From dismantling the Affordable Care Act to supporting Republican lawmakers’ attacks on Medicare and Medicaid, President Donald Trump has made it much more difficult for people to receive health care during his second term. Now a new report reveals how millions of Americans will literally die because of these policies — that is, once their votes for Trump are in the bag.
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“When the Republican Congress enacted Trump’s One Big Beautiful Bill in July 2025, it included massive cuts in the Medicaid program, totaling around $1 trillion over 10 years—but made sure to postpone them until 2027, conveniently after the midterm elections,” wrote The New Republic’s Norman J. Ornstein on Sunday. “The cuts focused on adding onerous work and paperwork requirements, all designed to force recipients off the rolls, and will remove somewhere between 10 and 15 million people from the program, leaving them without any health coverage. That is in addition to the millions losing coverage or facing huge premium increases with the erasure of subsidies for the Affordable Care Act.”
Ornstein added, “But the impact will go far beyond those directly losing their health insurance. Medicaid money does not go to Medicaid recipients. It goes to the providers. The loss of a major chunk of the money going out to them will have big reverberations.”
After detailing how the cuts will harm hospitals and nursing homes in essential ways, Ornstein characterized the consequences as devastating to American patients. For example, when it comes to the hospital cuts, ERs will be overtaxed while hundreds of necessary workers will be thrown into unemployment. Patients will find it more difficult to receive care, even as health workers struggle to make ends meet.
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“As for the nursing homes, some will close; others will cut staff and staff pay,” Ornstein wrote. “The ratio of residents to staff will decline, meaning residents unable to secure help when they need it for such vital tasks as getting medications when they require them, getting help going to the bathroom, getting help in bed to prevent bedsores or worse, having responsive care during a health trauma or emergency. More unqualified staff could mean more abuse of the residents.”
He concluded, “There will be more effects seen throughout the country, for everyone who is a part of our intertwined health care system, from those working in it to those using it. No wonder Republicans made sure none of the Medicaid cuts would happen before voters experienced the impact.”
Referring to America as a “kakistocracy,” or government run by the least competent and most corrupt, Ornstein opined that “it turns out that kakistocracy is not just a funny word, but a reality with horrific consequences.”
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