LyrArc Article Gist
This NYT editorial points out that the cuts to Medicaid amount to taking out a fourth of its budget and are sure to hurt low income Americans. The cuts are about $880 billion over 10 years for Medicaid. The $300 billion less in subsidies over ten years is likely to hurt the elderly. It also points out that removing the individual mandate will make it harder to reduce premiums as fewer healthy adults offset the costs of sick patients.

LyrArc Article Gist
Krugman in the NYT cites president Trump's reference in an interview with the Economist magazine to the expression "priming the pump." Trump in that interview in May 2017 said he had come with the expression and feels good about it. "Priming the pump" is an expression used by president Franklin Roosevelt during the Depression period. During the depression and in 2009 the economic crisis needed a stimulus response and priming the pump. The economy today with lower unemployment is not the time to increase deficits with tax cuts for the wealthy, says Krugman. Only infrastructure spending with a long term return justifies increasing the deficit. He is critical of Speaker Ryan for supporting deep cuts into Medicaid for poor people, and yet supporting the tax cuts weighted more towards helping higher income people.

LyrArc Article Gist
Losers in US Tax Mega Bill 2025- Medicaid users, food aid recipients, college borrowers, and EV drivers.

LyrArc Article Gist
One Big Beautiful Act passed in US Senate with Vance casting tie breaking vote. It renews the tax cuts from DJT's first term in office in 2017 and provides tax cuts to seniors, middle class, and small business. It provides 100% expensing for business to increase investment. Mothers get child care credit that is doubled, senior citizens over 65 years get a $6000 deduction. The seniors deduction means 88% of seniors will now pay no taxes on social security benefits from 64%. Medicaid changes so that able bodied Americans will have to put in 80 hours of work to qualify.  Note that the Medicaid program was becoming unworkable and unsustainable- starting with the idea of helping people unable to work and transitioning those who could work, it jumped to $228 billion cost in 2000 from $28 billion in 1980, ten times over 20 years. Going up to $918 billion in 2024, 4 times the 2000 level. Medicaid is now 62% of what Social Security costs, $918 billion compared to $1480 billion for Social Security. ...

LyrArc Article Gist
Krugman on tax breaks for large corporations that do not create jobs and large cuts to Medicare and Medicaid.

LyrArc Article Gist
Flat payment rates for Medicare Advantage to Insurers by the DJT administration which is questioning how health care needs of the country remain unmet and US healthcare comparing very unfavorably with other advanced countries in Europe and Japan and also in India. Some of this is because of the behaviour and practices of the health and pharmaceutical industries in the US. The 2027 payment by government for Medicare Advantage is 0.09 percent. In 2026 it was about 5%. In 2025 it was -0.16 percent and in 2024 it was -1.12% under the Biden administration showing a great deal of dissatisfaction with funding Medicare Advantage. Medicare Advantage was set up by the Bush Republicans in 2003 who set it up with the nice sounding name Medicare Modernization Act. It was an effort to help the insurance companies with government money. Today in the second term of DJT in 2026 affordability is what American people care about most and the DJT administration is unhappy with the insurance companies. Dr. Mehmet Oz is in charge of Medicare and Medicaid Services Agency of the federal government and he says about Medicare Advantage and new policy to save “taxpayers from unnecessary spending (on Medicare Advantage) that is not oriented towards addressing real health needs.” The DJT Kennedy-Oz approach is for comprehensive digital information linking all medical providers, making America healthy again, cutting through the dense fog created over the last 2 decades, making pharmaceutical costs as affordable as the best in European nations, and refusing to subisidize if delivery is poor and health results are poor.   ...

LyrArc Article Gist
The coverage of the Republican healthcare bill and how it affects the elderly, and people on Medicaid, people in rural areas, is likely to have changed public opinion in the U.S. about the necessity of ensuring all Americans have health coverage. The Pew survey cited here in this NYT report by Zernike and Goodnough was done in Jan 2017, and shows a shift. The shift would be much higher today after people look hard at the consequences of what were simply hypothetical positions or ideological positions taken without looking at consequences in daily living. On Medicaid that opinion by July 2017 compared to Jan 2017 has shifted 10 percentage points for Republicans to 53% who think Medicaid is important to them and their families, according to Kaiser research. There is stronger sentiment about people having benefits taken away.  [article-55059] The opinion has shifted to where people see that coverage is important and people should not have coverage denied or benefits taken away from them. Opinion remains strong in favor of changes to reduce the high premiums, but not to replace the existing health benefits and law with no law at all to replace it. That leaves 20 million more uninsured according to the Congressional Budget Office. Changes have to be constructive is the popular view today,  and this requires dialogue between Republicans and Democrats- which has not taken place. ...

