy by any stretch of imagination. Also, the expansion of Medicaid became, was also a function of two-thirds of our elderly being paid for their time in nursing homes by Medicaid, where people have basically run out of their assets, spend them down or, you know, with home care or whatever it is, and get in there. So there's a wide range of people who are reliant on this. Will you talk about the dynamic between Medicaid, like the federal government and the state government, and maybe contrast that to Medicare? Yeah, I think that's a really important point. And I think, you know, despite the fact that these cuts are going to be devastating, it doesn't mean that things

were well in terms of the status quo. But, you know, both of these Medicare and Medicaid were both passed during the civil rights era. And Medicare had a little more of a traditional national health insurance model. It's a federal program. It applies similarly in all 50 states. And it automatically, you know, is given to everyone 65 years of age and older, as well as some additional programs. Medicaid from its inception was a federal state program, meaning there are certain rules set at the federal level, and there's federal contributions that go to state programs so that they can run these programs provide its coverage. Now, the problem with that is that historically, states have differed hugely in terms of the generosity of their Medicaid programs.

You know, my state, Massachusetts, is a pretty good program. Some states are pretty miseries. and, you know, try to only cover the bare minimum. Now, and originally, it wasn't just enough to be poor to get Medicaid. You had to be poor and fall into certain eligible categories, you know, people with disabilities are blind or with dependent children. So the big change, as you mentioned, was the Affordable Care Act. That allowed anyone below a certain income to qualify. And it was actually supposed to be for the whole country.

But as you're aware, the Supreme Court ruled that it had to be optional for states. And so most, but not all, states have now implemented this Medicaid expansion. In 2017, Trump tried to really, you know, basically repeal the Affordable Care Act. And that effort sort of famously went down in defeat. There was a lot of opposition. There was divisions within the Republican ranks. I think what they're trying to do now is more similar to 2017 than people realize. they're framing it not as an affordable care act repeal they're framing it as sort of uh you know

making the program last longer for those who are most eligible for it uh it's all a lot of nonsense it would do very it would have similar impacts as that 2017 repeal uh in terms of like kicking people off and how and how that happens state to state we don't really necessarily know right Like, I mean, you, people, different states will impose different sort of like new eligibility requirements to fashion their program to fit the fewer dollars they have. So in some states it theoretically could be, okay, like I happen to know Massachusetts Medicaid in terms of nursing homes. I've had some, you know, I'm from Massachusetts. I've had some personal experience with this. You can't have more than $5,000 assets.

um uh and you know in terms of you know and and you can't have given away the money or anything like that for like five years in advance or in uh in the past uh before medicaid comes in and starts providing paying for uh nursing homes theoretically a state i would imagine we won't see a lot of this but theoretically they could say okay you can you can only have two hundred and fifty dollars worth of assets or something to that effect so that they minimize the number of people who are eligible for nursing care or they could say it used to be 140 percent, 138 percent of poverty. Now it's just going to be back down to 105 percent of poverty. I mean, there's going to be a lot of people who are going to lose

their eligibility because of this. There is. And I think, and to answer your question about the role of states and sort of modifying the impacts, I think that's true. I think that's true and also not true at the same time. So it's certainly true that if you just cut federal support for states in terms of the Medicaid dollars that flow from the federal government to the states, you're right. States will have leeway. How much do they want to pony up to make up for that shortfall? And the CBO, the Congressional Budget Office, has traditionally projected that states might pony up as much as 50% of the decline, of the decline, to offset that's a client for certain kinds of cuts, like if you were to eliminate the boosted federal support

for the ACA Medicaid expansion population. That population gets extra support from the federal government compared to other patient groups. So yes, that is right. States might. Now, I think states are more constrained than people realize, and maybe even in the CBO is previously projected. you know, are taxpayers going to go for a tax height at the state level? Are states going to cut other services? Is it even feasible to generate that kind of money, that kind of tax revenue internally in many cases? Probably not. And the other point I would make, and this kind of brings us to the specific provisions of the bill, some of the provisions and some of the cuts that will be realized are going to really be nationwide. It's not just here's less money, figure out what to do. with it. It's actually, oh, no, these are new rules and restrictions that will prevent people from actually being allowed to enroll in Medicaid, regardless of what states want to do. And first and foremost in that list are the Medicaid work requirements. Medicaid work requirements, which we, you know, worth talking about, are actually the single

