Senate GOP to Medicaid Recipients: Drop Dead
The haphazard budget is almost over the finish line.
Polar payoff
The business proposition of organized crime isn’t complicated: Parasitic gangsters suck the hard-earned money out of good citizens’ wallets to line their own pockets and deliver kickbacks up the chain of command. In the United States Senate, Lisa Murkowski has made Alaska into pretty important turf. Her unique ability to waffle on major deals or rebel against major nominations in the Trump era has put her in a prime position to collect when it’s time.
So last night and well into the early hours of this morning, Republican leaders turned their attention to Murkowski. They may have titles like “chairman” or “majority leader” or “whip,” but for at least 24 hours no one doubted who the boss really was.
To appease Murkowski, Republicans initially sought two special carveouts for Alaska: One would exempt Alaska from cuts to the SNAP food-assistance program for people with low incomes, and the other would create an Alaska-shaped exception to Republicans’ efforts to gut Medicaid. Because the bill had to conform to the Senate’s strict rules for budget-reconciliation bills, the parliamentarian threw out the Medicaid exemption. But they kept the SNAP one—by making it so that states with elevated error rates in their payments could delay implementing work requirements. Yes, it literally would pay to have an error-prone system.
Other major bosses that Republicans tried to buy off included Sens. Rand Paul (R-Ky.), Susan Collins (R-Maine), and Thom Tillis (R-N.C.). Among other offers, GOP leadership proposed eliminating an excise tax on solar and wind energy and doubling the rural hospital fund (a pocket of money that was there to undo the harm caused by the other parts of the bill they were passing) to $50 billion through 2030.
They weren’t won over. Fresh off an announcement that he will not seek re-election, Tillis felt comfortable calling the bill a sham that will wreak havoc on the health care system. Collins was less vocal in her opposition, but it didn’t seem like Republican leaders saw her as gettable. For Paul, there was a brief discussion about lowering the debt ceiling from a $5 trillion increase to just $500 billion. That was not entertained for long, as it would hand Democrats a major leverage point likely later this year and no other Republican besides Paul actually cares about the national debt anymore.
So Murkowski became the final senator to court in order to get the necessary 50 votes on their swamp water budget. (Budget-reconciliation bills can’t be filibustered, hence the 50-vote threshold; Vice President JD Vance ultimately cast the deciding vote.)
Ironically, Murkowski has played this role before only to scoff at the idea of a “polar payoff.” In 2017, when Republicans were seeking to repeal and replace the Affordable Care Act, then-Senate Majority Leader Mitch McConnell sought to allow Alaska—and Alaska only—to access a multi-billion-dollar fund. The legislation reserved $182 billion for states with high health insurance premiums, but one percent of that fund was specifically dedicated to states with premiums at least 75 percent higher than the national average; only Alaska met that threshold.
To Murkowski’s credit, she saw through the cynicism of the kickback, saying at the time, “Let’s just say that they do something that’s so Alaska-specific just to, quote, ‘get me.’ Then you have a nationwide system that doesn’t work. . . . That then comes crashing down and Alaska’s not able to kind of keep it together on its own.”
When Republicans attempted to repeal Obamacare again later that year, they also sought carveouts for Alaska to get Murkowski over the finish line. Among these was a proposal for grandfathering native Alaskans into Medicaid to exempt them from expansions that were set to be rolled back several years later. Alaska’s low population density would have also helped it obtain special access to federal funds.
Nonetheless, Murkowski held firm and refused to help Republicans rip apart the Affordable Care Act.
Less than a month ago, it seemed like we’d see the same show again. Murkowski promised to make sure that “Alaskans and people around the country are not impacted in a negative way” (emphasis ours).
That didn’t last. On Tuesday, Murkowski voted to gut Medicaid for the nation (in addition to all the other components of this bill). Instead of raising a principled objection to stop it from happening, she suggested she would try to work in the future to make the very thing she just allowed to happen less bad.
“My hope,” she told reporters after the vote, “is that the House is gonna look at this and recognize that we’re not there yet.”
When a reporter asked Murkowski (quoting Rand Paul) whether the deal Republicans struck to obtain her vote counted as a “bailout” for Alaska, Murkowski glared at him silently for thirteen seconds before defending herself and saying “I find that offensive.”
Vance refrigeration
All of this is irrelevant to JD Vance, who posted on X late last night that the budget has only one true purpose: deporting people. Whether it results in millions of Americans losing access to health care, the poorest citizens losing income, or the United States becoming a nation of rolling blackouts does not matter as long as enough migrants are rounded up.
“The thing that will bankrupt this country more than any other policy is flooding the country with illegal immigration and then giving those migrants generous benefits,” Vance wrote. “The OBBB fixes this problem. And therefore it must pass.”
“Everything else—the CBO score, the proper baseline, the minutiae of the Medicaid policy—is immaterial compared to the ICE money and immigration enforcement provisions,” he added, referring to the roughly $150 billion the bill allocates to the Department of Homeland Security for immigration enforcement, including massively expanding the number of ICE agents.
In case you didn’t follow that, cutting millions of Americans’ health insurance is just the price we have to pay for throwing out as many people as possible who pay into entitlements but don’t draw on them. And that’s how we . . . avoid bankruptcy?
Winter is coming
Repeated attempts at national suicide is the prevailing theme of the second Trump presidency: The cranks and shock jocks appointed to high-ranking government positions, the Justice Department’s rampant lawfare, DOGE’s dismantling of public trust in institutions and American soft power, the tariff policy (policies? It’s hard to keep track) all suggest as much. The budget is just the latest cry for help to a public that—for the past few election cycles—is uninterested in lending a hand.
The budget was supposed to be a means of extending the Trump tax cuts from his first term. But it rapidly morphed into a transfer of wealth from the nation’s poorest to its most obscenely rich. It also became a health care bill, an energy bill, and at one point, a bill aiming to sell off vast amount of public lands.1
House Republicans will now have to pass this behemoth of a budget, which they could try and do as soon as tomorrow. Alternatively, they could try to meld their demands with the garbled mess the Senate just created, though that would mean the Senate would have to revote. And because there are at least a few remaining independent voices left in the upper chamber, it’s much harder to get controversial legislation through the Senate than the House—even when you only need the support of half the senators. So the likelihood remains that the House GOP leadership will try and stuff this through as is in order to have it on Trump’s desk by week’s end, if you feel like placing some bets.
Utah Sen. Mike Lee’s proposed public land selloff ran into obstacles with the Senate parliamentarian, then again with some GOP senators whose constituents have access to and use public lands. Despite being among the most committed Trump sycophants, Montana’s senators sprang into action against Lee’s proposal.
Deeply offended? She should be deeply ashamed. What a coward, in every sense of the word.
Doesn't Vance understand the importance of immigrant labor to farmers, meat packers and restaurants? Who is going to do these jobs, unless you foresee a near future depression with 20% unemployment?