How Democrats use health care alarmism to cling to power



When the sky’s red at night, we’re in for mild weather. When Punxsutawney Phil sees his shadow, we’re in for six more weeks of winter. And when Democrats start losing, we’re in for a lot of fearmongering about health care.

Rep. Al Green’s (D-Texas) outburst during President Trump’s address to Congress last week was the latest example of Democratic health care alarmism. The Texas congressman waved his cane and shouted that Trump had “no mandate” to cut Medicaid before the sergeant-at-arms escorted him from the floor. The House later censured him for the disruption. Though Green is known for his dramatic antics, this was part of a well-established tradition.

Republicans’ budget resolution is a good step in that direction, but they’ll need to work on their messaging to hold onto their House majority long enough to make a real difference.

In 2017, Republicans controlled the House, Senate, and presidency, positioning them to fulfill their 2010 promise to repeal and replace Obamacare. The proposed American Health Care Act aimed to modify key aspects of the law while preserving others, but it ultimately failed in the Senate.

The Affordable Care Act, signed by President Obama, barred insurers from denying coverage to people with pre-existing conditions or charging them higher premiums. While intended to protect vulnerable patients, the policy led to higher premiums for everyone, including those already struggling to afford health care.

Republicans proposed a different solution: letting the states place people with pre-existing conditions into “high-risk pools,” allowing insurers to charge them high premiums, and providing government subsidies to offset those costs. The chronically ill could access the care they needed without driving up costs for everyone.

More doom, more gloom

This all sounds fairly tame and technocratic, but if you watched Democrats’ campaign ads leading up to the 2018 midterms, you’d get the impression that Donald Trump and then-House Speaker Paul Ryan (R-Ohio) had personally executed every cancer-ridden grandma in the country. About half of the party’s ads that cycle focused on health care, especially the issue of pre-existing conditions.

And it worked. Democrats picked up 41 seats, ending Trump’s trifecta.

In 2022, Democrats were polling badly in the lead-up to that year’s midterms. Joe Biden was unpopular, the Afghanistan withdrawal had become a national embarrassment, and inflation was out of control. Right on cue, health care hysteria commenced.

Sen. Rick Scott (R-Fla.) laid out an 11-point plan for that election cycle, which included a proposal that — in his words — “all federal legislation should sunset in five years” unless Congress repassed it. While this proposal probably wouldn’t have had much effect other than creating more work for Congress, Democrats saw their chance and pounced.

Then-Sen. Debbie Stabenow (D-Mich.) claimed Scott’s proposal would “end Medicare and Social Security and Medicaid.” The Democratic National Committee flooded the airwaves with the same alarmism.

That November, Democrats managed to hold down their losses in the House and even expanded their Senate majority. While it would be an overstatement to attribute their strong performance to health care alarmism alone, it certainly didn’t hurt.

History repeating?

Today, the Democrats find themselves in a similarly precarious situation. Republicans, once again, have a trifecta, and Trump is basking in the best approval ratings of his political career. Democrats have so far failed to marshal an effective resistance or even settle on a cohesive message — so they’re breaking out the old playbook.

Green’s theatrics about proposed Medicaid cuts attracted plenty of attention, but his fellow Democrats are starting to parrot the same talking points. Sen. Maggie Hassan (D-N.H.) recently warned that House Republicans’ plan “could take health care away from up to 25 million Americans.”

In reality, this is just more fearmongering. Advocates of socialized medicine like Wendell Potter, who quit his job as a Cigna executive to shill for single-payer health care, insist that expanding Medicaid is simply “the right thing to do.” Even though ironically, he also explained elsewhere how insurers turn Medicaid into their own personal piggy bank.

Sticking millions of more people on Medicaid — including illegal immigrants, if some Democrats have their way — hurts the very people it’s designed to help. Since Obama raised the eligibility threshold to 138% of the poverty line, the result has been overcrowding, provider shortages, and massive cost overruns.

It would be very convenient if lawmakers could fix American health care by throwing more money at it, but that’s simply not the case. Comprehensive reforms are needed to tackle systemic issues of waste, fraud, and inefficiency.

Republicans’ budget resolution is a good step in that direction, but they’ll need to work on their messaging to hold onto their House majority long enough to make a real difference. Otherwise, House Minority Leader Hakeem Jeffries (D-N.Y.) will ride a blue wave of health care alarmism straight to the speaker’s chair in 2026.

