#1705 Threatened Social Safety Nets Are Foundational to Healthy Societies - podcast episode cover

#1705 Threatened Social Safety Nets Are Foundational to Healthy Societies

Apr 22, 20253 hr 6 minEp. 1705
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Episode description

Air Date 4/22/2025

George W. Bush proposed privatizing Social Security and didn't succeed. But, as with appointing Justices that would eventually overturn Roe V. Wade, groundwork was being laid as part of a multi-decade effort that would, they hoped, pay off in the future. So don't be surprised when they come for your earned benefits programs just as they came for the fundamental right to bodily autonomy.

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KEY POINTS

KP 1: What few people know about the program that saved America - Meg Jacobs - TED-Ed - Air Date 6-17-21

KP 2: Trump is coming for Social Security. And he has a new 'Big Lie' to justify it. - All In with Chris Hayes - Air Date 5-5-25

KP 3: What DOGE could mean for Medicare and Medicaid? - Consider This - Air Date 2-10-25

KP 4: Food banks feel the pain from higher prices and cuts to government programs - PBS NewsHour - Air Date 4-10-25

KP 5: Important HHS services _will grind to a halt_ with cuts, former Secretary Sebelius says - PBS NewsHour - Air Date 4-2-25

KP 6: Trumps Butchering Social Security to Feed His Starving Billionaires w/ Alex Lawson - The Hartmann Report - Air Date 3-12-25

KP 7: 'The federal workforce feels tormented': Federal employees on the consequences of losing their jobs Part 1 - On Point - Air Date 4-1-25

KP 8: INTERVIEW: Tim Faust on Defending Medicaid - The Worst of All Possible Worlds Part 1 - Air Date 3-31-25

(00:51:58) NOTE FROM THE EDITOR

On the false moral arguments for cutting social safety nets

DEEPER DIVES

(01:02:18) SECTION A: SOCIAL SECURITY

(01:51:24) SECTION B: GENERAL CUTS

(02:34:52) SECTION C: MEDICAID & HHS

SHOW IMAGE

Description: Photo of a homemade protest sign that says “Hands Off My Social Security” from the Hands Off nationwide rallies.

Credit: Private permission photo

 

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Transcript

Welcome to this episode of the award-winning Best of the Left podcast. We knew for decades before the overturning of Roe versus Wade that Republicans wanted to repeal abortion rights. But I recall an argument I heard many years ago from someone ostensibly on the left about how wrong the left was to worry about it, because after all, George W. Bush had been in office for eight years and he didn't stop abortions.

Now, I knew that that was a profoundly uninformed point at the time, but it was also evidence that some people just don't understand the time horizons over which these kinds of plans to dismantle cherish rights and government programs play out. George W. Bush also proposed privatizing Social Security and didn't succeed there either. But in both cases, groundwork was being laid as part of a multi-decade effort that would -- they hoped -- pay off in the future.

So don't be surprised when they come for your earned benefit programs, just as they came for the fundamental right to bodily autonomy. For those looking for a quick overview, the sources providing our Top Takes in about 50 minutes today includes TED Ed, All In with Chris Hayes, Consider This, The PBS NewsHour, The Hartmann Report, On Point, and The Worst Of All Possible Worlds. Then in the additional Deeper Dives half of the show, there will be more

in three sections

Section A, Social Security; followed by Section B, General cuts; and Section C, Medicaid and Health and Human Services. But first, we're still in major promotion mode as we've launched our new weekly YouTube show, SOLVED! We really need every hand on deck we can get, so subscribe to the Best of the Left YouTube channel, watch, like, comment, all of those things. The response so far has been, I think entirely positive, a hundred percent positive.

Which is fair because it's mostly people who already liked us who are watching and commenting. But we have also started to hear from some people who have found us newly through YouTube. So we are gratified to hear all of that because we are really proud of the show we are making and definitely want as many people as possible to see it. So you going and checking it out and liking and commenting and doing all those things helps other people find it.

So we absolutely appreciate any help you can give. And now, on to the show. In 1932, the Great Depression entered its third winter. One in four Americans was unemployed, marking the highest unemployment rate in the country's history. Tens of thousands had lost their homes and life savings, and there was very little confidence that Republican president Herbert Hoover could turn things around. So when the election came, voters flocked to his Democratic competitor.