LyrArc Article Gist
With government spending currently at 24% of GDP, the budget proposed by Paul Ryan, chairman of the House Budget Commttee, proposes to bring this down to 22.5% in 2012, and to 20% by 2018. The Ryan proposal would cut spending by $5.8 trillion for 2011-2021, with spending $6.2 trillion less than proposed by the Obama administration. It is a bold effort by House Republicans to bring the deficits down from the $1 trillion plus levels of the last 3 years. Major changes are made under this proposal to Medicare, and Medicaid. People who retire after 2021, would choose from an array of private insurance programs, and the federal government would help pay the premium. Medicare under this arrangement would be a "premium support" system. Medicaid would become a block grant for the states. This proposal estimates a saving of $771 billion on Medicaid over 10 years. The Food Stamp program would also become a block grant system. In addition to this the top individual and corporate tax rates would be 25% instead of 25%, with the changes being revenue neutral as a series of tax breaks would be eliminated....

LyrArc Article Gist
Senate Finance Committee chairman says Senate Democrats have found ways to reduce the cost of the health care plan from $1.6 trillion to $1 trillion. A tax on some employer provided health benefits, cuts in Medicare and Medicaid spending, employers helping to pay the cost of health insurance for low-income workers, and limiting the eligibility for subsidies to households with incomes at 3 times the poverty level or $66,150, instead of 4 times the poverty level. Also a reduction in the plan to give tax credits to small businesses to help them buy insurance. And expansion of Medicad would be delayed to 2013.

LyrArc Article Gist
The Congressional Budget Office analysis of the Republican House health Care bill shows 24 million Americans would lose health insurance over 10 years. In terms of budget savings the bill saves $337 billion over 10 years. The increase in uninsured comes from the roll back of expansion of Medicaid under the House plan, the reduction of tax credits, plus the removing of income based credits replacing it with tax credits based on age. President Trump is promoting the bill saying it will reduce the premiums that have gone up since Affordable Care Act was passed and increase competition. House Speaker Ryan in promoting his plan says he is not in "some coverage beauty contest." The House Plan says Ryan, does not mandate that all be covered, but simply says coverage is in a free market giving people the option to buy insurance that they want, so that the numbers of insured would not be as many as under a mandate.

LyrArc Article Gist
Republican governors hold governorships in 30 states in the U.S. They have a different perspective on the expansion of Medicaid envisaged in the healthcare law, as long term funding for the expansion is uncertain. With the deficit reduction planned in negotiations between president Obama and the Republican controlled House the outlook for money going to state funding is precarious.

LyrArc Article Gist
The Fiscal Survey of States, a report put out by the National Governor's Association, says that Medicaid will become an increasing burden on state budgets as help from the federal government declines. The report points out that state general fund revenue remains $21 billion below 2008 levels, just as the states prepare for less federal help.

LyrArc Article Gist
WSJ Analysis of $1 trillion Medicaid Cuts in the One Big Beautiful Act-who it impacts most. It means less money for insurers, hospitals, and 9 million able bodied Medicaid recipients being moved to being covered by new employers. Under extension of Obamacare able bodied Americans were added to Medicaid in some of the states. Some states such as Texas and Florida and other southern states decided not to do this. The One Big Beautiful Act removes this extension of Obama care and the funding to states and adds the able bodied requirement to cut funding by about $1 trillion. Insurance companies who covered the insured and got payments from the federal government will lose these payments. Hospitals will also lose these payments from the federal government that sent money to the states for funding Medicaid. Overall Medicaid funding is proportionally cut more in Republican states. In Arizona, Kentucky and Virginia Medicaid cuts will be 18%, compared to 9% in New York and 13% in California. 93% of the cuts are in states that have expanded Medicaid to include able bodied adults. The Big Beautiful Act also cuts down on provider taxes which hospitals used to get more funding. Rural hospitals are given access to a $50 billion fund in the Act  so they can be kept open. ...

LyrArc Article Gist
Paul Ryan, chairman of the House Budget Committee, explains his U.S. budget proposal to bring down the deficit. Ryan's Republican budget proposal is a bold effort to make a break from a status quo which is leading to higher levels of U.S. debt as a percentage of GDP. It envisions changes to Medicare, Medicaid, and the tax code. It is built on the idea that sustainable finances will lead to a better economic future for America, compared to small changes to the staus quo envisioned in Democratic proposals and the 2012 budge proposal of the Obama administration. It is also bold in its effort to tackle Medicare with a "premium-support" system, and Medicaid by turning it into a block grant system. It also incorporates the Bowles -Simpson President's Deficit Commission's ideas for simplifying the tax code.

