What A Day - Will Republicans Slash Medicaid?

Episode Date: February 25, 2025

As House Republicans prepare to begin voting on their big policy blueprint this week, one of the programs they're targeting for major cuts is Medicaid. The federal healthcare program covers around 80 million Americans, mostly people living near or below the poverty line. While President Donald Trump has endorsed the House's budget plan, he has also said that Medicaid is 'not going to be touched.' Sarah Kliff, investigative health care reporter for The New York Times, explains what the proposed Medicaid cuts would mean for actual people.And in headlines: Trump had an awkward meeting with French President Emmanuel Macron over Ukraine, Trump officials continued to sow confusion over an email demanding federal workers justify their jobs, and the president picked right-wing podcaster Dan Bongino as the next FBI deputy director.Show Notes:Check out Sarah's work – https://www.nytimes.com/by/sarah-kliffSubscribe to the What A Day Newsletter – https://tinyurl.com/3kk4nyz8Support victims of the fire – votesaveamerica.com/reliefWhat A Day – YouTube – https://www.youtube.com/@whatadaypodcastFollow us on Instagram – https://www.instagram.com/crookedmedia/For a transcript of this episode, please visit crooked.com/whataday

It's Tuesday, February 25th. I'm Jane Coaston. And this is What Today, the show that says if you buy tickets to Fyre Festival 2, it would have probably been for the best if you had just sent that money to me. On today's show, federal workers continue to get jerked around by President Elon Musk. And a judge blocks Trump administration immigration enforcement in some houses of worship. But let's start with health care. Millions of Americans, just around 80 million people or one in five, rely on a program called

Medicaid for health care. From grandparents in nursing homes to pregnant moms to kids with disabilities, they all rely on Medicaid for health care. From grandparents in nursing homes, to pregnant moms, to kids with disabilities, they all rely on Medicaid for support. In fact, in 2019, Medicaid paid for half, yes, half, of all births in the United States. And the GOP has been trying to get Medicaid for decades. Especially since Medicaid expansion added millions of low-income adults, including those without kids, to the program after the passage of the Affordable Care Act in 2010. They claim that Medicaid encourages dependency and that the people who use Medicaid are

becoming, quote, slaves to a government entitlement program. But Republicans have a big problem. Here's Steve Bannon on his War Room podcast to explain why. Medicaid you got to be careful because a lot of MAGA is on Medicaid. I'm telling you, if you don't think so, you are dead wrong. Medicaid is going to be a complicated one. Just can't take a MedEx to it. Although I would love to. Yeah, see, lots of people are on Medicaid, including lots of working

class and low income voters, which includes lots and lots of folks who voted for President Donald Trump. And Republicans in Congress, especially those who are facing tough reelection battles ahead, know it. Take Republican Representative Robert Bresnahan, who represents Northeastern Pennsylvania, including Scranton.

About 27% of his constituents are on Medicaid. Republican Senator Josh Hawley of Missouri has spoken out against cuts to the program. About 21% of his constituents are enrolled in Medicaid. You know who else knows just how much President Donald Trump's voters need Medicaid? President Donald Trump. He told Fox News host Sean Hannity last week. Medicare, Medicaid, none of that stuff is going to be touched.

But while a bunch of Republicans and Trump have voiced concerns about cutting Medicaid, the House GOP and Trump have put forward a budget proposal that asks for nearly a $1 trillion cut to Medicaid. Yes, Donald Trump has sworn to never cut Medicaid and endorsed a budget that cuts Medicaid. The full Donald Trump experience. Republicans are debating the budget resolution today, and already two members of Congress, Representative Thomas Massey of Kentucky and Representative Victoria Sparks of Indiana, have said they're a no on the current version. With a razor-thin margin in the chamber, House

Speaker Mike Johnson can only afford to lose one Republican if he wants to get the proposal adopted. And while my math isn't great, two is bigger than one. So to get a better idea of what these proposed cuts to Medicaid would mean for actual people, I had to talk to Sarah Cliff. She's an investigative health care reporter for the New York Times, and she's covered health care policy for a long time. Sarah, welcome to What a Day! Thank you for having me. So health care policy is a long time. Sarah, welcome to What a Day. Thank you for having me. So healthcare policy is notoriously complicated.

