Big Beautiful Bill, Small Ugly Republicans:
How Trump’s Budget Sells Your Health to the Rich

By T‑Paine

“Medicare is a lifeline for our nation’s seniors and people with disabilities. We must strengthen it, not slash it.” - Senator Ted Kennedy

They called it “big” and “beautiful.” We call it what it is: a plan to rip over $1 trillion from Medicaid and Medicare — programs you, your parents, and your kids rely on — and hand it over to the richest Americans through new tax breaks. Trump’s proposed budget isn’t some accounting trick. It’s a blueprint for a massive upward transfer of wealth: the largest in modern U.S. history. It says the quiet part out loud: poor, sick, elderly, and disabled people are expendable — and the ultra-rich must be pampered with your tax dollars.

How Much Are They Cutting?

Trump’s budget slashes nearly $1 trillion over 10 years from Medicaid and Medicare combined. Medicaid covers over 80 million Americans- kids, pregnant people, seniors in nursing homes, disabled adults. Medicare keeps health care within reach for 65+ retirees. These aren’t “extras.” They’re survival.

Where Does the Money Go?

Straight into tax cuts for people with yachts, private jets, and off-shore bank accounts. The budget expands the Trump tax law that already slashed corporate rates, giving another round of breaks worth hundreds of billions more.

Who Gets Hurt?

Your neighbor with cancer. The kid in your school with epilepsy. The nursing home staff barely paid to keep grandma alive. The rural hospital at risk of closing. The mental health clinic in your county. The ripple effect hits everyone, even if you’re not on Medicaid — because entire health care systems rely on these programs to keep the doors open.

Who Benefits?

Roughly 1% of Americans. Hedge fund managers. Executives. Corporate shareholders. Billionaires. The people who fund campaigns, buy politicians, and don’t worry about $600 hospital bills.

Who Pays the Price?

Everyone else. Seniors on fixed incomes. Disabled Americans who rely on Medicare for life-saving care. Working-class families with loved ones who need long-term support. Rural hospitals already on the brink of closure. Communities of color, who disproportionately depend on Medicaid. Cutting these programs isn’t just budget math — it’s a death sentence for the vulnerable.

How It Got This Bad

Medicare and Medicaid were born out of a simple promise: that no American would have to choose between paying for health care and keeping a roof over their head. Signed into law by President Lyndon B. Johnson in 1965 as part of the Great Society, Medicare was designed to guarantee affordable health coverage for the elderly — a population that, before its creation, faced devastating medical bills and often no care at all. Medicaid aimed to cover low-income Americans, including children, pregnant women, and the disabled, making sure health care wasn’t a luxury reserved for the wealthy. This was a radical step — a government program acknowledging that health care is a right, not a privilege. For decades, these programs have saved millions from bankruptcy, provided lifesaving care, and stabilized the health system.

But this success has always been a thorn in the side of conservatives and corporate interests who profit from illness. Big Pharma, private insurance companies, and hospital chains see Medicare and Medicaid as threats to their bottom lines — public programs that set limits on drug prices and demand accountability. These industries don’t want you healthy; they want you dependent on expensive medications and treatments that line their pockets.

Starting with Reagan, who dubbed Medicare “socialism,” right-wing politicians have waged a relentless campaign to privatize, cut, or dismantle these programs. They frame the debate as a financial crisis to justify slashing benefits and shifting costs onto patients. The “free market” solution means turning health care over to corporations who prioritize profit over people. Through the 1980s and 1990s, policies chipped away at Medicaid funding and expanded private alternatives. The Bush administration pushed Medicare Advantage plans, which funnel public dollars to private insurers while providing less comprehensive care. The GOP’s 2010 budget proposals sought massive cuts to Medicaid and Medicare, blaming the programs for the federal deficit — even though the real culprits are tax breaks for the wealthy and corporate loopholes.

Trump’s first term brought this assault into the open, attempting to repeal the Affordable Care Act and cut Medicaid by billions. His “Big Beautiful Bill” continues this legacy, gutting programs that millions rely on to fund tax cuts for billionaires. In short, the war on Medicare and Medicaid isn’t about budgets — it’s about power. Conservatives and their corporate backers want to keep people sick and scared, so they can make money off suffering. Your health is their profit. And that’s why this fight matters now more than ever.

The Money Behind the Cuts

Since the programs’ inception in the 1960s, conservatives have pushed to privatize or shrink Medicare and Medicaid—not because they care about “deficit reduction,” but because Big Pharma, private insurers, and healthcare conglomerates stand to gain trillions from dismantling public care. These industries fund politicians who promise to roll back government healthcare.

Key players:

• The Koch brothers and their network have long backed campaigns to shrink the social safety net, funneling millions to candidates who push privatization and cuts.
• Pharmaceutical companies, led by giants like Pfizer, Johnson & Johnson, and Merck, spend billions lobbying Congress every year. They profit enormously from higher drug prices when Medicare can't negotiate prices or when public care shrinks, forcing people to rely on expensive private options.
• Private health insurance companies, such as UnitedHealth Group, Anthem, and Cigna, fund candidates and PACs aligned with anti-Medicare agendas, hoping to expand their market share by gutting public programs.
• Republican lawmakers like Paul Ryan and Mitch McConnell have received significant campaign contributions from these industries while advocating for Medicare and Medicaid cuts.
• Some politicians have financial conflicts of interest, holding stocks or investments in pharmaceutical or insurance companies that benefit from cuts to public healthcare.

