The method to Trump's Medicaid Cut Madness

Maine unions are speaking up for their members and their communities in the face of Trump’s attacks. Just this week postal workers organized multiple protests in Bangor and Portland, teachers rallied at Deering High School and Rowe Elementary for full funding of public education, federal workers spoke out against mass firings in Brewer, Social Security workers denounced layoffs that could paralyze the system, and nurses marched on Sen. Susan Collins office, calling on Mainers to defend Medicaid.

After two months of MAGA blitzkrieg, it’s encouraging to see Maine labor taking to the streets. We’ll need to raise our organizing efforts another order of magnitude to begin to limit the damage Trump and Musk are inflicting on public education, health care, federal workers, and workers in general. But this was the first week where it felt like there were two sides to this fight and marked a stark contrast with the pathetic spectacle of 3 out of 4 (Golden, King, and Collins) of Maine’s congressional delegation voting for Trump’s budget the week before.

As unions ramp up the fight, it’s worth thinking through what Trump hopes to achieve in the coming year and what drives him.

First, there’s his obvious thirst for revenge against enemies, real and imagined. It would be a mistake to underestimate his uniquely self-centered vision of politics. This means there is not always a larger objective at play. He might well strip Maine of tens of millions of public education money just because he’s enraged that Gov. Mills had the gall to stand up to him in public. Even if that were to ruin Laura Libby’s run for the Blaine House.

Second, Trump’s journey from apolitical playboy to MAGA fascist began when he realized his path to power passed through the right-wing evangelical church and white nationalist movements. Now that he has united and empowered these forces for his own gain, he must feed the monster. Trump’s campaign against immigrant workers will disrupt tourism, construction and agriculture in Maine and most likely lead to higher inflation, but he will reap political power from the fear it instills.

Third, what is Trump’s economic game plan? This is a big question, including tariffs, foreign investment, AI, and a lot more. But I will focus on just one part of it here: the federal budget and taxation. Trump wants to extend tax cuts for corporations and the richest 1 percent. Trump’s 2017 tax cuts reduced corporate taxes from 35 to 21 percent and cut individual income taxes on the wealthiest from 39.6 to 37 percent. Those cuts cost the government approximately $2 trillion in revenue between 2018 and 2025. Extending the cuts to 2034 will cost another $4 trillion in revenue. The 2017 tax cuts (and COVID spending) ballooned the deficit, and this cannot be done again without threatening the value of the dollar as the global reserve currency—the secret power to the American financial system. So, this time around, Trump has to slash the federal budget in order to pay for his tax cuts.

When the infamous gangster Sonnie Hutton was asked why he robbed banks, he replied, “Because that’s where the money is.” Where will Trump find $500 billion per year to hand over to his rich pals in the federal budget?

Not all parts of the budget are equally vulnerable, nor equally lucrative. Take Trump’s decree abolishing the Department of Education. Firing the few thousand federal education workers might save about $250 million. That’s not even a rounding error in the $6.9 trillion federal budget. In fact, if Trump succeeds in firing, let’s say, 20 percent of the roughly 3 million current federal employees, that would save approximately $60 billion per year. That sounds like a lot of money, but it’s just 8 percent of the Pentagon budget.

Eliminating the Department of Education, USAID—he can cross that off his list—and the FBI would free up about $100 billion. Eliminating bigger targets like the Departments of Transportation and Agriculture would cut around $300 billion from the budget, but there’s virtually no chance Trump will cut what are effectively huge subsidies to Big Ag and the auto industry. That leaves the big ticket items like paying the interest on the national debt ($892 billion), the Department of Defense ($872 billion… and rising), and veterans benefits and federal pensions ($500 billion). Trump either can’t, or won’t want to, strip significant funds from these pools.

[Read Next: Tax the rich, it’s a decent start]

What does that leave? Social Security accounts for 21 percent of the federal budget ($1.5 trillion) and Medicare is about 15 percent ($912 billion). Trump has promised—promised!—not to touch those popular programs, even if his billionaire Secretary of Commerce Howard Lutnik might well be more eager to pick seniors’ pockets. It would be foolish to pretend Trump won’t eventually try to cut these programs, but he’s most likely to look for an easier target.

Which brings us to Medicaid and the associated Children’s Health Insurance Program, which account for about 8 percent ($626 billion) of the federal budget. Medicaid disproportionately serves economically vulnerable portions of the working class, providing subsidized prenatal care, medications, nursing homes and elder care, and serving as a critical safety net for people with disabilities. At the same time, Medicaid reimbursements to hospitals and health care facilities deliver much needed resources to every county in the country. Without Medicaid, rural health care will suffer quickly and drastically. The closure of Northern Lights hospital in Waterville is a canary in a coal mine. Cutting Medicaid by 25 or 50 percent would devastate health care in Maine. Be that as it may, $626 billion must look awfully tempting to Trump.

At the rally to defend Medicaid organized by the Maine State Nurses Association last week, Julianna Hansen, an RN in the neurosurgical and trauma unit at Maine Med asked, “Our seniors, those with disabilities, and our young people are the ones who would most be hurt by cuts to MaineCare [Medicaid in Maine] and CubCare. How can Sen. Collins and our elected representatives even consider taking away this life-saving care?”

It’s a good question. Sonnie Hutton had an answer. Unfortunately, we know what Trump’s will be. If we want a different one from Sen. Collins—or whoever replaces her in 2026—we’ll have to build on what we did this week in the months and years to come.