So to start this all off, can you give me a very quick primer on Medicaid? Who does it cover? How do you qualify? And who pays for it? So Medicaid is a major health insurance program in the United States. It covers about 80 million people. It is jointly paid for by the federal government and the states. And the way you qualify is by falling into a certain category. So Medicaid is a little

different from Medicare. Medicare is the program for seniors. You qualify by being over 65. Medicaid you have to have some kind of eligibility criteria. So you're under a certain income, you have a disability, you are a kid under a different income threshold, you're pregnant. There's all these different eligibility categories. They vary a little bit state to state. They've changed a lot over the past decade. But basically, you have to have some kind of need that the government has decided, yes, we're going to have these people qualify for the Medicaid program. So it's not just poor people, right?

I think that that's kind of the assumption, but it's such a bigger program than that. Yeah, and it's especially grown over the past decade since Obamacare. One of the big things Obamacare did is it expanded Medicaid to cover anyone under a certain income. The very wonky threshold is 138% of the poverty line. I think that hovers around like $17,000, $18,000 a year for an individual

person at this moment. And it also covers a lot of things you might not expect. Nursing care. Some people might be surprised to know that Medicare, the program for the elderly, actually doesn't cover much nursing care. So a lot of people end up having their nursing care paid for through Medicaid. It covers children up to about four times the poverty line. So that's definitely getting into middle class. It's a really reaching program that's covering one in five Americans right now. And Medicaid has also been a political target

of Republicans for decades. Why? Yeah. There's a number of arguments right now. And the ones I've heard kind of reporting in areas that supported Donald Trump heavily is a frustration with government dependence, the idea that people didn't work for their benefits. In the United States, we have a health insurance system where typically you

get your health coverage at work. So I do hear this argument in kind of Republican circles about these people aren't working. Why should they be getting this coverage and that they're just kind of relying on a government handout versus doing the work they should be doing to get a health insurance plan. Yes, those babies got to get them in the mines. Yeah, I mean one thing I would even add about the adults on Medicaid, the vast majority of them are working already. Right. They're working but you know maybe they're a ride-share driver, maybe they're at a low-wage job, they're working but they're not earning enough and they're not getting offered health insurance at

work, which is how they ended up on you know a government program. Right. And yet even as Republicans have vilified Medicaid as you mentioned as a handout as welfare, they failed to make the kind of drastic spending cuts to the program they say they won't. Why? They're in a tricky spot. I mean you see this this kind of fracture right now between Republican rhetoric and what they're actually proposing. So there's definitely in the House budget, they're aiming to cut roughly $880 billion in cuts over a decade.

That works out to about 10% of all federal Medicaid spending. But there's also this kind of hesitance among Republicans because they know so many of their voters rely on these programs. You've had Steve Bannon out there saying, don't touch Medicaid. You've got Josh Hawley, someone who's not known for his liberal politics, saying, don't touch Medicaid. And I think it boils down to the fact it's really hard to claw back benefits. We absolutely saw this during the Obamacare repeal debate. Once people are using a program and it turns out Medicaid is actually very well liked. The people on Medicaid give it very very favorable remarks. That makes it really tough for legislators to you know just take 10% of the spending away

on a program like that. Yeah let's let's get into the budget. How are they looking to get those major savings from Medicaid? Yeah I mean that's a wonderful question I would like better answers to. All we have right now is kind of a list of proposals they're thinking about. One of the ones I'm pretty sure you're going to see pass this Congress is a work requirement, basically requiring people on Medicaid to file paperwork showing that they're working or that they're looking for a job in order to earn benefits. But you mentioned that most people on Medicaid are working. So it feels like that's not going to get you to $880 billion.

That just is a thing that sounds good. Well, so it definitely doesn't get you to $800. It does get you to about $100 billion. We'll get the small share of people who are not working, might no longer have Medicaid. But there's also just going to be some natural attrition, right? When you put up more things you have to do and forms you have to fill out, you're going to see people fall off of Medicaid.

When you're looking for those big cuts, like when you really need to get 880 billion out of the program, there's kind of two that jump out at me as the ones that would get you there. One that's really floating around, we're working on a story about it right now, is dialing back the funding for Medicaid expansion. This is part of Obamacare that expanded Medicaid well beyond the populations, you know, traditionally covered people who are disabled, who are pregnant, children in low-income households to anyone

who earns less than a certain amount. And you can, you know, shave about, I think it's about $500 billion out of Medicaid spending by reducing the funding for that specific program. So that's kind of getting you there. The other big one, it's circulated in conservative circles for a year, is doing some kind of cap on Medicaid spending. Sometimes like a per capita cap that is a certain amount you get for each beneficiary. That would be a really big change from how Medicaid works now, where there's no limit on a per person spending. You'd get the medical claims, you pay them. This would put a firm limit. That

could be a pretty big cut. It all depends on like where you sent that, you know, ceiling for spending, how big of a cut that one becomes. But those are ones kind of circulating in the mix right now. Yeah, I was thinking about how during Trump's first term, he saw some of his lowest approval ratings ever around the time he tried to repeal the Affordable Care Act, Obamacare. I mean, his approval rating was lower after the failed ACA repeal than it was after the insurrection. So why do you think that was the thing that voters seemed to really hammer him for?

