Trump’s Real Health Care Problem

From Medicaid cuts to vaccine availability to Obamacare subsidies, the president’s troubles are mounting.

Stop us if you’ve heard this one before: Congress is staring down the barrel of a possible government shutdown unless it can pass a new funding bill by October 1. There’s just those small little matters of the Epstein files and Trump’s D.C. takeover to square away first. Happy Tuesday.

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Make America Healthy Again hats are given out at a news conference on removing synthetic dyes from America's food supply at the Health and Human Services Headquarters in Washington, DC on April 22, 2025. (Photo by Nathan Posner/Anadolu via Getty Images)

Another Health Care Election

by William Kristol

I don’t know if Donald Trump has a personal health problem. But I’m confident he has a political health care problem.

At 8:15 a.m. yesterday, bright and early on Labor Day, our president took to Truth Social. That of course isn’t unusual. Trump posts at all hours on any day. But this was, for him, an unusual type of pronouncement. He wasn’t boasting about invented achievements. He wasn’t ranting about dastardly opponents. Instead, he seemed . . . concerned. Almost puzzled. Dare one say, pensive?

Okay, “pensive” may be overstating it. Still, Trump did appear to be concerned.

The Centers for Disease Control is “being ripped apart,” he fretted. Surely Donald Trump hasn’t suddenly developed an appreciation for the importance of not “ripping apart” government agencies. But he is, I’d judge, alarmed about the political effects of what’s happening there. And who’s been doing that ripping apart? His own secretary of health and human services, Robert F. Kennedy Jr.

Trump’s deputy chief of staff, Stephen Miller, said on Friday that Kennedy is “a crown jewel” of Trump’s administration. Trump’s post yesterday did not repeat this encomium. In fact, it didn’t even include a statement of confidence in his HHS secretary. To the contrary: Trump says that Kennedy is one of those “rip[ping] themselves apart” in the controversy.

Crown jewels don’t rip themselves apart.

Trump’s post also followed a long article in Sunday’s Washington Post claiming that a strong bond had developed between Trump and Kennedy. The Post also quoted Trump’s leading outside strategist, Steve Bannon, on the importance of Kennedy to Trump’s overall authoritarian project:

Bobby Kennedy is the instrument, he is the linkage that pulls MAGA and MAHA together. That combination, if we grow it smartly, is going to be unbeatable.

But Bannon didn’t seem confident that the linkage was “growing smartly.” Indeed, the Post reported that Bannon had “suggested that Trump should use his Truth Social media platform to defend Kennedy’s moves at CDC ahead of his scheduled appearance before a Senate panel Thursday.”

But Trump didn’t do that yesterday. Instead he expressed concern about the CDC being ripped apart.

Bannon’s grandiose future plans for a transformational political coalition notwithstanding, I suspect Trump is aware that Kennedy’s assault on Americans’ health is right now a problem for his administration. He’s also aware that, as Lauren Egan reported yesterday, his administration is under assault on health care more broadly.

After all, Trump has always insisted he wouldn’t cut Medicaid and still insists he hasn’t, even as the reconciliation bill that he championed and signed did so. Democrats are going to make reversing those cuts a centerpiece of their September messaging. They’re going to hammer Republicans for every rural hospital closure that happens between now and November 2026. Trump knows that’s a vulnerability.

And that’s not the only vulnerability. Last week, Ryan Fournier, head of Students for Trump, interrupted his normal Trump cheerleading and transgender bashing to warn about the political consequences of allowing federal support to end for the insurance premiums on the state exchanges set up in the Affordable Care Act:

2026 READOUT: Trump voters rely on premium tax credits. Letting them vanish means higher costs, lower turnout, and a Democrat Senate. Not an option. Republicans must extend premium tax credits.

As of now, Republicans haven’t acted and don’t intend to act to extend those tax credits. They expire at the end of this year. Insurers are already preparing to raise premiums. Trump’s pollster, Fabrizio Ward, has warned that Republicans in competitive congressional districts could see their deficit among registered voters expand to 15 points if the subsidies aren’t extended.

So, as we head into the September showdown on next year’s budget, Republicans have handed Democrats a politically powerful agenda on the issue of health care: Undo the Medicaid cuts. Keep the health insurance tax credits. Provide vaccines.

Trump is now on the unpopular side of these arguments. He doesn’t care about the substance, and will be tempted to give in and take these attacks off the table. But that would fracture his base. MAHA doesn’t like vaccines. Many congressional Republicans, not just the Freedom Caucus, hate concessions on Medicaid or Obamacare. So Trump’s path ahead is rocky.

The Democrats’ path, on the other hand, is pretty simple: Promote and publicize doctors, nurses, hospital administrators, and patients and their families, explaining the damage Trump is doing. And then spend all month in D.C. fighting on their behalf.

In 1994, 2010, and 2018, the midterms focused on health care. And they were very bad for the party in power. This September is key to a repeat performance in 2026.

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AROUND THE BULWARK

• Bulwark Movie Club! Sarah Longwell, JVL, and Sonny Bunch all watched Armando Iannucci’s darkly hilarious 2017 movie “The Death of Stalin.” Watch along and try not to make too many connections to our current politics.

• Michael Anton’s Final Flight... Before he quits the Trump administration, the author of the infamous “Flight 93 article” will try to make sense of ‘America First.’ Good luck with that, writes GABRIEL SCHOENFELD.

• Hungary Could Free Itself from Orbánism Next Spring... An upstart opposition leader, Péter Magyar, is shrewdly capitalizing on the prime minister’s blunders, reports H. DAVID BAER.

