Democrats Lean On Messages About Medicaid Cuts

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Hey there, it's the NPR Politics Podcast.

I'm Sarah McCammon.

I cover politics.

I'm Barbara Sprint.

I cover Congress.

And I'm Don Gagne.

I too cover politics.

And today on the show, while Congress is in its August recess, lawmakers, especially Democratic lawmakers, have been talking about Medicaid.

That's because the tax and spending bill that Congress passed last month cuts the health care program, which many elderly, low-income, and disabled Americans rely on.

Don, you've spent some time at town halls in Michigan.

What are you hearing from the Democratic politicians at these events?

One of the reasons I'm particularly interested in the state of Michigan, beyond the fact that it's

a big swing state in elections, the Michigan Department of Health and Human Services estimates that as many as 700,000 people in the state could lose their Medicaid coverage because of this bill.

And of course, those town halls, lots of them, they've been in Marquette, they've been in the Lower Peninsula, in the Detroit suburbs in Monroe County.

And let me play a clip of tape from one of them.

This one, sponsored by the Michigan Democratic Party, drew a crowd to a local union hall to hear U.S.

Senator Mark Kelly from Arizona.

Here he basically describes the GOP as bowing down to Donald Trump.

A lot of them really talked a good game.

You probably saw that.

Right?

I mean, there were, you know, members who were like, well,

we can't cut funding to Medicaid.

This is a bad decision.

This came from Republicans.

But ultimately, you saw what happened.

You know, they

tend to fall in line.

These are Democratic town halls, right?

This one was at a union hall.

The audience, mostly Democrats.

They are certainly angry.

They are certainly frustrated.

And I do hear from them that they're just looking to be involved in some way at this point.

They don't want to sit home and do nothing and yell at their television or

their phone.

So I'm hearing from people that they expect to be engaged, they they expect to be active.

But again, we are still way over a year from the next federal election.

And Barbara, how does this messaging from Democrats about Medicaid compare with what you're hearing from Republicans?

Well, the messaging is also about parts of the one big beautiful bill, really touting elements that they think are going to be welcomed by their constituents.

Things like no taxes on tips or overtime, something President Trump, of course, campaigned on, investments in border security and ICE, very important, of course, to the GOP base.

And then the message of, hey, if we didn't pass this, you would have had to pay about $3,000 more a year.

And that's, of course, because this legislation makes those 2017 tax cuts permanent.

And they're also talking about Medicaid, you know, the very thing that Democrats are talking about, but for different reasons.

Republican lawmakers say there is support for things like work requirements for Medicaid.

You know, they frame this as something that will overhaul and ultimately strengthen the program.

Now, this is complicated a little bit by a latest report from the nonpartisan Congressional Budget Office.

It gives a little more fodder for Democrats on their own messaging, makes it a little bit harder for Republicans.

Their newest report predicts this new law will not only boot millions of low-income Americans off of Medicaid and federal food assistance, but that financial resources for the lowest 10% of households by income will fall by 3.1% because of cuts to programs like Medicaid.

And on the flip side, the richest Americans will see earnings rise by an average of 2.7% driven by tax cuts.

So that does complicate this a bit as these parties try to message.

Democrats seem eager to talk to their constituents about Medicaid.

They're holding these town halls.

What about Republicans in that regard?

It's a little different.

I mean, I will say I check every day to see if there are more GOP town halls listed.

There are some, there have been some, not as many as Democrats, certainly.

This isn't really surprising.

The NRCC, the National Republican Congressional Committee, has previously encouraged its members to avoid town halls, which they say can often be overtaken by Democratic activists and lead to viral moments

instead of sticking to smaller, you know, more targeted events with constituents.

Things like going to hospitals to talk about the impact of no taxes on overtime.

Same thing in restaurants with talking about no taxes on tips.

That being said, there there have been some GOP town halls.

Nebraska Congressman Mike Flood is one of the folks that has had one.

He faced lots of shouts and backlashed, and he did address Medicaid defending those work requirements.

If you are able to work and you are able-bodied, you have to work.

If you choose not to work, you do not get free health care.

You do not get free health care.

And I think we have to be a little cautious in drawing big conclusions from these individual town halls where we see lots of shouting, like we can hear in that tape.

You know, there's an understandable tendency, I think, to look at that and say, oh my gosh, look at the outrage, look at all the shouting at a Republican town hall.

That must mean the dynamic in this district is shifting, especially as everyone is trying to read the tea leaves for the midterms next year.

But we have to remember that there are a lot of activists and Democratic organizers who do show up to these town halls.

So it's not always the best representation of the mood in the district.

That's not to say that there aren't town halls where outrage from constituents of the same party as the member does bubble up.