largest driver of uninsurance, of loss of coverage in this bill. Nearly five million people. people would become uninsured due to Medicaid work requirements. And so that's going to play out everywhere. Now, yes, some states could be meaner and more miserly. They actually allow states to, you know, require beneficiaries to redemonstrate sort of compliance at even greater rates than more is required nationwide. But it's going to affect even Massachusetts. And so, and even other sort of more liberal states. So it's going to play out in many ways at once. States will have to make choices, but also they will be constrained in their ability to mitigate the impacts of this law just by what's in it. Okay. And we have seen what work requirements do in terms of

kicking people off and in terms of their, I guess, their efficacy. Georgia, Arkansas have implemented programs like this. They got a waiver from the Trump administration in the first term, and they were disasters. They, the mechanism that has to be instituted to assess whether people are working, both keeps people who are actually eligible out of getting Medicaid and just costs more. So as a savings mechanism, it doesn't work, and as a work incentive program, it doesn't work. But give us a sense of who those five million people are projected to be. Are they just strapping young men who are just hanging out, who don't want to work, don't need the cash, but they feel very strongly about being on Medicaid?

I mean, it's such an offensive framing this whole, as you said, aviol-bodied man playing video games in their parents' basement, you know, collecting Medicaid as if that's something that you can. can just like do and enjoy um look the end of the day i'm banking all of my doctor visits and i am you know sort of just like i'm hoarding all of my doctor visits well this obsession with health care is something that people just kind of want to collect because it's fun and and and interesting you know that you have to impose co-pay you know it goes back to this moral hazard concept that you have to impose co-pays and deductibles because it's almost like a free you know buffet people will just stock up on you know, and more than they even want or need because it's free is obviously outlandish. I mean, in the real world, anyone who I think this is common sense, but also we certainly

see it on the health care provider side, and people avoid health care, even when it is available because it's not fun. No one wants to take time out to part of the doctor. People don't like taking prescription drugs. No one wants to be hospitalized. Certainly no one wants to come to the intensive care. You know where I work, right? You really don't need to create barriers to sort of to prevent that kind of, you know,

free loading. It's an offensive framing. At the end of the day, these are low-income people who need health care. And when it, as you said, it was studied in Arkansas and Georgia, particularly in Arkansas. And there's a few findings that are worth pointing out. In Arkansas, one study found that 95% of the target population of Medicare work requirements either was working or should have had an exemption from the requirements on the basis of being disabled, being in school, being a caretaker, one of these requirements. So if 95% met one of these either worked or met one of these requirements, why did 18,000 people in Arkansas lose health coverage?

It doesn't make sense. That number is too high, right? And the answer is very simple. Red tape keeps people from getting what they need. If you create hoops and hurdles for people to jump through, setting up online accounts, documenting work requirements, you know, documenting hours, do this, do that. People fall through the cracks, right?

I mean, I think it would probably happen to me, and I'm a health policy, you know, researcher and doctor and have all these advantages. Imagine if you're low-income, you may have chronic illnesses, you may have multiple medical appointments, you may have a lot going on in your life. It can be really difficult to do this. Now, so, yes, most of the people who are falling through the cracks are, should be the requirements, but are not, you know, jumping through the hoops. And two of the points on this. Number one is that, as you alluded to, these are administratively wasteful programs. In Georgia, they are spending millions and millions of dollars to corporate consultants to run these new IT systems, to try to get people enrolled.

And it's a dismal failure. They've enrolled in the first year of the program operating. They enrolled less than 2% of low-income Georgians who potentially should have been able to get into Medicaid. In Arkansas, it was also expensive. So we're actually working on an analysis that finds that, you know, nationwide, these systems would require billions of dollars of expenditures. Overall, they do save money in the sense that they kick people off Medicaid, but at what cost? They kick people off Medicaid.

They keep, they're barriered in Medicaid to people who otherwise actually would, are even eligible. They are eligible. Most of the people who will lose coverage are eligible, should remain in the program, and will fall through the cracks. And that is how this is designed, how this system is designed. And when they say, oh, no one would lose Medicaid because of this, if that were true, then how is it generating more than $300 billion and reduce federal Medicaid revenue? It has to be one or the other. Either it's kicking people out and saving money or it's not kicking people out and it would have no impact on the cost estimates of the bill. obviously it does. And so you're really just trading the health care of low-income people