I think it's personal, right? More personal than the insurrection is the idea, like, oh, I'm not going to be able to go to the doctor. I'm not going to be able to take my kids to the doctor. I'm going to have to think about, do I have the money to actually see someone. I think it just really hits people in a very deep personal way that a lot of issues don't. So even though you have this big lofty $880 billion goal now, there is a true question with some of the worry you're already seeing, the rhetoric around not cutting

Medicaid about whether they can actually achieve those levels of cuts and kind of get their party behind them Do you think that Medicaid is a harder political target than Obamacare is or was? Yes, I think so because it's it covers so many people again like one in five Americans are on Medicaid It's a huge middle-class program at this point with the way it funds nursing care And I think it's less polarizing than Obamacare was. I mean, Obamacare always had Obama in the name and tended to kind of divide along party lines. Whereas Medicaid, I think generally enjoys more support among Democrats, but it doesn't have that same kind of political

division built into it in the way that Obamacare did. And I think Trump seems to know that because we saw evidence with his win in 2024 of a major political realignment happening along economic lines. He was able to make big gains with middle and low income voters. But those are the voters, as you've mentioned, who are more likely to depend on programs like Medicaid. What specifically could these cuts to Medicaid mean for those voters who maybe took a chance on Trump? Yeah, I mean, they could mean losing your health insurance. So there's about 20 million people who are enrolled on the Medicaid expansion right now, and a lot of them are in red states. You've seen a lot more conservative states signing up for the Medicaid expansion since the last time Trump was

in office. So, you know, these are places like Montana, Missouri, places that, you know, do not tend to vote for Democrats quite as much. If Congress decides to dial back the funding, it'll be the states who have to come in and fill that budget hole. And it's a massive, you know, billions of dollar budget hole. I don't think a lot of states are going to be able to find those kinds of funds. So it really could come down to, you know, not having health insurance anymore. Sarah, thank you so much for joining me today. Thank you.

That was my conversation with Sarah Cliff, investigative health care reporter for the New York Times. We'll get to more of the news in a moment, but if you like the show, make sure to subscribe, leave a five star review on Apple podcasts, watch us on YouTube, and share with your friends. More to come after some ads. What A Day is brought to you by Magic Spoon. Magic Spoon has turned their super popular high protein cereal into high protein treats that are light, crispy, and taste just like those classic crunchy cereal bars. Magic Spoon's treats are so delicious and have already become one of my favorite on-the-go gym snacks. Magic Spoon is also launching a brand new high protein granola.

True to the Magic Spoon promise, it's packed with protein and so crunchy and so sweet, perfect for breakfast or a snack. Magic Spoon's high protein treats are crispy, crunchy, airy, and a very easy way to get 12 grams of protein on the go. They come in mouth-watering flavors like marshmallow, chocolate peanut butter, and dark chocolate. They're so good and so filling, too. And Magic Spoon's brand new granola packs in 13 grams of protein and zero added sugars. They come in delicious flavors, honey almond, and peanut butter. Get $5 off your next order at Magicspoon.com slash day. Or look for Magic Spoon on Amazon or in your nearest grocery store.

That's Magicspoon.com slash day for $5 off. Here's what else we're following today. Headlines. We've had some very good talks with Russia. Headlines. We've had some very good talks with Russia. We've had some very good talks with others. And we're trying to get the war ended with Russia and Ukraine. And I think we've come a long way in a short period of weeks. President Donald Trump met with French President Emmanuel Macron at the White House Monday.

Their conversation largely focused on the war in Ukraine. Macron's visit coincided with the third anniversary of Russia's invasion of the sovereign country. He and Trump spoke with reporters in the Oval Office before their meeting, and the two struck very different tones when it came to Russia. Macron seemed to push back on the Trump administration's current plan to get Ukraine to give the U.S. access to its rare earth minerals in exchange for continued American aid. The French president said it's Russia who should be helping pay for the costs of the war.

I support the idea to have Ukraine first being compensated because they are the one to have lose a lot of their fellow citizens and being destroyed by this attack. Second, all of those who paid for could be compensated but not by Ukraine, by Russia, because there was a want to aggress. This led to a very awkward exchange where Trump falsely claims that Ukraine is going to pay European countries back for their support. Europe is loaning the money to Ukraine. They get their money back. No, in fact, to be to be frank, we paid, we paid 60% of the total default. And it was through, like the US, loans, guarantee, grants, and we provided the real money, to be clear.

