Thanks to the Nazis, we have the idea of the Big Lie: That is, a lie so audaciously big that nobody could believe anyone would tell such a bold-faced lie and would, therefore, ordinary people assume that the statement must be true. That’s certainly been the case with the Democrats’ attack on the Medicaid part of the One Big Beautiful Bill (“OBBB”). It will, they say, cut spending so drastically that tens of millions will lose insurance and tens of thousands will die annually.
The only problem is that this is a Big Lie. The editorial board at Issues & Insights has actually looked at the numbers behind the hysteria and learned something interesting: All that the OBBB really does is return Medicaid spending to the precise trajectory it was on before Biden went on a spending binge. If people weren’t dying by the tens of thousands before Biden, they’re not going to be dying in such numbers now. Likewise, tens of millions will remain insured if they were insured before.
Image by AI.
Here are a few of the Big Lie claims that Democrats have made about the Medicaid portions of the OBBB:
The University of Pennsylvania, which was once (believe it or not) a reputable institution, published an analysis claiming that 51,000 people a year could die because of OBBB changes to Medicaid. The Annals of Internal Medicine was more staid, predicting only a precise 16,642 people per year dying unnecessarily because of the OBBB’s changes.
And it’s not just deaths. The CBO imagines 10-17 million people losing health insurance by 2023, while other Democrats are touting numbers up to 20 million.
You can sum it all up by looking at what Sen. Elizabeth Warren (D - Loopy Land) breathlessly opined in 2017, the last time Republicans tried to rein in Medicaid spending: “People will die.”
Most recently, to drive down support for Trump in rural areas (which have strongly supported him), Democrats are putting up big billboards saying things such as “Under Trump’s watch, Columbus [Indiana] Regional Health is cutting medical services.” Savvy drivers will catch that the message comes from the DNC, but many may miss it. NPR, AP, and NBC News are also warning any rural audience they still might have that Trump’s OBBB will kill them all.
The only problem is that none of these claims are true. Using data from the CBO and the Kaiser Family Foundation, Issues & Insights reports, “They are all based on one big, fat lie. There are no cuts to Medicaid.” (Emphasis in original.) They even produced a nice, clear chart showing what’s going on.
It turns out that, going back at least as far as 2010, Medicaid spending was on a very steady upward trajectory. Unaffordable, yes, but still steady. However, in 2021, Biden “massively expanded the program.” Not only did he spend more in the moment, “but Biden set Medicaid on a permanently higher spending track.” What the OBBB does is return Medicaid spending to its original configuration before the Biden anomaly.
Go check out the Issues & Insights post (here’s the link again), and study that chart very, very carefully. Then, follow the instructions in the last paragraph of that post: “So, the next time you hear anyone talk about Medicaid ‘cuts,’ hand out this chart.” After all, the only way to fight a big lie is to shout out the truth.