for tax cuts for the rich. So how many, I mean, so the work, so the work requirements are going to kick five million people off. That's five million. And that's five out of, the Medicaid, so just to run through the numbers real quick from the Congressional Budget Office, more than seven million people will lose, will become uninsured because of Medicaid, not only lose Medicaid, but not get alternative coverage. So 7 million Medicaid, about 4 million because of changes in an affordable care act marketplace rules. And then another 4 million will become uninsured because of the expiration of enhanced subsidies for Affordable Care Act marketplace plans that will happen anyway without the bill being passed to be clear. But they're not going to try to look up to finger about

that obviously. So if you total that up, we are talking about a historic increase in the number of people losing coverage in this country maybe in american history that is uh is it is it is coming down the pike and and and before we get to i mean this is where your report comes in because it translates what the implications of that type of historic loss of of of health care is before we get there the other myth i should say when they say you know when they know when they know that they're you know five six million people eight million people are going to lose their health insurance i mean not just medicare medicaid i should say but like you say they're not going to find another program and which to get on um there's only three million men in the country who are unemployed

of working age so like it's tough to them square this like they are they all able-bodied that are uh out there uh because they like to make it seem like it's just these guys like you say who are playing video games but the other um that we hear is there are 1.4 million undocumented immigrants who are on Medicaid, and that is absolutely, you know, fraud, waste, and abuse. How many undocumented immigrants are eligible for Medicaid in this country? And on it? Yeah, I mean, I don't have the number in front of me, but it's very few for several reasons. First of all, no federal dollars can go towards the Medicaid care, the Medicaid plans of undocumented immigrants.

So insofar as there is Medicaid coverage of undocumented immigrants, it's states who choose to do it entirely through their own internal state funds. That's the first thing. And so in some ways, it's not even really Medicaid. It's like Kentucky can connect or whatever. It's a state running a program to give some undocumented people. It's not enough care and it's not good enough. and, but it's something.

And the alternative is, let's just call a spade a spade. The alternative is letting these people die in the streets, right? You can talk around this all you want, but at the end of the day, it's not controversial that modern medical care saves lives. And when people say, well, if they go to the emergency room, no one's going to, like, you know, kick them out, you know, of the front door. True, although two important caveats. One is people who are uninsured avoid the hospital.

They avoid the emergency room, even in serious situations. Okay, that's the reality. They don't want, they're scared and they don't want to get hit with a big bill or whatever the consequences. Two, most of the life-saving benefit of health care comes from ongoing care of chronic conditions. So if you're not going to see the doctor regularly and so on and so forth, you're not really getting most of the benefit that modern medical care has to offer. I just want to make more of the point of the undocumented front, work from some colleagues of mine, have looked at the contributions that immigrants, both documented and undocumented, make into health care programs like Medicaid or Medicare or even private insurance premiums, and what they get out. On average immigrants, especially undocumented immigrants, use very little care. Some of that's because they're young and healthy relative to the rest of the population. Some of that is because of discrimination and lack of access. But either way, they don't get a lot of care out.

do pay into these programs for for a variety of reasons and on average they actually subsidize the u.s. health care system they put more in than they get out in services and social security for that matter i mean it's all wage taxes billions upon billions of dollars that go in and because they're not citizens they can't go and register to get the benefits of social security uh when they if they're still here in the country uh when they retire or um you know and become eligible for Medicare or go and sign up for Medicaid unless they're in one of 14 states around the country that have these auxiliary programs, you know, that are with state funds outside of federal Medicaid. So give us a sense of like, do you have a sense of like the cost, well, because I would

like to, you know, talk about like the human cost last, but the actual dollar cost that's a associated because like you say, I'm not doing, you know, I don't want to make it the, you know, the best metaphor I can come up with is if I get an oil change every 3,000 miles, my engine's going to be much better shape than if I wait 25,000 miles and try and bring my engine in when there's no oil in it or the oil's all gummed up, it's going to cost me a lot more to replace that engine without ongoing care. and maybe people show up at the emergency room, or they have then have an acute problem

and theoretically become ineligible, you know, become eligible because they're no longer capable of working. What is the actual dollar cost associated with it? Do we have a sense of that? I mean, is that something that can be measured? Because I got to imagine for every dollar that you spend on, ongoing, sort of just whole health type of care, you're saving, you know, money down the road because as far as I know, 80% of our health care costs are born emanate from 20% of the people

in our system because it's acute care. It's, it's, I wish I could give a straightforward answer. It is a little complicated. And I'll tell you why. As much as I'd love to say, if we just gave people really great care up front, we'd save money in the long term, I can't frame it quite like that. You will save lives, you will improve lengthen lives, you will make people live longer. But what complicates it is that if you're really just thinking this in very crude monetary ways, you know, there are ways, like, if people smoke, they may actually cost the health care system less because they die young, right? that's a horrible thing we don't want that so it is i i'm hesitant to say we it's hard to measure

