A bit OT, but what a gorgeous whale of a sentence! As always, the literary prowess of NTSB writers does not disappoint.
A bit OT, but what a gorgeous whale of a sentence! As always, the literary prowess of NTSB writers does not disappoint.
The goals are both obvious and specific; it’s a culture war being fought at the funding level.
[1] https://www.kff.org/tracking-the-medicaid-provisions-in-the-...
[2] https://www.nhs.uk/nhs-services/visiting-or-moving-to-englan...
For rural hospitals, the bill cuts $58 billion in Medicaid funding over 10 years but only provides a $25 billion rural fund that covers less than half the losses. This puts 300+ rural hospitals at immediate risk of closure since they're already operating on thin margins.
For elderly people, the bill blocks nursing home staffing rules until 2034 and freezes home equity limits at $1 million permanently, plus adds more verification requirements.
The evidence shows these aren't about efficiency. They're about creating barriers that cost more money to administer than they save, while cutting care for people who already qualify.
The requirements are designed to create barriers through bureaucracy. You have to report every month through a specific online portal, track your hours precisely, navigate exemption processes. Miss one monthly filing deadline and you lose healthcare. It's the most socially acceptable way to kick people off coverage without saying "we don't want poor people to have healthcare."
And it's not just work requirements. The bill also adds income verification twice a year instead of once, more asset checks, and cuts the actual funding. Each new hoop is another chance for eligible people to fall through the cracks. The goal is reducing enrollment through administrative friction, not promoting work.
It’s on those individuals to not “fall through the cracks” if they truly need our money to fund their healthcare — I don’t see the problem.
The new bill allows states to verify monthly instead of every three months, so people lose coverage faster. Even working people get tripped up because 43% of workers would fail to meet 80 hours in at least one month due to variable schedules common in low-wage jobs.[2] People with multiple jobs have to submit paystubs from each employer monthly. Seasonal workers and food service workers are especially vulnerable because their hours swing wildly due to factors beyond their control.
[1] https://ccf.georgetown.edu/2025/05/27/medicaid-and-chip-cuts...
[2] https://www.cbpp.org/research/health/medicaid-work-requireme...
Most Medicaid recipients already work. They're not choosing dependency, they're working jobs that don't pay enough to afford healthcare. Taking away their healthcare doesn't suddenly make employers pay more, it just leaves workers desperate, which is exactly what those employers want.
You're essentially arguing we should eliminate the safety net that keeps our low-wage economy functioning. That would either force employers to pay living wages (unlikely) or create mass suffering among workers (more likely). Which outcome are you hoping for? Because right now it sounds like you'd rather have sick, desperate workers than challenge the employers who created this system.
And most who don't can't. You included them earlier but they're worthy to keep in mind.
Also, this "verify monthly" sounds like fearmongering. All I see is "requires individuals who are enrolled meet requirements for 1 or more months between the most recent eligibility redeterminations (at least twice per year)." Also: "Requires states to conduct eligibility redeterminations at least every 6 months for Medicaid expansion adults."
The Medicaid expansion is not everyone on Medicaid, just a subset who before expansion were presumed not to be entitled to a government subsidy since they don't have any dependents or any disability and could just work.
I do think it's probably not the worst thing if people who have no dependents or disability are motivated to go get a full-time job because it's kind of a hassle to have to prove eligibility.
The DNC is now advocating that taxpayers not only must pay for all the healthcare of people who don't want to work at all, but we also need to make it a maximally convenient experience. The reason Democrats keep losing elections is that they can't read the room -- most people who work and are not upper-middle-class levels of comfort don't like the emphasis on maximizing the comfort and convenience of groups like the voluntarily unemployed and undocumented immigrants when it comes at the expense of working taxpayers who follow the rules. This is why the Big Beautiful Bill passed: It actually throws a bone to people who work via things like tax breaks on overtime pay and tips, and via restoring the SALT exemption. Between these 3 policies, you can see a benefit to people across the wealth spectrum who share one thing in common: people who work hard. I know the Dems are still doing fine in rich areas, but there are two problems which are intertwined:
1. There aren't enough of those rich Democrats who just want to open the tax money spigot, the ones who wouldn't mind paying an extra $30,000 in taxes next year to put their money where their mouth is.
2. Even when there are enough to win, the rest of the population still pays most of the actual tax dollars and they are increasingly resentful of what they see as rich Democrats helping themselves (via the government) to everybody's money to bestow as favors on people who don't seem to need it. I know your heart is in the right place, but the policies are not connecting with the people, as evidenced by the fact that the Democrats keep losing ground among the non-wealthy working demographic (which, in the Democrat narrative, ought to be their strongest base).
Note: I certainly don't agree with everything in the "OBBB," but there are some good ideas in there.