Talking Points

Background Explainer on the Issues 

Process Background (only if asked)

THERE’S TOO MUCH WASTE AND FRAUD

Cuts Won’t Address Waste or Fraud

As I’ve been doing this work, I was actually surprised to learn how little fraud there is in the Medicaid system. In 2024, there were no cases of fraud prosecuted against beneficiaries of Medicaid. The handful of fraud cases prosecuted have been by service providers, equipment providers and health insurers. Cutting $625 billion from Medicaid does nothing to address waste, fraud, and abuse. Instead, it terminates healthcare for millions of seniors in nursing homes, veterans, children, and people with disabilities. Instead of investing in government oversight and prosecutors who will actually stop corporate abuse, some in Congress want to take away healthcare and use the money to pay for new tax breaks for billionaires and wealthy corporations. 

WORK REQUIREMENTS

People Need to Be Healthy In Order to Work

I was surprised to learn that roughly 92% of people on Medicaid are working or can’t work. When they tried it in Arkansas in 2018, more than 18,000 people lost access to Medicaid because of the complicated reporting requirements but employment numbers still didn’t go up. People just lost their healthcare but still weren’t able to work. I worry that the work requirement will make it harder for people to get and stay healthy enough to work. It doesn’t seem fair to punish people fighting cancer and other serious chronic diseases, gig workers and freelancers, caregivers, and people who get laid off—by terminating their healthcare—will only make them sicker and less able to work. 

SCARCITY / WE CAN'T AFFORD IT / MY TAXES

One thing that I was surprised to learn is that this bill would give the richest 1% income earners (with annual incomes over $914,000) an average tax cut of over $80,000 in 2026. Things definitely feel really uncertain right now, but if Congress would focus on making our tax system more fair by taxing billionaires and wealthy corporations rather than giving them tax breaks, we would have money to cover important programs like Medicaid without raising taxes on low-income and middle class people like us. 

INDIVIDUAL RESPONSIBILITY / IT’S NOT THE GOVERNMENT’S RESPONSIBILITY

Programs like Medicaid exist as a safety net for all of us. Whether we have insurance or make a good wage or not, most of us are one medical emergency away from crushing medical debt. Iowa Health Link is there for any of us if we get in a tough spot. This push to cut Medicaid is too much, too fast, without thinking about what it would mean for all of us. We can’t afford these rushed cuts.

PEOPLE ON MEDICAID ARE LAZY AND DON’T DESERVE HEALTHCARE

Medicaid primarily funds healthcare for children, the elderly, people with disabilities and the working poor. People rely on it when they lose their jobs or get sick and can’t work. The bill will take away Medicaid for more than 10.3 million people and make Affordable Care Act marketplace plans more expensive. When people are uninsured, they go to the emergency room and often produce higher costs in the health care system, driving up ER wait times and causing the rest of us to pay more. 

I STILL DON’T BELIEVE YOU THAT THEY’RE GOING TO CUT MEDICAID. THAT’S A LIE. 

I get that. It's hard to know what is true of false these days. I'm making calls  just to be on the safe side because I cannot afford to be kick off of Medicaid. How would you be impacted if the cuts changes took effect?

Facts You Can Use to Support if They Are Open to Considering it’s not a lie:

• The House Energy and Commerce Committee just released bill text on Monday of this week and voted it out of committee. 

• The nonpartisan Congressional Budget Office estimates that the bill provisions will cut Medicaid by about $625 billion and that around 10.3 million people will lose access to Medicaid.

HOW DOES THIS BILL AFFECT MEDICARE?

The bill does not cut Medicare itself but it creates administrative barriers for low-income seniors and disabled people who are on Medicare to also enroll in Medicaid.  For low-income people, Medicaid can cover premiums and other cost-sharing for Medicare recipients, making it possible for people to afford coverage when otherwise they couldn’t.

House Republicans plan to pass a ten year budget called budget reconciliation that would slash spending on critical health, housing, food assistance, education and climate programs so they can cut taxes for billionaires and corporations and pay for their mass deportations. 

On February 25th, the House of Representatives passed a budget resolution that includes topline numbers and instructions to Congressional committees to make:

•  $4.5 trillion in tax cuts to the rich & corporations and $2 trillion in cuts to spending

•  $880 BILLION in cuts to Medicaid which could cause 36 million people to lose Medicaid

•  $250 BILLION in cuts to food assistance (SNAP) 

•  Funds mass deportations

This is the first step in the process to pass the budget reconciliation. If they pass this budget plan,  the bill would give an estimated $280,000 PER YEAR to the richest 1%. 