Franklin D. Roosevelt promised a New Deal for Americans, a comprehensive set of legislation to support struggling citizens and put the country back to work. The massive federal intervention Roosevelt proposed was a radical challenge to the individualist ideals that governed many Americans' lives. But due to the extreme circumstances, he began his presidency with public and political support.

With the help of his advisors, Roosevelt's first a hundred days in office were perhaps the most eventful of any US President. In just over three months, he pushed over 15 bills through Congress and created an alphabet soup of government agencies to help farmers, workers, and businesses. The New Deal's first priority was stabilizing the banks. Over the previous three years, many Americans had withdrawn their savings out of fear the bank would lose their money in bad investments.

So to regain the public's confidence, FDR increased federal oversight of commercial banks, and created bank insurance to guarantee that any deposited funds would always be available. Next, he established the Federal Emergency Relief Administration. FERA cataloged each state's need for relief and provided funds to help citizens afford groceries, rent, clothing, coal, and other necessities.

Meanwhile, the Agricultural Adjustment Administration subsidized farmers and educated them in improving planting techniques. These policies fed and housed thousands, but they didn't significantly address the New Deal's biggest promise: reducing unemployment. So the Civilian Conservation Corps was established to employ over 250,000 young men for projects like tree planting, irrigation, and fire prevention.

The CCC offered onsite work camps that provided food, shelter, and education to those employed, mostly young single men with families in need of relief. Subsequent programs like the Work's Progress Administration and the Tennessee Valley Authority added projects, building roads, bridges, and hydroelectric dams. The WPA also funded art, writing and theater programs.

These initiatives cut civilian unemployment in half, and they did so alongside labor acts that abolished child labor, granted unions the right to collective bargaining, and set the first national minimum wage. Benefits were also created to help those unable to work. The Social Security Act established an old age pension system, in addition to unemployment insurance, disability benefits, and welfare assistance. But despite these sweeping policies, the New Deal helped some groups more than others.

Black Americans were hit hardest by the economic downturn, and the New Deal's impact on Black communities varied widely. In northern cities like Chicago, Black citizens received a large share of jobs, vocational training and education, with New Deal programs teaching more than 1 million Black Americans to read. Northern Black communities also received an influx of public housing, though it was heavily segregated. In the south, results were less positive.

Roosevelt relied heavily on the support of Southern Democrats who welcomed economic development but fought to preserve white supremacy. They ensured that new labor laws excluded domestic servants and agricultural workers, occupations held by many Black Americans. These politicians and many others also undermined Eleanor Roosevelt's attempts to push her husband towards supporting a federal anti-lynching law. As a result, the New Deal has often been called a raw deal for Black communities.

And many modern inequities in housing, employment, and financial stability are partially due to New Deal programs prioritizing white Americans. In these ways and more, the New Deal didn't fully live up to its promises. Despite employing over 8 million Americans, unemployment never went lower than 14%, and the US economy wouldn't fully recover until the country's mobilization for World War II. But this bold campaign of progressive policies did empower unions to start their own revolution.

In the coming decades, northern liberals, Black Americans, and other working minorities united to fight discriminatory hiring. In the process, they reshaped the Democratic party, challenging its racist leadership, and laying the groundwork for an emerging civil rights coalition. There were small lies, there were big lies, and then there's The Big Lie. And that is a coordinated campaign of blatant falsehoods to systematically burn down and destroy institutions.

And we saw Trump do it in 2020 before our very eyes, undermining the legitimacy of America's free and fair elections. And we saw him do it last night on the biggest stage, undermining the legitimacy of America's most important safety net for its citizens: Social Security. There is a pattern to what Trump is doing, and what he's goading other Republicans into saying.

It is a pattern Trump established throughout the 2020 election and its aftermath, all the way up to January 6th and beyond: a deliberate attempt to alter reality with lies about the balloting that were so audacious and so obviously untrue. They're sending millions of ballots all over the country. There's fraud. They found them in creeks. We caught them as you know, it's fraudulent, dropping ballots, doing so many things, nobody can even believe it. Dead people voting.

It was a massive dump of votes. And then you get to Detroit and it's like more votes than people. We have a company that's very suspect. Its name is Dominion. This election was lost by the Democrats. They cheated. It was a fraudulent election. They flooded the market. Now, to be clear, those claims were all false. They were laughed out of court, dozens and dozens and dozens of time.

