9 ms·

A culture war on poor people who need Medicaid? That doesn’t seem like class war to you?

xp84 1y ago
Can you point out what aspects of the bill relating to Medicaid are most concerning? I don't just mean the DNC talking points, but rather specific provisions. When I read through the actual provisions[1] they are far less scary than what I hear being used as DNC fundraising fodder. For instance, I can't just show up in the UK without any legal status and automatically have all free healthcare from the NHS[2]. But the provisions removing federal tax money support to provide free healthcare to the undocumented is one of the things being pointed to by opponents of the bill as being especially evil. If you feel that way, why is the US the only country that ought to do that? [1] https://www.kff.org/tracking-the-medicaid-provisions-in-the-2025-budget-bill/ https://www.kff.org/tracking-the-medicaid-provisions-in-the-... [2] https://www.nhs.uk/nhs-services/visiting-or-moving-to-england/how-to-access-nhs-services-in-england-if-you-are-visiting-from-abroad/ https://www.nhs.uk/nhs-services/visiting-or-moving-to-englan...
- postpawl 1y ago
  The work requirements force people to file paperwork proving 80 hours of work monthly, and Arkansas showed this paperwork maze caused 18,000+ people to lose coverage even though 95% already met the requirements or qualified for exemptions. Arkansas spent $26.1 million just on administration with no increase in employment, and Georgia has spent over $40 million with 80% going to bureaucracy, not healthcare. For rural hospitals, the bill cuts $58 billion in Medicaid funding over 10 years but only provides a $25 billion rural fund that covers less than half the losses. This puts 300+ rural hospitals at immediate risk of closure since they're already operating on thin margins. For elderly people, the bill blocks nursing home staffing rules until 2034 and freezes home equity limits at $1 million permanently, plus adds more verification requirements. The evidence shows these aren't about efficiency. They're about creating barriers that cost more money to administer than they save, while cutting care for people who already qualify.
  - xp84 1y ago
    Why can't people without disabilities or dependents work 20 hours a week?
    - postpawl 1y ago
      It's not about whether they can work 20 hours. Most already do. Arkansas found 95% of people either met the requirements or qualified for exemptions, but 18,000+ still lost coverage due to the paperwork maze. The requirements are designed to create barriers through bureaucracy. You have to report every month through a specific online portal, track your hours precisely, navigate exemption processes. Miss one monthly filing deadline and you lose healthcare. It's the most socially acceptable way to kick people off coverage without saying "we don't want poor people to have healthcare." And it's not just work requirements. The bill also adds income verification twice a year instead of once, more asset checks, and cuts the actual funding. Each new hoop is another chance for eligible people to fall through the cracks. The goal is reducing enrollment through administrative friction, not promoting work.
      - frumplestlatz 1y ago
        The reporting requirements don’t seem particularly onerous. It’s on those individuals to not “fall through the cracks” if they truly need our money to fund their healthcare — I don’t see the problem.
        postpawl 1y ago
        What's the point of making requirements even stricter if they cost more to administer than they save and don't increase employment? The Congressional Budget Office estimates 5.2 million people would lose coverage by 2034, with savings primarily coming from eligible people losing coverage due to paperwork barriers rather than increased employment.[1] The new bill allows states to verify monthly instead of every three months, so people lose coverage faster. Even working people get tripped up because 43% of workers would fail to meet 80 hours in at least one month due to variable schedules common in low-wage jobs.[2] People with multiple jobs have to submit paystubs from each employer monthly. Seasonal workers and food service workers are especially vulnerable because their hours swing wildly due to factors beyond their control. [1] https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts-in-the-house-passed-reconciliation-bill-explained/ https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts... [2] https://www.cbpp.org/research/health/medicaid-work-requirements-will-harm-low-paid-workers https://www.cbpp.org/research/health/medicaid-work-requireme...
frumplestlatz 1y ago
Call it “ideological” instead of “culture” if you prefer. The goal is the same — defund the opposition.
- postpawl 1y ago
  Why frame it as ideological though? That doesn't explain which agencies get protected and which get cut. The NTSB stays funded because rich people fly on planes too. But Medicaid gets cut because wealthy people don't need it. Look at weather service cuts. They're gutting the National Weather Service while Trump's appointees have ties to companies like AccuWeather and Satellogic that would profit from privatizing weather data. It's about class interests. Agencies that serve everyone or that rich people depend on stay funded. Programs that only help poor people get cut, or get privatized to benefit specific wealthy interests. Make the wealthy better off through tax cuts and new business opportunities, make poor people worse off through service cuts.
  - frumplestlatz 1y ago
    The cuts seem to be about defunding work around climate change.
    - postpawl 1y ago
      You're right that a lot of the NOAA cuts target climate research specifically. But think about who benefits from attacking climate science. Oil companies and existing wealth structures that profit from fossil fuels. Climate research threatens those business models, so gutting it protects those interests. The cuts go way beyond climate though. They're cutting 107,000 federal jobs across agencies while defense spending increases 13%. Framing this as ideological makes it sound like an abstract battle of ideas, but it's not abstract at all. Real people are losing health insurance, real hospitals are closing, real communities are losing weather warnings. Meanwhile wealthy people get tax cuts and connected companies get business opportunities. It's about material interests, not ideology.