• Can Democrats Stop Bleeding Voters? SARAH LONGWELL and Third Way’s MATT BENNETT join MONA CHAREN to talk about tanking Democratic voter registration numbers, words you should never say, the working class, the donors, and more. All that on the latest Mona Charen Show.

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Quick Hits

TWO PLUS TWO EQUALS A BILLION: Here is a simple fact about import tariffs: The importing party pays them. If a U.S. company tries to import a product today from a country on which Trump has placed tariffs, that company will both pay the exporter the cost of the product and pay a tariff to the U.S. government. This is basic, fundamental, 2 + 2 = 4 stuff. It’s like saying shoppers, not stores, pay sales tax or that workers, not their companies, pay income tax.

Donald Trump, however, is famously unable to grasp this simple fact. Over the years, he has claimed dozens of times that other countries pay the cost of tariffs—which is a bedrock reason why he sees them as such a beautiful and useful economic tool. And because Trump is unable to grasp the fact that Americans pay tariffs, the task falls to the rest of the right-wing media and political ecosystem to keep the simple truth safely away from his constituents.

So witness this remarkable Fox News exchange over the weekend between presidential daughter-in-law Lara Trump (here playing the role of “journalistic interviewer”) and Treasury Secretary Scott Bessent:

LARA TRUMP: They will say that the tariffs are a hidden tax on the consumers here in the country. But give us the reality.

BESSENT: If they’re so bad, and the American consumer’s paying them, why do we hear the European companies, or the Chinese companies, or the Chinese complaining about tariffs, if it’s all being borne by the American people? It’s just not happening.

Now, for those of us whose brains aren’t rotting out our ears, Bessent’s hypothetical is easy to answer. European companies and Chinese companies suffer from American consumers being forced to pay more for their products, because it makes those consumers less likely to buy those products. Not exactly rocket science.

But what’s particularly interesting here is that this isn’t a flailing face-saving response to a hostile interviewer. It’s the friendliest-turf discussion imaginable. The White House itself tweeted out the clip afterward. This is political messaging under Trump 2.0: Inconvenient facts aren’t to be swept under the rug, but loudly denounced as ridiculous lib nonsense.

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‘GREAT’ IS DEBATABLE: They say there’s no bad ideas in a brainstorm. But the “postwar plan for Gaza circulating within the Trump administration,” which the Washington Post reported on Sunday, certainly contains quite a few—ah—creative suggestions.

The 38-page prospectus seen by The Washington Post envisions at least a temporary relocation of all of Gaza’s more than 2 million population, either through what it calls “voluntary” departures to another country or into restricted, secured zones inside the enclave during reconstruction.

Those who own land would be offered a digital token by the trust in exchange for rights to redevelop their property, to be used to finance a new life elsewhere or eventually redeemed for an apartment in one of six to eight new “AI-powered, smart cities” to be built in Gaza. Each Palestinian who chooses to leave would be given a $5,000 cash payment and subsidies to cover four years of rent elsewhere, as well as a year of food. . . .

Called the Gaza Reconstitution, Economic Acceleration and Transformation Trust, or GREAT Trust, the proposal was developed by some of the same Israelis who created and set in motion the U.S.- and Israeli-backed Gaza Humanitarian Foundation (GHF) now distributing food inside the enclave. Financial planning was done by a team working at the time for the Boston Consulting Group.

“Forced relocation of the entire Gaza population” is a cruel enough idea that even Trump might have trouble getting behind it. But “crypto-based relocation of the entire Gaza population to Make Gaza Great Again” is the sort of big crackpot proposal it’s easy to imagine him getting excited about. Nothing about the plan is official U.S. policy . . . yet.

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A SAD UPDATE: The House Oversight Committee is withdrawing its request for Robert Mueller to testify this week about the government’s handling of the Jeffrey Epstein investigations. The reason? Mueller’s family announced over the weekend he is suffering from Parkinson’s disease. The New York Times reports:

In recent months, Mr. Mueller, a former F.B.I. director, has had difficulty speaking and experienced mobility issues, people familiar with his condition said. . . . “Bob was diagnosed with Parkinson’s disease in the summer of 2021,” the family said in a statement to The New York Times. “He retired from the practice of law at the end of that year. He taught at his law school alma mater during the fall of both 2021 and 2022, and he retired at the end of 2022. His family asks that his privacy be respected.”

Mr. Mueller became F.B.I. director two weeks before the Sept. 11, 2001, terrorist attacks. During his tenure leading the bureau, he had a reputation as a commanding figure, known for not only his ability to remember minute facts about major national security cases but also his physical stamina.

Questions arose about Mr. Mueller’s health after he delivered a halting performance before Congress in 2019 about his report on ties between Mr. Trump’s campaign and Russia, and whether Mr. Trump had obstructed that investigation.

In retrospect, the Mueller investigation during Trump’s first term feels like a sea-change moment in our political history. Mueller, a former FBI director, was known for his poker-straight principles and by-the-book fastidiousness when he was appointed to lead the special-counsel investigation into Russian interference in the 2016 presidential election. Rather than simply cooperate with the investigation—or even quietly stonewall it—Trump fought Mueller tooth and nail every step of the way, denouncing the investigation as a “witch hunt” and taking a number of actions against it that arguably amounted to obstruction of justice. Going by the preexisting rules, these would have been bad, self-incriminating, moves. But Trump rewrote the rule book—and the post-truth “witch hunt” strategy has been serving him well ever since. Mueller finished his report, endured a very choppy congressional testimony that looks different now under the current light, and immediately left public life. Trump’s still here.

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