But Trump was obsessed with convincing his fan base that the voting system in the US, gold standard for free and fair elections around the world, was shot through with fraud -- I mean in numbers that were preposterous. And it wasn't a new obsession. I mean, look at these headlines. "Donald Trump warns vote could be rigged." "Trump ratchets up rigged election claims, which Pence downplays." "Donald Trump's rigged election claims

raise historical alarms." All of these headlines were from the 2016 election campaign, the election Trump ultimately won in the electoral college. He didn't challenge that outcome. But once he lost in 2020, Trump went back to his old playbook, this well-established playbook, particularly the myth of dead people voting for Democrats. This has been a fringe right wing talking point for years, and Trump elevated the lie to new prominence.

He used it in his quote, "perfect phone call" with Georgia Secretary of State, Brad Raffensperger, to pressure his fellow Republicans into basically a coup: into rigging the state's vote totals to favor Trump, even though he lost the state. And Raffensperger debunked that lie in his testimony to the January 6th Committee. The other thing, dead people, so dead people voted. And I think the number is in close to 5,000 people.

And they went to obituaries, they went to all sorts of methods to come up with an accurate number, and a minimum is close to about 5,000 voters. So secretary, did your office investigate whether those allegations were accurate? Did 5,000 dead people in Georgia vote? No, it's not accurate. And actually in their lawsuits, they alleged 10,315 dead people. We found two dead people when I wrote my letter to Congress that's dated January 6th. And subsequent to that, we found two more.

That's 1, 2, 3, 4 people, not 4,000, but just a total of four. Now, Trump's lies had a purpose, right? The purpose is to destroy faith in the electoral system so as to overthrow American democracy, to destroy that faith so that you can destroy the institution itself. And he rolled out the same play last night, as he blasted out his new Big Lie about a beloved government program, one that Republicans have long hated, but that 71 million Americans currently rely on.

We're also identifying shocking levels of incompetence and probable fraud in the Social Security Program. Believe it or not, government databases list 4.7 million Social Security members from people aged 100 to 109 years old. It lists 3.6 million people from ages 110 to 119. I don't know any of them. I know some people that are rather elderly, but not quite that elderly, but we're gonna find out where that money's going and it's not gonna be pretty. Identical, right? He sees dead people again.

The dead people voting in the Georgia election, the dead people getting checks from Social Security. All the dead people committing fraud. Suggesting that Americans who died long ago are still having their Social Security checks delivered to someone and somehow cashing them in their name even though they're dead, and there's a death certificate. Again, think about it for 20 seconds. It's obviously preposterous.

In fact, a government investigation last year found that from 2015 through 2022, 7 years, of all the money the agency paid out in benefits, and that is $8.6 trillion, a staggering sum, less than 1% was improper payments. That's a really good record. And most of the erroneous payments were overpayments to living people. I mean, again, think about this, right?

In the same way you, if you think through the dead people voting at scale issue, if you have ever had a loved person die when they were on Social Security, you know the checks don't keep coming. Also, Social Security automatically stops payments to people who are 115 years old. Its capped there, which I'm sure is a bureaucratic headache for the handful of Americans who lived that long.

The version of the lie Trump and his unelected co-president Elon Musk are telling appears to be based on their inability to read the data they collected. Because Social Security's software system necessitates that some entries with missing or incomplete birth dates will default to a reference point of more than 150 years ago. I don't know the origins of this, but here's the thing. The fraud claims are bunk. They're totally false. It's just the Big Lie about voting, again. Dead people voting.

But just like they did with the election Big Lie, Republicans are amplifying it. What he's finding with his algorithms crawling through the data of Social Security System is enormous amounts of fraud, waste, and abuse. Tens of millions of deceased people who are receiving fraudulent Social Security payments. More than 13 million people on the records receiving benefits who are over 119 years old. I'm shocked enough.

Who do we have at 200 years old or who do we have older than America that's getting Social Security? Everybody whose grandfather died and is still getting Social Security? Gimme a break. Yeah, they're lies. They are lying. Those are all lies. It's not happening. Okay? Millions of people? Millions? Here's the thing. They want to destroy Social Security. They are coming for Social Security. Musk has already installed someone from DOGE at the Social Security Administration.