xp84 1y ago

Can you point out what aspects of the bill relating to Medicaid are most concerning? I don't just mean the DNC talking points, but rather specific provisions. When I read through the actual provisions[1] they are far less scary than what I hear being used as DNC fundraising fodder. For instance, I can't just show up in the UK without any legal status and automatically have all free healthcare from the NHS[2]. But the provisions removing federal tax money support to provide free healthcare to the undocumented is one of the things being pointed to by opponents of the bill as being especially evil. If you feel that way, why is the US the only country that ought to do that? [1] https://www.kff.org/tracking-the-medicaid-provisions-in-the-2025-budget-bill/ https://www.kff.org/tracking-the-medicaid-provisions-in-the-... [2] https://www.nhs.uk/nhs-services/visiting-or-moving-to-england/how-to-access-nhs-services-in-england-if-you-are-visiting-from-abroad/ https://www.nhs.uk/nhs-services/visiting-or-moving-to-englan...

postpawl 1y ago
The work requirements force people to file paperwork proving 80 hours of work monthly, and Arkansas showed this paperwork maze caused 18,000+ people to lose coverage even though 95% already met the requirements or qualified for exemptions. Arkansas spent $26.1 million just on administration with no increase in employment, and Georgia has spent over $40 million with 80% going to bureaucracy, not healthcare. For rural hospitals, the bill cuts $58 billion in Medicaid funding over 10 years but only provides a $25 billion rural fund that covers less than half the losses. This puts 300+ rural hospitals at immediate risk of closure since they're already operating on thin margins. For elderly people, the bill blocks nursing home staffing rules until 2034 and freezes home equity limits at $1 million permanently, plus adds more verification requirements. The evidence shows these aren't about efficiency. They're about creating barriers that cost more money to administer than they save, while cutting care for people who already qualify.
- xp84 1y ago
  Why can't people without disabilities or dependents work 20 hours a week?
  - postpawl 1y ago
    It's not about whether they can work 20 hours. Most already do. Arkansas found 95% of people either met the requirements or qualified for exemptions, but 18,000+ still lost coverage due to the paperwork maze. The requirements are designed to create barriers through bureaucracy. You have to report every month through a specific online portal, track your hours precisely, navigate exemption processes. Miss one monthly filing deadline and you lose healthcare. It's the most socially acceptable way to kick people off coverage without saying "we don't want poor people to have healthcare." And it's not just work requirements. The bill also adds income verification twice a year instead of once, more asset checks, and cuts the actual funding. Each new hoop is another chance for eligible people to fall through the cracks. The goal is reducing enrollment through administrative friction, not promoting work.
    - frumplestlatz 1y ago
      The reporting requirements don’t seem particularly onerous. It’s on those individuals to not “fall through the cracks” if they truly need our money to fund their healthcare — I don’t see the problem.
      - postpawl 1y ago
        What's the point of making requirements even stricter if they cost more to administer than they save and don't increase employment? The Congressional Budget Office estimates 5.2 million people would lose coverage by 2034, with savings primarily coming from eligible people losing coverage due to paperwork barriers rather than increased employment.[1] The new bill allows states to verify monthly instead of every three months, so people lose coverage faster. Even working people get tripped up because 43% of workers would fail to meet 80 hours in at least one month due to variable schedules common in low-wage jobs.[2] People with multiple jobs have to submit paystubs from each employer monthly. Seasonal workers and food service workers are especially vulnerable because their hours swing wildly due to factors beyond their control. [1] https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts-in-the-house-passed-reconciliation-bill-explained/ https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts... [2] https://www.cbpp.org/research/health/medicaid-work-requirements-will-harm-low-paid-workers https://www.cbpp.org/research/health/medicaid-work-requireme...

frumplestlatz 1y ago

Call it “ideological” instead of “culture” if you prefer. The goal is the same — defund the opposition.

postpawl 1y ago
Why frame it as ideological though? That doesn't explain which agencies get protected and which get cut. The NTSB stays funded because rich people fly on planes too. But Medicaid gets cut because wealthy people don't need it. Look at weather service cuts. They're gutting the National Weather Service while Trump's appointees have ties to companies like AccuWeather and Satellogic that would profit from privatizing weather data. It's about class interests. Agencies that serve everyone or that rich people depend on stay funded. Programs that only help poor people get cut, or get privatized to benefit specific wealthy interests. Make the wealthy better off through tax cuts and new business opportunities, make poor people worse off through service cuts.
- frumplestlatz 1y ago
  The cuts seem to be about defunding work around climate change.
  - postpawl 1y ago
    You're right that a lot of the NOAA cuts target climate research specifically. But think about who benefits from attacking climate science. Oil companies and existing wealth structures that profit from fossil fuels. Climate research threatens those business models, so gutting it protects those interests. The cuts go way beyond climate though. They're cutting 107,000 federal jobs across agencies while defense spending increases 13%. Framing this as ideological makes it sound like an abstract battle of ideas, but it's not abstract at all. Real people are losing health insurance, real hospitals are closing, real communities are losing weather warnings. Meanwhile wealthy people get tax cuts and connected companies get business opportunities. It's about material interests, not ideology.