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To give rich Americans a $4.5 trillion tax cut, Trump will cut health care for the poor
In 2017, during his first term, President Trump’s central economic achievement was a massive tax cut for the rich. How massive? This year, the Trump bump will amount to an average of $61,090 for the top 1%, and $252,300 for the top one-tenth of the 1%. The world’s wealthiest companies will also rake in billions, thanks to a corporate tax rate that was cut from 35% to 21%.
Amid his firehose of lies and distractions, it’s important to recognize the economic ambition of Trump’s second term is to make these tax cuts permanent.
Trump has made no secret of his agenda. Here he is, on the campaign trail last year, telling a room full of billionaire donors, “You’re all people who have a lot of money. I know 20 of you and you’re rich as hell. We’re going to give you tax cuts.”
Donors contributed more than $50 million to his campaign that night.
If that wasn’t brazen enough, consider who occupied the front rows at his inauguration on Jan. 20. Was it former presidents or family? Nope. It was the CEOs of Amazon, Tesla, Facebook — the new American oligarchs.
The looming con, as always with Trump, is in the numbers. He and his Republican enablers in Congress can only sop his billionaire pals by one of two means: ballooning the deficit and/or punishing the poor and vulnerable with draconian cuts to Medicaid.
The New York Times, in an uncharacteristic burst of candor, summarized the budget plan the GOP-led House passed last week as one that “helps the rich and cuts aid to the poor,” noting that Republicans, who had been voted into office promising to help working-class voters, were now “teeing up cuts to programs that provide health care and food to the poor.” The plan “instructs the Energy and Commerce Committee, which oversees Medicaid and Medicare, to come up with at least $880 billion in cuts.”
The likeliest target is Medicaid, a program that provides long-term health care to more than 70 million Americans, including many of those who live in nursing homes. According to recent polling, Trump actually won voters who are Medicaid recipients in the 2024 election.
You would be hard-pressed to find many American voters who favor raiding Medicaid to subsidize tax cuts for corporations and billionaires. According to public polling, more than three quarters of the public supports the program, including nearly every person actually enrolled in it.
Trump has said many times, publicly, that he wouldn’t touch Social Security, Medicare and Medicaid. And there’s no doubt that he’ll make some version of the same claim, when he addresses a joint session of Congress tonight. In other words: he’ll lie.
Because that’s what Trump does whenever the math—or reality—contradicts his aims, whether he’s talking about the vote count in an election, his response to a pandemic, or, in this case, a fake promise to protect medical care for Americans in need.
So far, the president has been able to pressure congressional Republicans into supporting his tax cuts by claiming that his cuts to Medicaid will focus on fraud and waste. But that’s something not even his own loyalists believe. “You got to be careful because of lot of [Trump voters are] on Medicaid,” Steve Bannon said, on a recent episode of his podcast, the War Room. “I’m telling you, if you don’t think so, you are dead wrong. Medicaid’s going to be a complicated one. Just can’t take a meat axe to it, although I would love to.”
Sen. Josh Hawley, a Republican of Missouri, already told the Times he wouldn’t vote for Medicaid cuts. “Work requirements are fine, but 21% of the residents in my state receive Medicaid or CHIP (Children’s Health Insurance Program),” he said. (Notably, Hawley is running for reelection in 2026.)
You would be hard-pressed to find many American voters who favor raiding Medicaid to subsidize tax cuts for corporations and billionaires.
But Trump doesn’t do complicated. What he and Republicans do, when the real human cost of their plutocratic ambitions become clear, is to crank up the lies and distortions. Already, congressional Republicans are seeking to use a budgetary gimmick that would hide the $4.5 trillion dollars in proposed tax cuts from public view, by claiming that they cost nothing because Trump’s tax cuts are already in place. Welcome to the new and improved edition of Voodoo Economics.
It’s true that Medicaid and Medicare are frequent targets of fraudsters. In 1990s, when I was an investigative reporter in Miami, I wrote about the wide array of scammers who would, for example, bill the government $650 per month for protein fortified milk that never got delivered to Medicaid recipients. But these charlatans racked up profits of a few million, at most.
In fact, one the largest fines for health care fraud ever handed down—$1.7 billion—was levied against Columbia/HCA, a huge for-profit hospital chain led by none other than Rick Scott, the Republican Senator from Florida, who has used his vast personal wealth to fund his political campaigns.
It’s fitting that Scott, like Trump, has used a dark legacy of fraud to catapult himself to the seat of power. Men like this now control the fate of millions of Americans, mostly poor and older citizens who can’t afford basic medical care without government support.
They can demagogue and deflect and propagandize all they like. But if Trump and Republicans make cuts to these programs to enrich their powerful friends, millions of vulnerable Americans will suffer, and the cruel con at the heart of Trumpism, and the GOP, will be laid bare for all to see.
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