I would prefer to never be corrected by a French person. Trump also once again refused to condemn Russian President Vladimir Putin, at all, really. Instead, he doubled down on his choice to call Ukrainian President Vladimir Zelensky a dictator last week. Mr. President, is Volzansky a dictator? Would you use the same words without including him? I don't use those words lightly. You don't? Interesting.

Also Monday at the United Nations, the U.S. joined our historic BFFs Russia, Iran, North Korea, wait, what? In voting against a resolution to condemn the Kremlin's invasion of Ukraine. It passed anyway. Trump was asked to explain the vote on Monday during Macron's visit, to which he said, I would rather not explain it now, but it's sort of self-evident, I think. That's not the word I would use. The UN also passed a watered down US resolution that calls

for an end to the war in Ukraine. The US abstained from voting on that resolution after European leaders inserted some anti-Russian language. It also passed. Two days after asking federal workers to justify their jobs, the Trump administration continued to sow chaos. We're recording this Monday night and the Trump administration continued to sow chaos. We're recording this Monday night, and the story is still changing a lot. But the drama all started Saturday with an email from the Office of Personnel Management to more than 2 million federal workers. It asked them to list five things they did at work last week, and demanded a response by Monday night. Before the email went out, though, Doge Leader Non-leader Elon Musk said on

Twitter, quote, failure to respond will be taken as a resignation. But some government agencies balked and told employees not to respond. That included agencies led by staunch Trump loyalists like the Justice Department and the Pentagon. By Monday afternoon, multiple news outlets reported that OPM had backed off, telling top agency officials responses were now voluntary. The personnel department also made clear that failing to respond would not be considered a resignation. But President Trump voiced support for Musk's demand during his Oval Office meeting with

the French president. I thought it was great because we have people that don't show up to work and nobody even knows if they work for the government so by asking the question tell us what you did this week what he's doing is saying are you actually working and then if you don't answer like you're sort of semi-fired or you're fired because a lot of people are not answering because they don't even exist they don't even exist also what does semi-fired mean? Okay, and as if all of that wasn't confusing enough,

Musk weighed in on the whole thing on Twitter Monday night. He said that the email request was, quote, trivial and so many failed what he called an inane test. He wrote, quote, have you ever witnessed such incompetence and contempt for how your taxes are being spent? Well, Elon Musk seems to have a prominent role in this administration, so yeah, I have. Also Monday, NBC News reported emailed responses from federal workers were likely to be fed

into an artificial intelligence system to figure out whose jobs were worth keeping. NBC News cited anonymous sources in its report. A federal judge Monday blocked immigration agents from making arrests at some churches, mosques, and other places of worship. Former President Biden initially barred agents with Immigration and Customs Enforcement, or ICE, from raiding quote-unquote sensitive locations like churches, schools, and hospitals. But Trump's Department of Homeland Security, led by Secretary Kristi Noem, tossed out those restrictions late last month. A group of congregations from multiple states

sued Noem and DHS over the order a few days later. The plaintiffs include some Quaker congregations and Baptist churches, as well as a Sikh temple. At a hearing earlier this month, the religious groups argued that the threat of ICE entering their places of worship has discouraged migrants from attending service. At a hearing earlier this month, the religious groups argued that the threat of ICE entering their places of worship has discouraged migrants from attending service. Lawyers for the Trump administration downplayed those claims.

In a court filing, they insisted the faith groups have no proof their congregations were being targeted for immigration raids. But a federal judge sided with the congregations, saying that the new DHS policy could violate migrants' right to religious freedom. He put the policy on hold while the lawsuit makes its way through the courts. It's important to note, though, Monday's ruling only applies to the faith groups that join the lawsuit, not all places of worship. It states that any immigration agents who make arrests at their facilities will face penalties. I'm going to accept the role proudly as a deputy director in the number two spot at the Federal Bureau of Investigation.

Dan Bongino, the former Secret Service agent turned right wing podcaster, announced on his show Monday that he plans to accept the role as FBI deputy director. He said he needed to turn in his man card to get a little emotional about the whole thing because I guess men aren't allowed to feel feelings. President attorney general bondi and now director. Gosh, that sounds good to say. FBI director, Akash Patel offered this role, a role I expressed an interest in. And ladies and gentlemen, I told you, you see, it's hard for me.