‘Waste, fraud, and abuse’ hype masks the real issue: Entitlement bloat



It’s the oldest trick in Republicans' playbook: They campaign on cutting spending and shrinking government, but when it comes time to pass actual legislation, they increase spending instead. To distract from that reality, they point to “waste, fraud, and abuse.”

Listen closely to all the hype about the DOGE — the Elon Musk-inspired, unofficial Department of Government Efficiency — and you’ll find nobody proposing to eliminate or structurally reform any major programs. Instead, leaders are giving Americans the impression that we can solve our inflation and debt crisis by trimming foreign aid, selling vacant buildings, and slashing overpayments in programs where waste and fraud are features, not bugs. This time must be different.

Cute messaging about egregious wasteful spending, which offends no corporate or individual constituency, will not solve the current crisis.

On the upside, an unprecedented conservative media campaign, led by Musk, has spotlighted wasteful spending and the need for cuts. On the downside, despite all the social media buzz, no one has presented a serious plan to reduce, eliminate, or restructure the key programs driving deficits and inflation. In fact, in December's budget bill, Musk and Donald Trump backed an additional $110 billion in deficit spending without using any so-called wasteful programs as offsets.

Recycling the idea of cutting “waste, fraud, and abuse” — “no, really this time!” — might have worked before the $7 trillion COVID-19 debt bomb. But it won’t dent the $1.2 trillion in annual money printing needed to service the debt’s interest. Telling Americans we can achieve fiscal solvency simply by cutting painless waste, reducing foreign aid, or making government more “efficient” sets us up for failure.

The only way to curb inflation is to level with Americans about the real source of the problem: consensus spending by both parties, not the “waste, fraud, and abuse” they keep blaming. Either we cut those programs or accept inflation — no middle ground. The silver lining is that inflation’s bite has created a mandate to make a trade-off: We can end dependency on certain programs if we muster the political will.

We don’t need an AI tool or a latter-day Manhattan Project to figure out how to balance the budget. We already know what must be done; the challenge lies in devising the right messaging and political will to enact it.

The federal budget isn’t a mystery. According to the Congressional Budget Office, fiscal year 2025 will bring another $2 trillion deficit, with $7 trillion in spending and $5 trillion in revenue — and that’s before factoring in any expansion of Donald Trump’s first-term tax cuts. The CBO projects $1.1 trillion in interest on the debt, but those figures have repeatedly been revised upward.

The 10-year outlook appears even bleaker, especially once we factor in the CBO’s unrealistic revenue projections, its consistent underestimates of spending, and its failure to account for major catastrophes — such as COVID-19, the Great Recession, or annual weather disasters — that always push deficits beyond expectations. For example, while the CBO estimates the $7 trillion budget will only rise to $10.3 trillion by the end of the 10-year window, our spending has already doubled over the past decade, largely because of COVID-19.

What, then, drives our $7 trillion budget for fiscal 2025? Let’s break down the major government expenditures.

The “untouchables” of our budget make up the overwhelming majority of the tab. Social Security, Medicare, military, and veterans’ programs (both discretionary and mandatory), plus interest on the debt, total more than $5.2 trillion of the $7 trillion budget. Several hundred billion dollars of Medicare is offset by user premiums, bringing the net “untouchable” spending closer to $5 trillion. Yes, one could shave off some Pentagon waste and address Social Security and Medicare overpayments, but tightening eligibility would spark a political backlash that Trump may not want.

No hidden stockpile of “waste, fraud, and abuse” exists to eliminate. The only way to lower the deficit is to target the remaining $2 trillion, which includes discretionary spending and nonuniversal entitlement programs such as Medicaid, food stamps, and housing.

Republicans will also need to devolve education, agriculture, transportation, and energy spending to the states. They must eliminate housing subsidies and mortgage giants like Freddie Mac and Fannie Mae. In other words, they must convince the American people that the choice is between dependency programs or permanent stagflation and unaffordability. Cute messaging about egregious wasteful spending, which offends no corporate or individual constituency, will not solve our current crisis. Honesty remains the only viable path forward.

Republicans should craft their reconciliation bill to fully repeal the Green New Deal and all climate regulations, reset discretionary spending to pre-COVID-19 levels, and enact welfare reform stronger than the 1996 measure. Some commentators falsely claim Social Security and Medicare are the only paths to reducing deficits, neglecting the many “other mandatory spending” programs that are not universal. Coupled with substantial health care reforms to lower consumer costs, this approach offers the only realistic way to address inflation.