We expect some of the bigger cuts to housing and climate funding will come through the annual appropriations process ( a different bill) in order to offset the cost of the tax breaks for billionaires and corporations.

The next step in the process is for committees to write and vote on the pieces of the legislation in committee. Then the House of Representatives will vote on a detailed budget called a budget reconciliation. This will be very close and it can be defeated if we convince two more (Republican) Members of Congress to vote NO.

The Senate has also not agreed to the House's plan so there are important Senate targets as well. House and Senate leadership are negotiating topline numbers. 

The Budget Processes: There are two separate & parallel funding processes happening. The 10 year budget reconciliation and the one year appropriations bill(s).

Budget Reconciliation: The tax and budget bill we are talking about is a ten year budget bill called budget reconciliation. It only needs 51 votes (or 50 plus the Vice President to cast the tie-breaking vote) to pass. This means it can pass with only Democrats and no Republicans voting for it. It has two phases. 

Phase 1. Pass a budget resolution with top line spending and cutting goals. This happened in the House on 2/25 but it still needs to pass in the Senate for Senate committees to begin work. 

Phase 2. Congressional committees get specific about where exactly the cuts should come from and write a budget reconciliation that will have to get voted on in both Houses and signed by the president. The House Ways and Means is beginning to write the bill the week of March 10th.  

Appropriations: The annual spending bills, which are very detailed, are called appropriations bills. Some of the cuts to programs, particularly climate and housing funding will happen later in the year in the appropriations bill. They are still being cut to offset tax cuts for billionaires and corporations. Don’t let offices tell you otherwise. They just can’t be included in the tax and budget package according to Congressional rules.  

Continuing Resolution (CR): The week of March 14th Congress passed a controversial Continuing resolution funding the government through September 30th. 10 Senate Democrats for Republicans bill. We’ll return to this issue closer to the September deadline. 

The appropriations bills, including the CR, require a 60 vote threshold to pass the Senate (so at least 7 Democratic Senators). Additionally, there are far-right members of the House Republican caucus who never vote for appropriations bills. It is likely that Speaker Johnson will need at least some Democrats to vote to keep the government open. 

Talking Points on Specific Issues

SNAP/Food assistance 

More than 1 in 8 households say they have difficulty getting enough food, yet they propose to cut a MINIMUM of $250 billion: 40 million people could lose SNAP

Trickle Down Economy Doesn’t Trickle Down 

When billionaires and corporations get more tax breaks, they just hoard it. When Trump passed his Tax code in 2017, they promised that workers at corporations would get raises. 90% of workers got no raise. Only the top 10% of paid employees got raises. 

When working and middle class people get more money in their pockets, they spend more by going out to activities, which actually helps stimulate the economy.  

Medicaid: 

• Medicaid is a lifeline for coverage and a foundational source of economic and health security for 80 million Americans, and a key funding pillar for the doctors and hospitals on which we all rely. 

• Medicaid is the largest source of federal funding to states, directly ensuring states do not need to deplete resources for other essential services. Medicaid is also a critical funding source for many hospitals and especially helps rural hospitals keep their doors open. Since 2010, 74% of rural hospital closures have been in states that did not expand Medicaid coverage to all low-income adults. Medicaid improves access to care and reduces burdens on the health system. Compared to those without insurance, people with Medicaid are more likely to use preventive care (checkups and screenings), be connected to a primary care provider, and receive regular care for chronic conditions. According to analyses of the House budget resolution, up to 36 million individuals might lose Medicaid coverage

• Many rural hospitals have closed maternity wards and other vital services or even closed entirely. Hospitals rely heavily on Medicaid and Medicare. If Congress cuts health care spending, many more rural hospitals could close. This will affect everyone including people with other insurance. 

Housing 

• Our country is experiencing the worst housing emergency since at least the great depression. From big cities to small towns, and even rural communities, families are struggling to pay their rent or mortgage, and far too many are living on the brink of eviction. Millions of Americans are homeless, living on the brink of homelessness, or unable to provide basic necessities to cover their housing costs. People feel abandoned by government and hopeless for any change. Local governments do not have the financial resources to fix this crisis.

• For decades, the federal government has cut taxes for corporations and the people who own them, while decreasing funding for affordable housing, public housing and homelessness for our states and local communities. More recently, corporations and venture capitalists have commodified housing, causing our high rent and affordability crisis. From small towns to big cities, they are buying up family homes and apartment buildings, driving up the cost of rent and the cost of owning a home. This created conditions in which greed and rent inflation has turned a decades-long housing crisis into an outright humanitarian and political emergency.  