President Trump announced Bongino's appointment Sunday. Trump posted on Truth Social that FBI director Kash Patel, a Trump loyalist, announced Bongino's appointment Sunday. Trump posted on Truth Social that FBI Director Cash Patel, a Trump loyalist, chose Bongino for the role. The president called Bongino, quote, a man of incredible love and passion for our country. Like Patel, Bongino has never served in the FBI. But the deputy director role does not require Senate confirmation. Bongino served on the presidential details for then-presidents George W. Bush and Barack Obama. He was a commentator on Fox News before leaving the network in 2023. In 2018, Bongino said, quote, owning the libs is a lifestyle. You must own

the libs repeatedly. And his online persona includes spreading misinformation like lies about the 2020 election being stolen. And that's the news. One more thing. This administration is trying to make me, and you, insane. It's difficult to keep up with the rage bait, sort out what matters from what doesn't, and not just scream on street corners or on social media. But sometimes it's worth saying, what in the entire hell are you doing? Case in point.

Ed Martin is the interim U.S. Attorney for the District of Columbia. Before his posting, he was probably best known for his work on behalf of the Stop the Steal campaign that aimed to overturn the 2020 election results. And on Monday, he posted a tweet from the official account for the U.S. Attorney's office, as one does. The tweet was in reference to the Associated Press' lawsuit against three Trump administration officials for their efforts to bar the AP from press briefings and Air Force One over the outlet's refusal to use the new Gulf of America moniker. The tweet reads as follows, quote, as President Trump's lawyers, we are proud to fight to protect

his leadership as our president, and we are vigilant in standing against entities like the AP that refuse to put America first. Now, a few things. First, I know you probably can't see this, but mercifully, there is only one Donald Trump, so the location of the apostrophe in Trump's is wrong. I'm a punctuation pedant. But also, that's not what a U.S. attorney is. See, if you go to the official website of the U.S. attorneys, it will tell you what a

US Attorney is. It reads, quote, charged with ensuring that the laws be faithfully executed, the 93 United States Attorneys work to enforce federal laws throughout the country. Did you get that? Did you get that the job of a US Attorney is to enforce federal law and not to be Donald Trump's personal attorney? If you're a US Attorney, your job is to act on behalf of the American people. Legal briefs won't say your name at the top.

It'll say United States versus whomever. And this might be tough for Ed Martin to understand, but the United States is not Donald Trump. And the United States was not Joe Biden or Barack Obama or President James Buchanan for God's sake. The job of a US attorney is not actually to run cover for the American president in a stupid battle over the name of the Gulf of America slash Mexico. You're not standing against fascism, you're standing against a journalistic

outfit that the president of the United States is mad at. There's a lot I could ask for from the attorney general for my former home city. I could ask that he show at least some small amount of interest in doing his actual job, which is not, contrary to Martin's opinion, pursuing people who have, quote, acted unethically in their criticisms of Elon Musk and the Department of Government efficiency, quote, to the end of the earth or acting as Donald Trump's personal lawyer. But I will ask this instead. Be less embarrassing.

Say less online, do less of whatever this is, because you can be the most enthusiastic supporter of Donald Trump to ever exist, but man, just be less embarrassing. ["The New York Times"] Before we go, Trump's attack on birthright citizenship isn't just illegal, it's a legal fever dream. On this week's Strict Scrutiny, Melissa, Leah, and Kate team up with historian Kate Masur to break down just how absurd his executive order really is.

Plus, a SCOTUS preview, fresh nonsense from the Fifth Circuit, and a critical investigation. Are the men okay? Listen to strict scrutiny wherever you get your podcasts or on YouTube. That's all for today. If you like the show, make sure you subscribe, leave a review. Don't tell fired federal workers that it's all good because, quote, God has a plan and tell your friends to listen. And if you're into reading and not just about how Missouri Republican Representative Mark Alford told a town hall full of recently fired workers in Belton, Missouri, there are jobs available.

God has a plan and purpose for your life. And everyone in the crowd got very understandably mad, like me. What a Day is also a nightly newsletter. Check it out and subscribe at Crooked.com slash subscribe. I'm Jane Coaston and maybe don't bring God into this whole Doge thing. What a Day is a production of Crooked Media. It's recorded and mixed by Desmond Taylor. Our associate producers are Raven Yamamoto and Emily Four. Our producer is Michelle Alloy. We had production help today from Johanna Case, Joseph

Dutra, Greg Walters, and Julia Clare. Our senior producer is Erica Morrison, and our executive producer is Adrian Hill. Our theme music is by Colin Giliard and Kashaka. Our production staff is proudly unionized with the Writers Guild of America East.