The agency has already announced enormous layoffs. They're already closing offices. This is gonna make things start to break there. Last weekend, the previous Social Security administrator, Martin O'Malley, warned that Trump and DOGE were breaking the whole agency, saying quote, "ultimately, you're going to see the system collapse, and an interruption of benefits. I believe you will see that within the next 30 to 90 days. People should start saving now."

I don't know if that's a credible prediction. I really don't know. Social Security is an amazing and robust system, right? But it's an incredible statement, given that Social Security has never missed a monthly payment in 90 years. It is a program, like our voting system, that is incredibly free of fraud, incredibly efficiently run, insanely popular with the American populace, just like free and fair elections. Keep your eye on the ball here. Right?

Huge tip off last night of what they're about to do. Trump knows all this. Musk knows all this. It's why they are telling The Big Lie about Social Security, just like the big election lie. The objective now, as it was then, is to fabricate this elaborate, grotesque lie about a cherished institution of American government, to sow enough fear, doubt, and uncertainty among enough people that Trump can get away with destroying it. Empty shelves, an unusual scene in a normally stocked warehouse.

Radha Muthiah, President and CEO, Capital Area Food Bank: What we were expecting to be about 55 tractor trailers' worth of food, and we just heard a couple of weeks ago that half of those will no longer be on their way to us. These vacant racks stand out in Washington, D.C.'s Capital Area Food Bank, a 123,000-square foot building where staff store inventory and pull orders for delivery to more than 400 regional partners. Radha Muthiah is the food bank's president and CEO.

She says the recent USDA cuts made a deep impact here. Six hundred and seventy thousand meals' worth of food that we now have to scramble to look for other sources of food to be able to try and at least partially bridge that gap. I understand evaluating these programs. Every administration does that.

We are happy to share data, client testimonials on the impact of these programs on working adults, on children who are able to focus more on school, on seniors who can combine this with food, with medication that they need. In February, food banks nationwide began noticing canceled USDA deliveries in their systems. The funding freeze comes after the Trump administration cut two other programs that provide aid to food banks and schools.

Agriculture Secretary Brooke Rollins defended the cuts on FOX News. But right now, from what we are viewing, that program was nonessential. It was an effort by the left to continue spending taxpayer dollars that were not necessary. Republican lawmakers are also considering cuts to the Supplemental Nutrition Assistance Program, or SNAP, previously known as food stamps. Last year, about 42 million people used the program.

In a statement to the NewsHour, a USDA spokesperson said: "The USDA has not and will not lose focus on its core mission of strengthening food security, supporting agricultural markets, and ensuring access to nutritious foods." The agency also noted a recent approval of $261 million in purchases of fruits, vegetables, and tree nuts to food banks. This is an extraordinarily serious moment for food banks all across the United States.

Vince Hall is the chief government relations officer for Feeding America, a nationwide network of more than 60,000 food pantries and distributors. He says an end to pandemic era aid, rising inflation and stagnant wages has led to record high demand at food banks. Any reduction in the supply of food to food banks is going to have very significant impacts for people facing hunger. Food banks were already maxing out their supply chains.

They were already going to every conceivable donor, looking for every conceivable pound of food and asking every community to support. And so the reality is, we're going to be short, we're going to be short on foods. Just outside Washington, leadership at Catholic Charities' Alexandria food pantry say they expect to see a drop in the variety and quantity of their USDA orders. It's food that U.S. Army Reserve veteran Philip Tinsley relies on.

Well, it's important for your own health, but more important for, I guess, some of your mental health, that you don't think, well since I'm poor, I have to be treated like trash. Or since I am poor, I have to eat bad food. Or since I'm poor, I have to eat secondary food that other people don't want. This is really what anyone would go and get off the shelves. And in this region, some food banks are starting to see more former federal workers enter their doors.

Tens of thousands of federal employees have been fired since the Trump administration took office, leaving some searching for ways to make ends meet. This is my first time going to a food pantry as a client. I have been a volunteer in the past. This former federal contractor was let go in mid-February and recently lost her health insurance. She spoke to the NewsHour anonymously for fear of retribution.

Coming here and admitting that I need some extra assistance took a bit of courage to having never been in this situation before. I think it's important that people take a step back and take the politics out of it for a second and realize that these are real peoples' lives. And the need spans far and wide, with some of the highest food insecurity rates in rural areas, like here in Rappahannock County, Virginia. We do not have any grocery stores nearby.