These corporate interests shape legislation and public policy to:

• Restrict Medicare’s ability to negotiate drug prices, keeping costs high.
• Promote “Medicare Advantage” plans — privatized versions of Medicare that funnel public money to private insurers while often providing worse care.
• Push for Medicaid block grants and work requirements, which cut eligibility and increase uninsured rates.
• Use budget “scare tactics” about deficits and entitlement “crises” to justify cuts that benefit wealthy donors.

The so-called “fiscal responsibility” arguments are smokescreens. The cuts are designed to enrich corporations and the ultra-wealthy, even if it means worsening health outcomes for millions. Understanding these ties helps expose the real villains behind the policy and why cutting your healthcare isn’t about saving money — it’s about making billionaires richer.

The Big Lie: Decades of Deception

If you tuned into the 2023 State of the Union, you might have heard Republicans insist they’re not cutting Social Security or Medicare. But let’s be real: this claim is nothing new. It’s been a staple lie stretching back decades — a political magic trick to keep voters calm while quietly chipping away at the safety net. From Reagan’s attacks in the 1980s to the more recent budget battles, GOP leaders have promised to protect these programs, only to slash funding, impose stricter eligibility rules, and push privatization schemes behind closed doors. They count on confusion, false headlines, and the slow grind of bureaucracy to do their dirty work.

Medicare and Medicaid aren’t “going broke” because of seniors living longer or more people needing care. They’re being squeezed to boost profits for private insurers and pharmaceutical giants — the very donors funding these politicians. According to the Congressional Budget Office (CBO), Medicare spending has grown mainly due to rising healthcare costs and expensive new medical technologies—not runaway enrollment. Social Security’s trust fund is projected to last until 2034, and Medicare’s Hospital Insurance fund until 2028, providing lawmakers ample time to fix solvency issues — if they chose to prioritize it.

• The top 1% of Americans control more wealth than the bottom 90% combined. Yet their tax rates have dropped drastically since the 1980s, freeing up billions that could easily cover Medicare and Social Security shortfalls.
• Pharmaceutical companies, which benefit massively from privatized health care, spend over $300 million annually lobbying Congress, pushing for policies that inflate drug prices and reduce transparency.
• Administrative overhead for private Medicare Advantage plans is often higher than for traditional Medicare, meaning more of your tax dollars go to marketing and profits instead of care.
Fraud and waste in Medicare amount to about 3-10% of total spending annually—billions of dollars that could be reclaimed with stronger oversight.
• According to the Urban Institute, raising the Medicare payroll tax by just 1% on earnings above $400,000 would eliminate the program’s projected shortfall for the next 75 years.

Higher Costs, Less Care

Medicare and Medicaid cuts don’t just shrink budgets — they shrink your access to care. Doctors might stop accepting Medicare patients because reimbursement rates drop. That means fewer places to get treatment, longer waits, and your health taking a back seat to profit margins.

Prescription Prices That Soar

Without these programs protecting millions, drug companies will jack up prices. Imagine having to choose between paying rent or your medication — and don’t expect relief from Big Pharma, whose profits depend on your pain.

Hospitals on the Brink

Many hospitals, especially rural ones in Ohio, rely heavily on Medicaid funding to stay open. Cuts mean closures, forcing you to travel farther for emergency care — sometimes too far to get help in time.

Your Loved Ones at Risk

If you care for aging parents or have a child with special needs, these cuts threaten vital support services that keep families whole. Without Medicaid, caregivers bear the full burden — emotionally and financially.

The Safety Net That’s Being Cut Away

Social programs like these were created to protect us from the worst-case scenarios: serious illness, disability, aging. When they’re dismantled, it’s not just numbers on a spreadsheet — it’s your neighbor, your cousin, your community left vulnerable.

A Story You Won’t Hear in the News

Meet Linda. She’s 67, a retired factory worker from a small town outside Akron. After decades on her feet, her arthritis made it impossible to keep working. Medicare was her lifeline—covering her doctor visits, physical therapy, and the medications that let her walk without crippling pain. But now, with these brutal cuts looming, Linda faces a terrifying choice: pay for her meds or pay for food. Her pharmacy just raised prices. The co-pays went up again. And the local hospital, the one she’s relied on for years, just announced it’s closing its emergency room because Medicaid funding dried up.

Linda’s story is not unique. It’s the story of millions of Ohioans who get caught in the crossfire of these ruthless budget battles. These cuts aren’t abstract — they’re about real people losing their health, their dignity, their lives. When politicians talk about “balancing budgets,” remember Linda’s pain. When they brag about “reducing government waste,” remember the faces of the families now scrambling to survive. This is what happens when greed wins. When profits matter more than people.