Source: Tax Policy Center and Penn-Wharton Budget Model

The TCJA, like the current legislation, gave big tax breaks to the wealthiest Americans. But it also threw a few crumbs to people further down the scale. By contrast, the House Reconciliation Bill, by slashing benefits — especially Medicaid — will cause immense, almost inconceivable hardship to the bottom 40 percent of Americans, especially the poorest fifth.

Medicaid, in case anyone needs reminding, is the national health insurance program for low-income Americans who probably don’t have any other way to pay for medical care. In 2023 Medicaid covered 69 million Americans, far more than Medicare (which covers seniors), including 39 percent of children.

Providing health care to children, by the way, isn’t just about social justice and basic decency. It’s also good economics: Children who receive adequate care grow up to be more productive adults. Among other things they end up paying more taxes, so Medicaid for children almost surely pays for itself.

And although Republican legislation apparently won’t explicitly target childrens’ care, it will impose paperwork requirements that will cause both children and their parents to lose coverage.

Back to the comparison with the TCJA. It's true that 2017 would have looked considerably worse in this comparison if Trump had also succeeded in his attempt to destroy the Affordable Care Act, depriving millions of Americans of health insurance coverage. But he didn’t. This time the assault on health care and the tax cuts for the 0.1 percent are part of the same legislation — a “big, beautiful bill,” as Trump calls it. And after some adjustments to make the bill even nastier, it’s likely to pass.

Wait, it gets worse. One of the ways Republicans will try to slash Medicaid is by requiring that adult Medicaid recipients be gainfully employed — or, more accurately, that they demonstrate to the satisfaction of government bureaucrats that they are gainfully employed, which is not at all the same thing.

The belief that many Americans receiving government support are malingering, that they could and should be working but are choosing to be lazy, is a classic zombie idea. That is, like the claim that cutting taxes on the rich will unleash an economic miracle, it’s a doctrine that should be long dead. It has, after all, been proved wrong by experience again and again.

But right-wingers simply refuse to accept the reality that almost everyone on Medicaid is either a child, a senior, disabled or between jobs. A recent article in the Times by Matt Bruenig had a very illuminating chart:

Only 3 percent of Medicaid recipients were non-disabled working-age adults persistently not working — the kind of people right-wingers imagine infest the program. And it’s a good bet that a fair number of these people had extenuating circumstances of some kind.

So what do work requirements actually accomplish? They don’t get lazy people to work. What they do, instead, is take away benefits from people who are legally entitled to aid, because they can’t overcome the paperwork and administrative barriers. Think about it: Low-income adults, even when working, are often employed as day laborers or in other informal ways that don’t generate the right forms. They may lack the formal education to deal with complex reporting requirements. So the people who need help most are unjustly cut off.

Why, then, are Republicans doing this? Part of the answer is to save money: By making the poor even poorer they reduce the extent to which tax cuts for the rich explode the budget deficit.

But I’m actually skeptical that this is the whole story, or even most of it. If you pay attention to what right-wing Republicans do, as opposed to what they say, it becomes obvious that they don’t really care about budget deficits. Oh, they do a lot of posturing, issuing dire warnings about debt and pretending to be deficit hawks. But can you think of a single example in which the U.S. right has been willing to give up something it wants, such as tax cuts for the rich, in order to reduce the deficit?

As I see it, right-wingers’ rhetoric about the budget deficit is a lot like their rhetoric about antisemitism. It’s not something they actually care about. It’s just a club they can use to bash their opponents.

But in that case, why the cruelty toward less-fortunate Americans? Well, as I see it the cruelty, as opposed to the dollars saved, is actually the point. Inflicting harm on the vulnerable isn’t something they do with regret, it’s something they do with a sense of satisfaction.

OK, I’ll probably get a lot of grief for saying that — but maybe not as much grief as I would have gotten a few months ago. For does anyone doubt that the people now running America are bullies completely lacking in any kind of compassion?

And why do bullies beat up people who can’t defend themselves? Because they can.

MUSICAL CODA

Grim stuff, so here’s a palate cleanser