because yes yeah i get it but yes i agree with you it is it is silly what what is absolutely silly and what is absolutely illogical is to only cover acute care and not cover ongoing outpatient care which is more cost effective unquestionably it's more cost effective to do primary care to do ongoing care to treat chronic illnesses than to wait for the catastrophes at only And there's no question about that. But it also does go back to like what value do you place on a human life, you know? And I do think that if you incorporated everything and some very holistic, society-wide kind of analysis in terms of what you're talking about with disability and health harms and everything, yes, I do think it is highly cost-effective to provide care throughout the lifespan to everyone. But look, they want to scapego.

This has been central to the Trump's whole health care plan has been scapegoating immigrants from on the campaign trail. They said this. And, you know, this is, and Florida has been doing this before the election. They're requiring that, you know, patients report their documentation status, publishing reports that are very shoddy alleging that X number of dollars is going towards for undocumented immigrants. It's a very small proportion. They probably need better care.

At the end of the day, there's also public health justifications for caring for everyone, right? We saw this certainly with COVID-19 that excluding people from care, you know, potentially for infectious diseases, doesn't really make any sense whatsoever. Talk about the implications of this bill on providers, because my understanding is we have about 700 hospitals around the country that are, heavily reliant on Medicaid payments because of the nature of the patients that they serve, and that up to 200 of them, particularly rural hospitals, are in danger of just closing because of the amount of patients that they would essentially,

of patients who could pay, essentially, that they serve, they would just have to close. Yeah, I mean, it's not complicated, right? If you, poor patients use Medicaid. Hospitals that take care of poor patients, through eye on Medicaid as their funding stream. These patients aren't going, we know what hospitalizations cost. Forget about it. So, yeah, I mean, safety in hospitals, and there's been a lot of emphasis on rural areas, but I want to emphasize it's not only rural areas. There's safety in hospitals and urban and suburban areas that are equally at risk. And, yes, this will pull the rug out from under them if all of a sudden, you know, a significant proportion of their, of their patients become uninsured, right? We said about 10 million, so, you know, 7 million patients, people may become uninsured who have Medicaid. That's about 10% of all patients, all people with Medicaid.

That's a huge hit to hospitals' bottom lines. And that's not going to only impact those patients. Those hospitals will have to make hard choices. They can cut staff. They can cut services. They can provide less care. They can close in a worst case scenario. And you've probably heard the Senate talking about some sort of kind of rural hospital bailout fund that would somehow address this issue because it's very politically sensitive, including for a public.

I mean, just to give an example, there was a recent Kaiser Family Foundation poll that found that about 64% of the American public is against the big beautiful bill, right? And then when you tell those people, while conducting the poll, are you aware this will decrease funding for local hospitals? The percentage who are opposed or view it unfavorably rises from 64% to 79%. And in fact, you even convert Republican support, a lot of Republican supporters of the bill to the opposition when you just, when you just say that, right? So it's very politically sensitive. But their plan to address it as utter bunk. First of all, the amount of the money in this fund is going to be nowhere near the amount of reduced federal Medicaid spending.

So it's just a band-aid on a big gaping wound that's caused by the cuts. Second of all, it doesn't do anything for the patients, right? Okay, so the hospital's still there, but I can't go there because I'm uninsured, and I'm going to wait until my condition gets worse and not take medications I need. So I think it's really just about optics and is going to have very little real world impact, although the details of whatever it is are not yet clear. It may not amount what we have to see. So one of the fundamental aspects of your...

study is what is what's it going to cost in terms of lives these cuts did you tell us what what that figure is yeah um so um you know basically our study builds off estimates of coverage losses that have been provided by the congressional budget office and it combines those estimates with a variety of studies that have been done in debt over decades that really quantify the relationship between coverage and health outcomes. So we look at both lives, but also sort of other kinds of health outcomes, things like, did you get a mammogram within the past 12 months? Have you, do you have a personal position? Do you take all the medications you need? You know, did you go into medical debt? So, you know, let's to jump to the deaths for a minute.