Congress cannot focus solely on tax cuts this time. Yes, lawmakers should extend the 2017 tax cuts and add targeted cuts to spur small-business growth, but unlike in 2017, the primary emphasis should be on curbing government spending. A frank discussion about the true nature of these expenditures is essential to meet the mandate of lowering inflation at long last.

Restore self-government by handing debt power to states



Donald Trump last week shocked Congress by demanding that the debt limit either be abolished or at least suspended during his presidency — a stance typically championed by Democrats. While the plan, thankfully, has been shelved for now, there might be a way for conservatives to turn this political lemon into lemonade. What if Congress eliminated the debt limit in the much-anticipated budget reconciliation bill but did so in a way that tackled the debt itself rather than the ceiling?

Want to restore relevance to state legislatures and self-government while addressing the debt crisis? Consider putting the states in charge of managing the debt. The idea might not be as far-fetched as it sounds.

As part of the upcoming reconciliation bill, Congress could implement a rule requiring that the debt limit cannot be raised unless two-thirds of state legislatures approve.

We are no longer a self-governing people. Politics today reveals a troubling reality for both the right and the left: Our government no longer operates of, by, for, or in response to the people. The cause lies in the dismantling of the federalist system created by the Constitution. Instead of states representing the people in federal government, the entire arrangement has been turned upside down.

The states have become a joke, a bunch of shleppers doing the bidding of the federal government and groveling for its attention and money. Our founders envisioned the need for localism when America was a relatively homogenous group of just 3 million people. How much more so now with 340 million very diverse individuals and communities?

From a liberal and conservative perspective, restoring the balance of power the founders intended requires flipping the tables. Few solutions achieve this better than devolving debt authority to the states, an idea first proposed by the Goldwater Institute and recently promoted by Rep. Eric Burlison (R-Mo.) on my podcast.

Putting the states in the driver’s seat

Empowering the states through this transformational reform will strengthen self-governance. It will make state and local elections more relevant, align state governments with the priorities of their people, and hold the federal government more accountable.

States and local governments have lost influence because they collect only $3.5 trillion in revenue combined, while the federal government collects $5 trillion in one central pot. The federal government then returns about $1.1 trillion to the states, burdened with conditions and distortions that leave state officials unable to control their own destinies.

The federal government collects most of its revenue from the wealthy, leaving half the country indifferent to reining in federal overreach. Meanwhile, the truly wealthy accept their burden, content to pay what amounts to a bribe for maintaining their status. At this point, we might as well hand our money to the King of England. These funds bear no connection to self-governance or the character of our communities and epitomize the “taxation without representation” that sparked the war for independence.

In recent years, much of this revenue hasn’t even come from taxes but from money printing to service the interest on the debt through treasury auctions. This practice has burdened Americans with an even worse tax — long-term, intractable inflation. What if we shifted control of the printing presses to the states, placing them firmly in the driver’s seat?

Empowering grassroots conservatives

As part of the upcoming reconciliation bill, Congress could implement a self-imposed rule requiring that the debt limit cannot be raised unless two-thirds of state legislatures approve. Even a 26-state threshold would demand agreement from several Republican-controlled chambers for every Democratic-controlled chamber to raise the limit. This approach wouldn’t delegate Congress’ appropriations authority to the states but would instead impose a self-restraint, limiting federal spending without state approval to raise the cap.

Currently, Democrats fully control both legislative chambers in only 18 states. Even a simple majority-rule requirement would still need approval from eight GOP-controlled states or chambers to lift the debt ceiling. Shifting this power to state legislatures would bring the debate over the federal government’s scope to a local level, empowering conservative grassroots movements to wield a veto over excessive spending. It would also make state legislators key players in Congress’ most critical decisions, in effect serving as a backdoor repeal of the 17th Amendment.

Over time, this plan would compel states to take control of their own futures and permanently reduce the size of the federal government. Once states take the lead on managing the debt, the conservative vision of states fully overseeing health care, transportation, education, and agriculture could become a reality.

Civil society established the states, and the states established the federal government. Many of today’s public policy problems arise from flipping this governance on its head. Granting states authority over the debt limit could address not only the federal spending crisis but also fix the broader dysfunction of the federal government in a single, systemic move. Now, we need elected officials with the courage to champion this or other bold ideas to promote localism. It’s not too late to include this reform in next year’s most important bill.

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