For
journalists covering domestic policy, this past week poses some hard
choices. Should we focus on the Trump budget’s fraudulence — not only
does it invoke $2 trillion in phony savings, it counts them twice — or
on its cruelty? Or should we talk instead about the Congressional Budget
Office assessment of Trumpcare, which would be devastating for older,
poorer and sicker Americans?
There
is, however, a unifying theme to all these developments. And that theme
is contempt — Donald Trump’s contempt for the voters who put him in
office.
You may recall Trump’s remark
during the campaign that “I could stand in the middle of Fifth Avenue
and shoot somebody and I wouldn’t lose any voters.” Well, he hasn’t done
that, at least so far. He is, however, betting that he can break every
promise he made to the working-class voters who put him over the top,
and still keep their support. Can he win that bet?
When
it comes to phony budget math — remember his claims that he would pay
off the national debt? — he probably can. We’re not talking about
anything subtle here; we’re talking about a budget that promises to “abolish the death tax,” then counts $330 billion in estate tax receipts in its rosy forecast. But even I don’t expect to see this kind of fraud get much political traction.
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The
bigger question is whether someone who ran as a populist, who promised
not to cut Social Security or Medicaid, who assured voters that everyone
would have health insurance, can keep his working-class support while
pursuing an agenda so anti-populist it takes your breath away.
To make this concrete, let’s talk about West Virginia, which went Trump by more than 40 percentage points, topped only by Wyoming. What did West Virginians think they were voting for?
They are, after all, residents of a poor state that benefits immensely from federal programs: 29 percent of the population is on Medicaid, almost 19 percent on food stamps.
The expansion of Medicaid under Obamacare is the main reason the
percentage of West Virginians without health insurance has halved since
2013.
Beyond that, more than 4 percent of the population,
the highest share in the nation, receives Social Security disability
payments, partly because of the legacy of unhealthy working conditions,
partly because a high fraction of the population consists of people who
suffer from chronic diseases, like diabetics — whom Mick Mulvaney, Trump’s budget director, thinks we shouldn’t take care of because it’s their own fault for eating poorly.
And just to be clear, we’re talking about white people here: At 93 percent white, West Virginia is one of the most minority- and immigrant-free states in America.
So
what did the state’s residents think they were voting for? Partly,
presumably, they supported Trump because he promised — falsely, of
course — that he could bring back the well-paying coal-mining jobs of
yore.
But
they also believed that he was a different kind of Republican. Maybe he
would take benefits away from Those People, but he would protect the
programs white working-class voters, in West Virginia and elsewhere,
depend on.
What they got instead was the mother of all sucker punches.
Trumpcare, the budget office tells us,
would cause 23 million people to lose health insurance, largely through
cuts to Medicaid — remember, the program that benefits almost a third
of West Virginians. It would also lead to soaring premiums — we’re
talking increases on the order of 800 percent — for older Americans
whose incomes are low but not low enough to qualify for Medicaid. That
describes a lot of Trump voters. Then we need to add in the Trump
budget, which calls for further drastic cuts in Medicaid, plus large
cuts in food stamps and in disability payments.
What
would happen to West Virginia if all these Trump policies went into
effect? Basically, it would be apocalyptic: Hundreds of thousands would
lose health insurance; medical debt and untreated conditions would
surge; and there would be an explosion in extreme poverty, including a
lot of outright hunger.
Oh,
and it’s not just about crucial benefits, it’s also about jobs. Coal
isn’t coming back; these days, West Virginia’s biggest source of
employment is health care and social assistance. How many of those jobs would survive savage cuts in Medicaid and disability benefits?
Now, to be fair, the Trump budget would protect West Virginians from the ravages of the estate tax, which affects around 20 — that’s right, 20 — of the state’s residents each year.
So
many of the people who voted for Donald Trump were the victims of an
epic scam by a man who has built his life around scamming. In the case
of West Virginians, this scam could end up pretty much destroying their
state.
Will
they ever realize this, and admit it to themselves? More important,
will they be prepared to punish him the only way they can — by voting
for Democrats?
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