I remember in 2017 when Republican lawmakers were pushing to repeal parts of the Affordable Care Act, and that was a very common occurrence.

So it does happen.

We just have to be cautious about overgeneralizing.

You know, question for both of you, Don and Barbara.

I mean, beyond the messaging, I wonder is the strategy, either for Republicans or Democrats, is it different depending on what state they're representing, what they think their constituents want?

Or are you seeing more of a unified message and strategy nationwide?

What you are seeing is a Democratic Party that thinks it has an issue it can seize.

And they are doing that, and they hope to shine as big of a spotlight on it as possible.

Yeah, I agree with Zon.

And I think, if anything, that instead of it being state to state where we'll see some differences, there could be, you know, tweaks from district to district.

I mean, particularly on the House side, you know, it's important for lawmakers to talk about their specific district and its particular needs.

There is not a ton of swing districts, but they are out there.

And people running in those districts will have to tailor their message to that particular community.

But as Don said, I think both parties think that they have messages that can win, as Don described with Medicaid.

And I think on the Republican side, the coalescing around a national message seems to be essentially, look, we saved you a lot of money by extending those tax credits from 2017, and we're fixing Medicaid by kicking people out of the program who shouldn't be in the program to begin with.

So it will be interesting as this continues to see how close to those two messages each party can remain.

All right.

We're going to take a quick break.

We'll have more in just a moment.

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And we're back.

Don, the whole point of these messages is to reach voters, right, for either party.

What do we know so far about how these messages are resonating with voters?

Well, there's outrage, right?

But nobody is actually feeling these cuts just yet.

But we do know the bill is not popular.

So people are certainly receptive when there's a chance to stand up and to vent.

A Michigan poll in the weeks ahead of the final debate showed that more than 80% of voters in the state oppose cuts to Medicaid.

I talked to Corwin Schmidt.

He's a political scientist at Michigan State University about how it's playing and about that poll.

And specifically, he talked about the GOP argument that the bill goes after waste and fraud in the system.

It resonates with voters to say there's waste and fraud.

It's waste and fraud, though.

When you find out that your hospital might be considered waste and fraud and you're like, that provides essential services, that's a much different story, suddenly.

And there is new polling that backs up what the professor is saying there.

There's a KFF poll on the bill conducted in July since its passage that says overall the bill's approval rating, this is among all voters, is underwater.

63% view it unfavorably.

36%

like it.

And that's in line with other polling that we've seen.

Even if this message is resonating right now, I mean, the midterm elections are more than a year away still.

Are Democrats likely to keep talking about Medicaid for another year, Barbara?

I would be surprised if they stopped talking about Medicaid.

I think it's, I mean, as Don described, you know, big bulks of these adjustments to Medicaid won't take effect, you know, for a while.

December 2026, as Don said, for eligibility redeterminations to start being conducted, which is going to be every six months, then the work requirements in January 2027 and less dates often earlier, I should say.

Those are dates far in the future.

The challenge is not, in my mind, not so much, are Democrats going to keep talking about it or not?

I think they will, but it's very hard to campaign on something that voters can't yet feel.

And we know that personal impact is such a driver.

And I think it will be sort of a delicate task of messaging this from Democrats in a way that's effective, emotionally resonant for people,

when a lot of this won't actually affect their lives and their communities for quite some time.

But Democrats clearly think Medicaid is a winning issue for them.

Fidelity to that message is going to be key.

It's not always a strength in the Democratic Party.

And of course, the midterms historically favor the party that's out of power.

And, you know, with such a narrow margin of control of the House, it will probably be decided by just a few seats.

That makes for a complicated path.

You know, and to your point, Barbara, I mean, this is an issue that won't really be felt directly for a while, but it's only one issue.

I mean, what else will you both be looking out for in terms of messaging from Democrats Democrats and Republicans over the next year as we get closer to those midterms?

Well, first, we'll be watching the Democrats message discipline, right?

How much they are able to keep this front and center.

They seem confident that they will be and that it is an issue that voters do care deeply about and that voters are essentially on their side on it now, if you look at the polling.

But there will be so many other issues that they won't be able to ignore.

And we've all covered enough elections to know that to try to predict what's going to be on the agenda in a year and three months is a dangerous game.

Not to mention that President Trump will be driving a lot of the messaging for Republicans over the next year.

And he likes to move from message to message sometimes in the same day, let alone weeks and months.

So to your point, Don, who knows where we'll be a year from now.

But I think it's safe to say that Medicaid will be a focus, but we're going to leave it there.

I'm Sarah McCammon.

I cover politics.

I'm Barbara Sprent.

I cover Congress.

And I'm Don Gagne, covering politics.

And thank you for listening to the NPR Politics Podcast.

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