You know, we have a range of estimates, but our mid-range estimate for the big, beautiful, Bill Act would be more than 16,600 deaths annually. That would be stemming from the loss of coverage only from the Medicaid losses. So it would actually be higher if you incorporate marketplace, people with marketplace plans. We also estimate in terms of sort of other impacts that about 1.9 million people would lose a personal physician. 1.3 million would not get their needed drugs, 380,000 would go without a mammogram, 1.2 million would go into medical debt, 246,000 would be refused treatment because of their medical debt. So those are a few figures. And there often isn't enough emphasis on these health impacts. We spend, you know,

the national discussion around health care focuses a lot on dollars and cents. And that's important. But we do need to keep in mind what the whole point is of this health care system and that's to help people live longer and better lives it's not to profit from well it's it depends on who you ask i suppose does does your study take into account to the potential of these hospital closures because i got to imagine i mean it's i've got to imagine that's got to add it's very hard to predict right because it depends on which hospitals and when we say you know the 10% patients we're talking about hospitals where the percentage of patients that are on

Medicaid, you know, are over 50% in some instances. And so it's very difficult at that point to calculate like what happens if my hospital suddenly is no longer 20 minutes away, but rather

two and a half hours away. Will I go in for my regular checkup? Will I, how many acute situations will, you know, will take place in a particular population. And it's not just hospitals, too, because we know that when a hospital closes, doctors leave,

because they rely on the hospital for various things. So you're talking about an exodus of health care infrastructure and health care personnel. And that's right. In many of these places, there's only one show, there's only one game in town, right? Which is one of the reasons why health care has never been thought. It doesn't function in a market way well because a lot of times you only need one hospital. It's a small community, right? You don't need competition.

You don't want competition. But yes, that's exactly right. There will be other impacts that we did not model, you know, A, as you said, hospital closures. Also, what happens if states to, you know, cut funding to other programs in order to try to, you know, cover some of those holes, right? Then other, there could be other downstream consequences that, you know, we're not even looking at. And then there are other health-related provisions in this bill beyond Medicaid. You know, I don't know, billions of dollars. and taking away food aid for poor people, that's going to have health impacts as well.

Yep. Dr. Adam Gaffney, we will put a link to your study on the projected effects of proposed cuts and federal Medicaid expenditures on Medicaid enrollment, on insurance, health care, and health. Thanks so much for your time today. I really appreciate it. Great. Thanks for having me. Take care.

All right. All right, folks. we're going to take a break head into a shorter fun half today and actually 50 minute fun half yes

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and talking about the news. Patreon.com says Left Reckoning that's out on Sunday. See you. in the fun half. One second. Three months from now, six months from now, nine months from now. And I don't think it's going to be the same as it looks like in six months from now. And I don't know if it's necessarily going to be better six months from now than it is three months from now.

But I think around 18 months out, we're going to look back and go like, wow. What? What is that going on? it's nuts wait a second hold on for hold on for a second Emma welcome to the program hey what is up everyone

fun hack no me tea you did it fun pack let's go Brandon let's go Brandon let's go Brandon Bradley you want to say hello sorry to disappoint everyone

I'm just a random guy. It's all the boys today. Fundamentally false. No, I'm sorry. Women's... Stop talking for a second. Let me finish. Where is this coming from, dude? But dude, uh, you want to smoke his, um, seven, eight? Yes. Um, um,

All right, he's me? Is this name? Yes. Um, um, um, is it sneak? Is it me? It is you. Um, um, is it's me? Oh, how long is it's me?

I think it is you. Who is you? No sound. Every single freaking day. What's on your mind? We can discuss free markets, and we can discuss capitalism. I'm going to go to life. Libertarians.

They're so stupid, though. Common sense says, of course. Gobbled e gook. We fucking nailed him. So what's 79 plus 21? Challenge met. I'm positive quivering. I believe 96, I want to say.

857. 21, 85. 5.1. 1.5. 380. It's 9-11 person. $3,400, $1,900. $6, $5, $4, $3 trillion sold.

It's a zero-sum game. Actually, you're making anything less. But let me say this. Poop. You can call it satire, Sam goes to satire. On top of it all, my favorite part about you is just like every day, all day, like everything you do. Without a doubt. Hey, buddy, we see you.

All right, folks. Folks, folks. It's just the week being weeded out, obviously. Yeah, sundown guns out. I don't know. But you should know. People just don't like to entertain ideas anymore. I have a question.

Who cares? Our chat is enabled, folks. I love it. I do love that. Look, got to jump. I got to be quick. I get a jump. I'm losing it, bro.

Two o'clock, we're already late, and the guy's being a dick. So screw him. Sent to a gulag. Outrage. Like, what is wrong with you? Love you. Love you. Bye-bye.