LyrArc Article Gist
The $350 billon in proposed cuts to Medicare and Medicaid in the 2011 deficit reduction talks will do little to reduce the rapid rise in medical costs. Instead it shifts the costs to seniors, state governments and public hospitals. Gail Wilensky, former head of Medicare under the first President Bush and now a senior fellow at Project Hope, says this should not be confused with real reform to Medicare which reduces the rapid increase in costs. It does little in the way of fundamental changes that would reduce the growth in costs. About $53 billion comes from reductions to senior's ability to buy extra Medicare supplemental insurance or Medigap. Another $14-26 billion would have the government reduce payments to hospitals for unpaid debt. The few items to curtail fraud in the use of CT scans or purchase of power wheelchairs would provide savings of $2-3 billion over 10 years. $4 billion comes from lowering Medicaid payments to hospitals treating a high percentage of low income patients, hospitals such as Cook County Hospital in Chicago, San Francisco General Hospital, and Parkland Hospital in Dallas....

LyrArc Article Gist
House Democrats in the U.S. see the Republican health care plan making the same mistakes in 2017 that the Democrats made in 2008. With the passage of the bill in the House of Representatives with a vote margin on May 4, 2017, rushed through in the way the Obama bill was also rushed through, the nation remains as divided as ever on the issue of health care. The Republicans favoring limiting subsidies and cutting Medicaid, and using some of the savings for a tax cut. The Democrats favoring mandated coverage for all and large subsidies to reduce the number of uninsured Americans, with expansion of Medicaid for very low incomes. Democrats in the House say the Republican House bill will result in Republicans losing seats in the House in midterm elections.

LyrArc Article Gist
Vast majority of DJT supporters 88% (down from 95%), approve of the president DJT's overall performance. On tariffs and Big Beautiful Bill. Democrats vastly disapproving, the messaging on cuts to Medicaid even though it's funding had grown close to $1 trillion ($909 billion in 2024), the uncertainty on tariffs even though the $1 trillion China trade surplus needed serious corrective action, federal government job cuts, leads to much larger proportions of Democrats opposing than Republicans supporting leading to about 60% unfavorable overall on tariffs and Big Beautiful Bill. Such unpopular action is sometimes the role of government like the action to rebuild the trading system and bring restraint to runaway spending on benefits, and can be overcome with a strong economy and capital investment for growth in future years. Another problem for the DJT administration is in the messaging to get the message across when some of the president's actions can be inconsistent or appear inconsistent. Add to this the distractions such as international diplomacy on Ukraine that take the president's time. Yet changes were needed in the international trading system and tough action is sometimes necessary when most countries and groupings, China EU, Canada, Mexico, can game the system their benefit to the detriment of the American people and jobs/communities at home. On the Big Beautiful Bill at the rate of growth in funding for Medicaid to $909 billion in 2024 from $2 billion at its inception under LBJ in the 1960's some restraint on spending would ultimately keep such help flowing where it is needed over the long haul. ...

LyrArc Article Gist
DJT appeared on Oz's health show in 2016 as a presidential candidate, and sees OZ as a fellow tv show host, a kindred spirit with a passion for what he is doing. As head of Medicare and Medicaid after afailed effort for a Senate seat from Pennsylvania, Oz is still someone whit a keen sense for the politics as well as what is good for the healthcare of Americans. He shares apassion for good health as a goal for America that was held up by JFK, and his nephew Robert Kennedy Jr who now leads the Make America Health Again movement. Oz fervently believes the time for healthy America is now after many wasted years under Clinton/Bush/Obama when national interests were neglected for places like Bosnia in a historical conflict of Turks and Serbia that goes back centuries (Clinton), in the deserts of Iraq (older Bush), in the mountains of Afghanistan that claimed Brezhnev as a victim the younger Bush followed, two wars prolonged by Obama and closed by DJT and Biden. Something as basic as health and pharmaceutical prices was allowed to get as bad as it is in 2026 with prices through the roof. DJT's plan is to get the pharmaceutical companies to commit to certain prices, to the lowest price they sell the same medicine in Europe. This is what Dr Oz wants to see not just for the next 3 years but put into established practice for the future years.  Oz says about presenting the DJT plan on healthcare to Congress and the Nation- “We didn’t demand that they do it. We said, ‘This is something that is very popular and highly achievable.’ ” Healthcare costs, gas and automobile costs, energy costs, housing costs are all part of the 4-5 costs that are the key elements in the cost of living crisis or affordability crisis that is uppermost on the minds of Americans. Already the Medicare payments to insurers are going to be flat for 2026 compared to 2025, as part of policy to get costs down, push pharmaceutical costs down. ...