Democrats are betting they can convince the public that Trump’s ‘Big, Beautiful Bill’ is a giveaway to the rich at the expense of the poor.
As Senate Republicans prepare to roll out their own iteration of the president’s “Big, Beautiful Bill,” White House officials are testing their message on the modest entitlement reforms Republican lawmakers crafted in this year’s House-passed version: The GOP is “protecting” and “strengthening” Medicaid, not slashing it.
Behind closed doors, President Donald Trump made clear to Republican lawmakers that major cuts to Medicaid are a nonstarter for him in this year’s budget reconciliation bill. That forced House Republican leaders to find modest reforms to the program that will cut spending without haunting their most vulnerable members in the next election cycle.
Republicans have spent recent weeks pitching two Medicaid-focused reforms they think will play well with voters in 2026: slashing federal funding to states that give Medicaid to illegal immigrants and adding work requirements for able-bodied adults without children. They believe that when these reforms – which will save hundreds of billions in spending — are commonsense and easily digestible to the millions of Americans who want to see their hard-earned taxpayer dollars going to the truly needy.
“This bill will preserve and protect the programs, the social safety net, but it will make it much more common sense,” Office of Management and Budget Director Russ Vought told CNN’s Dana Bash on Sunday. “Look, one out of every $5 or $6 in Medicaid is improper. We have illegal immigrants on the program. We have able-bodied working adults that don’t have a work requirement that they would have in TANF or even SNAP. And those are something that’s very important to institute. That’s what this bill does.”
“No one will lose coverage as a result of this bill,” he insisted.
The White House is betting this strategy will insulate it from the new attack line Democrats have rallied around: Republicans are gutting Medicaid to offset tax cuts for the ultra-rich, a potent message that could hurt the GOP in the midterms, especially among the working-class voters Trump has brought into the tent. The White House’s rapid response account on X is leaning into this argument as Democratic lawmakers ratchet up their Medicaid-focused attacks on the legislation. It posted a graphic on Tuesday alleging that “most able-bodied welfare recipients aren’t working.”
If enacted as written in the House-passed reconciliation bill, Medicaid work requirements would kickstart in December 2026 and include exemptions for pregnant women, elderly people, and the disabled. The new work requirements are modest: Americans who fall under this category must work 80 hours a month to qualify for benefits, and school and volunteer work count.
The House-passed bill would also prohibit Medicaid reimbursements for gender transition care for minors and adults, increase the frequency of eligibility checks for recipients, prohibit for ten years any Medicaid reimbursements for family-planning organizations like Planned Parenthood, and reduce federal Medicaid matching from 90 percent to 80 percent to any state that provides state-Medicaid funds to illegal immigrants.
One administration official characterized Democratic lawmakers’ talking points on Medicaid as a “redux” of the party’s fixation with the Trump administration’s decision to deport illegal immigrant Kilmar Abrego Garcia. In fixating on entitlements, this White House official told National Review, Democrats are “rallying around something because they feel like they have to rally around something.”
And yet Democrats are convinced that focusing on entitlements is a winning message. They’ve spent recent weeks screeching from the rooftops in opposition to these proposals, arguing that Republicans are going well beyond their stated aim of rooting out waste, fraud, and abuse in the program. The gobs of cash Democrats are already spending on Medicaid-focused ads and billboards suggests the party will lean heavily into this message during the 2026 midterm cycle.
Meantime, fiscal hawks in the Senate like Rand Paul (R., Ky.) and Ron Johnson (R., Wis.) argue that the legislation will balloon the deficit and doesn’t cut enough spending. According to new estimates from the nonpartisan Congressional Budget Office, the legislation will add $2.4 trillion to the deficit through 2034.
For weeks, administration officials have maintained that reporters shouldn’t trust the CBO analysis, arguing that the forecaster’s estimates have been wrong in years past about Democratic and Republican-authored legislation alike. Administration officials also say that tariff revenue and growth from the tax cuts aren’t factored into the CBO’s analysis, and that the rescissions package the White House sent over to Congress this week aims to codify many of the spending cuts Republican fiscal hawks are eager for that were identified by the Department of Government Efficiency (DOGE).
Further complicating matters: One of the biggest opponents of the legislation is now Elon Musk, the brains behind DOGE, who left the White House last month after his special government employee contract ended. “This massive, outrageous, pork-filled Congressional spending bill is a disgusting abomination,” Musk wrote on X on Tuesday, again blasting the House-passed legislation for ballooning the deficit if enacted. “Shame on those who voted for it: you know you did wrong.”
There are also a number of Republican senators who think the GOP is going too far on Medicaid reform. While Senate Republicans are broadly on board with new work requirements for Medicaid, some worry that other changes will hurt their constituents. That’s been the concern of populist Republicans like Josh Hawley (R., Mo.) and centrists like Susan Collins (R., Maine), who are particularly worried that provider-tax changes will lead to mass rural hospital closures in their states.
As Senate Republicans work out the kinks in the bill, expect administration officials to continue making the case for modest reforms to Medicaid that they believe will be popular in 2026. Case in point: The first paragraph of a recent New York Times op-ed authored by four Trump administration officials begins with a nod to the administration’s view that benefits should go to those for whom the program was initially created: the needy.
“America’s welfare programs were created with a noble purpose: to help those who needed them most — our seniors, individuals with disabilities, pregnant women and low-income families with children,” wrote Health and Human Services Secretary Robert F. Kennedy Jr., Centers for Medicare and Medicaid Services Administrator Mehmet Oz, Agriculture Secretary Brooke Rollins, and Housing and Urban Development Secretary Scott Turner in a joint op-ed last month.
“For many,” the authors continue, “welfare is no longer a lifeline to self-sufficiency but a lifelong trap of dependency.”