We're coming down to the wire on Trumpolini's "Big Beautiful Ugly Bill", which besides cutting taxes for the rich will eviscerate Medicaid, which a huge number of low income people depend on to supplement Medicare, particularly in Alaska.  It remains to be seen whether Lisa Murkowski will vote against it, but even if she does it will take an additional 2 as yet unidentified Repugnants to vote no to crash the bill.

Yours truly of course is one of the folks depending on Medicaid. and I have no idea how it plays out for me if it passes.  No idea where the line will be drawn on who gets cut or whether the state will cough up money to fill in.  I do know if I get cut it will also cut many of the other residents of the Gulag with me, and how this place would stay open is a mystery.  Very exciting. lol.

https://alaskabeacon.com/2025/06/30/senate-moves-toward-final-vote-on-big-budget-bill-with-alaska-at-the-forefront/

US Senate moves toward final vote on big budget bill, with Alaska at the forefront

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Looks more and more likely Trumpolini's Big Ugly Bill will pass, which means now the question is how it will all end up playing out.  Obviously the 16M people about to lose their Medical Coverage will be none too happy, but since they're low income people with zero political power their complaints won't bother his Trumpness much.  More bothersome will be how the Bond Vigilantes react to the additional $3T in debt he'll have to sell to pay for making the rich richer?  Who wwill buy this toilet paper?  Perhaps with the Trump brand name plastered on the bonds the MAGAotts will buy them as collector's items?

Anyhow, the operative word of the week is UGLY.  It's gonna get ugly out there.

https://www.theguardian.com/us-news/2025/jul/03/trump-budget-bill

'It's harsh. I mean, brutal': Trump bill to cause most harm to America's poorest

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The most detailed and credible analysis of the projected mortality impact of the "One Big Beautiful Bill" comes from Yale University researchers, whose findings are cited across multiple sources in search results.

Annual Death Toll: 51,000 Americans

Have we ever seen that before?

HO Ho Ho Ho Chi Minh -- Ho Ho Ho Donald Trump

Tax cuts, spending hikes on defense and border security, and cuts to social safety nets in one 📦 giant package.

And America is without a political party that will work for those in need.


And that is why this is the Doomstead Diner.

5 points if you spot the mistake in the math.  No 10 points, because if you point the mistake out and solve this puzzle my point is only made stronger.

The Psychological Tactics Behind Republican Work Requirements in Social Programs

Republican lawmakers have long championed work requirements for social programs like Medicaid, SNAP (food stamps), and housing assistance. These policies are framed as promoting self-sufficiency and personal responsibility, but a deeper analysis show psychological and rhetorical strategies to advance broader political and economic goals. A deliberate use of psychological and rhetorical strategies intended to blow smoke up your ass.

Republicans consistently frame work requirements as a way to restore dignity and encourage self reliance echoing America's cultural emphasis on individualism.  Republicans define welfare as a handout that must be earned. 

Bill Clinton's Personal Responsibility and Work Opportunity Act imposed strict work requirements for welfare.  Bill shifted the Overton window and Republican Propaganda became Democratic Party Propaganda.  He significantly changed the way the Democratic Party was funded by modernizing its fundraising strategy and embracing large-scale, corporate-style donor operations that had previously been more associated with the Republican Party. I leave it to you to connect the dots.

Ending welfare as we know it played into narratives about lazy welfare queens, a racially charged stereotype popularized by Ronald Reagan involving several Cadillac cars, a fat woman, and lots of kids.  None of the stereotype was true. Most welfare recipients already worked, but the law led to deep cuts in assistance without significantly improving any employment outcome due to a paperwork trap that made benefits hard to get.

Republican lawmakers argue that Medicaid expansion under the ACA discourages work, despite studies showing 92% of Medicaid recipients who can work already do.  They simply can't afford private insurance.  They do not make enough money.  Framing the issue as moral rather than economic, Republicans bait and switch.  The switch avoids any talk of stagnant wages, lack of childcare, and the realities of gig work, which does not at the end of the day, pay.

Work requirements exploit deep-seated cognitive biases to make asshole policies seem reasonable.  It is done to make shit smell good.

If someone looses benefits, it's assumed they did something wrong.  The system is rigged so people loose benefits in a red tape paperwork trap.  Low wages, disabilities, no fucking jobs, are considerations that are not talked about.  With the onus of responsibility moved, it is assumed that everyone can easily comply with work requirements.

The Arkansas' Medicaid Work Requirement (2018) shows otherwise.  The state imposed a 20-hour a week work requirement for Medicaid. 18,000 people lost coverage for failing to report their hours.  People working could not jump through the hoops.  Sick people could not do the paperwork.

Republicans do not care.  They just say everybody dies.

Trump's new law strips coverage, jacks up costs, and risks 200,000 deaths

Various estimates have come dropping in for the potential death count resultant from the Big Ugly Bill, starting down around the ridiculously low figure of 50K.  How do you count up such a number?  Which deaths do you attribute to lack of access to care when hospitals close?  Which from peoplee who choose not to go to the doctor because they know they can't afford it?  Over what time period are you measuring this death toll?

Suffice it to say, the numbers are likely gross under estimates, but one thing is clear.  The death toll whatever it is will fall disproportionately on the poor.  The effects however won't stop there, since a huge number of middle class families of health care workers get paid by the medicaid budget.

Whatever it ends up being will take quite a while to play out.  Unpleasaantt time.

https://www.rollingstone.com/politics/political-commentary/trump-medicaid-big-beautiful-bill-americans-uninsured-1235379423/

Trump's Big Bill Will Make Americans Uninsured Again

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The OBBBA's Medicaid cuts are catastrophic in scale, with 11.8M–17M losing coverage, 1M+ jobs vanishing, and $100B+ in economic activity evaporating annually.

Rural areas and vulnerable populations (disabled, elderly, children) will bear the brunt.

First wave:  Administrative disruptions and provider strain (2025–2026)
Second wave: Mass coverage losses and job cuts (2026–2027)
Third wave:  Economic collapse in vulnerable states (2028–2034)