• We need Congress to raise taxes on corporations and billionaires and make big investments in affordable housing. 

Questions re deficit/spending 

Trump tax cuts cost about $2 trillion in lost revenue. By contrast, free community college would only costs $10 billion over 10 years 

The richest country in the world can afford to pay for the things our people need so long as we tax the rich and corporations. The 2017 tax cuts actually raised the deficit and if they pass this tax & budget bill it will increase it even more. If we tax the rich, the government can afford to pay for everything we need. 

Questions re cutting taxes for working class people

They are looking to extend Trump’s 2017 Tax code. Working class people got a few hundred dollars while millionaires got 70K in tax breaks. We support tax cuts for working class people but not at the expense of these massive cuts for billionaires. 

If they give you $100 more in tax cuts but then your health care costs go up by $300 a year that’s not helpful. 

Richest 400 billionaires now pay less than most Americans

We support increasing the child tax credit and the earned income tax credit. 

Government Spending & Waste (the other side’s argument)

• He's not cutting bureaucracy--he's cutting our jobs, families, schools, and communities.
  → A dad in Iowa just lost his dream job as an educator in our National Parks, leaving him scrambling to make ends meet.
  → A healthcare worker in the Veteran Affairs division out of Michigan lost her job after 28-years - four years away from retirement.
  → A disabled army veteran with four children, who was four weeks away from completing his probationary period at the Bronx Veterans Affairs hospital.
  
  

• Billionaires like Elon Musk are reaping the rewards of the Trump job cuts.
  → Trump is cutting essential jobs—teachers, nurses, park rangers—so billionaires like Elon Musk can rake in more taxpayer dollars.

General Talking Points about what Trump is doing

As Inflation Spikes, Trump Policies Raise Costs More While Cutting Billionaires’ Taxes

• Donald Trump promised on the campaign trail to eliminate inflation on Day 1.

• However, new reports on Wednesday show that inflation is up more than expected during Trump’s first month in office.

• Trump’s policies are making things worse and bringing costs up:

• Tariffs Increase Costs: He’s imposing tariffs on our allies and closest trading partners—which will increase prices on middle-class families buying groceries, cars, and gasoline. 

• Deportation of Farm Workers Will Leave Produce Rotting: He plans to aggressively deport America’s hardworking farm workers and separate them from their families, which is not only cruel—but will continue to raise the price of groceries as produce rots in the fields.

• Undermining CDC As Bird Flu Grows: Egg prices are up nearly 53 percent over the last year. They will likely worsen amid an outbreak of avian flu, which has led to an egg shortage as farmers cull their flocks to prevent the disease from spreading. But instead of tackling the crisis, Trump and Musk are attacking the Centers for Disease Control and Prevention and removing access to public health data.

• Trump is only focused on bringing costs down for billionaires and corporations by forcing through massive tax cuts paid for by cuts to Medicaid and public schools. He and his cronies don’t even talk about bringing down prices anymore.

• Trump’s chaos is costing us jobs—hundreds of thousands of them.
  → Teachers, factory workers, and clean energy employees are being laid off right now, not because of the economy, but because Trump is making a choice to gut jobs and freeze funding.
  → It is affecting more than just our nation’s capitol. 80% of the workforce being laid-off lives outside the Washington area, including military personnel, park rangers, and postal workers.
  
  

• He's not cutting bureaucracy--he's cutting our jobs, families, schools, and communities.
  → A dad in Iowa just lost his dream job as an educator in our National Parks, leaving him scrambling to make ends meet.
  → A healthcare worker in the Veteran Affairs division out of Michigan lost her job after 28-years - four years away from retirement.
  → A disabled army veteran with four children, who was four weeks away from completing his probationary period at the Bronx Veterans Affairs hospital.
  
  

• Billionaires like Elon Musk are reaping the rewards of the Trump job cuts.
  → Trump is cutting essential jobs—teachers, nurses, park rangers—so billionaires like Elon Musk can rake in more taxpayer dollars.

• Prices keep rising, and now Trump is taking away paychecks too.
  → While billionaires are raking in taxpayer dollars, families are facing historic prices for basic necessities, like eggs, milk, and gasoline, and struggling just to get by. 

→ These firings will ensure that fewer Americans have reliable paychecks to cover the cost of Trump inflation.