So for a family to be able to go and get fresh produce from a grocery store, they have about a 30-minute drive anywhere within the county. Rappahannock Food Pantry President Penny Kardis says they will look to their community to fill the gaps. It would be a challenge for us. We would have to — besides looking at our current donors, we would possibly have to look at corporate donors. That's a little bit difficult for us.

We have no businesses in the area, so that would — we'd have to look really far outside for that. Sue Raiford has lived here for 30 years. She says after a bad work accident about a decade ago, she could barely walk and weighed only 75 pounds. And when I went into the pantry, these people just surrounded me. And they said, oh, we have got to fatten you up. Here, here, here. And it's been that type of welcoming companionship that is always here for everyone that walks through these doors.

It's that community Raiford fears will be hurt as cuts are made to the programs many here rely on. Like myself, many, many seniors, we don't have means to go out to the grocery stores. We just can't do it. I think without that support from the government, many lives will be shattered. And that's the heartbreak. Medicare provides health care to 66 million people who are 65 and older. Medicaid serves 80 million low-income people and disabled Americans.

How big a part of the overall U.S. health care system are these programs?

Well, it's less than half of the population, but roughly half, and maybe a little bit more, of expenditures because the people in these programs have some of the more serious health care needs - higher rates of chronic diseases that go along with being from low-income and maybe historically underserved backgrounds, higher rates of chronic diseases that go along with aging, and the risk factors for many conditions like cancer and other health problems that go up with age.

And, Ari, I think it's important that maybe listeners understand that Medicare has a much higher cost per person because of the age of the population. Medicaid is actually one of the most, if you will, by cost, efficient programs for women and children. About half of the births in the United States are paid for by Medicaid. So, Kathleen, when you saw Elon Musk post on X that Medicare and Medicaid were where the big money - in his words - fraud is happening, did that ring true to you?

Was that a big concern of yours when you ran HHS? Fraud, waste and abuse have always been a focus of the federal agencies. One of the things that happened with the Obama administration was really ramping up that kind of fraud-rooting-out activities that we did in coordination with the Department of Justice.

The notion that this is somehow an undiscovered area, that people who are not at all familiar with the programs or the way they operate are going to suddenly be able to identify and root out, is just flat-out wrong. Mark, how did you react to seeing that post from Elon Musk? Well, I totally agree with Kathleen that this is an ongoing battle.

So I think that the real question for DOGE is can they find a way to get these inappropriate programs out while, by the way, Ari, at the same time, keeping President Trump's promise that he is not going to cut or disrupt Medicare benefits? Do you fear that this mission to eliminate waste and fraud could be a pretext for making broader sweeping changes to Medicare and Medicaid that are not actually motivated by waste and fraud and don't actually address waste and fraud?

The reason that I'd like to take them at their word, Ari, is that the staff at CMS under... CMS - the Centers for Medicare & Medicaid Services, yeah. Centers for Medicare & Medicaid Services that oversees these programs - they are in place now. So Dr. Mehmet Oz - Dr. Oz has been nominated to be the next administrator. He's still waiting for a confirmation hearing, so he's not there.

But in contrast to some of the other public health agencies at HHS, there's a whole team of people who are in politically appointed deputy roles, working with the career staff, who have a lot of experience with CMS and the private sector on working with Medicare and Medicaid programs.

The CMS team has also brought in some long-experienced career professionals, including people who were there on the career staff working with me, including the new chief operating officer at CMS, who has a tremendous amount of nonpartisan experience in finding ways to address fraud, waste and abuse in Medicare and Medicaid programs.

So just so I understand, in other parts of the government, from the Treasury Department to the Justice Department, we have seen career officials and nonpartisan civil servants either fired and replaced or encouraged to leave. You're saying the opposite appears to be true at the Centers for Medicare & Medicaid Services?

I think something distinct is happening here in that, you know, the DOGE team, as I understand it, didn't just show up but is working directly, following some of the guidance and the experience of the career staff and the political leadership to find the effective ways of addressing fraud and abuse, and hopefully to modernize some of the data systems there, too. Kathleen, do you give them the benefit of the doubt? Do you trust them to take a nuanced, data-driven approach?

Well, I'm encouraged by what Mark is saying about what his knowledge is about the people who are coming into the agency. But the proposals, Ari, that are out by, I would say, Republicans in Congress are very much aimed, particularly in the Medicaid program, at cutting benefits. They are not about fraud, waste and abuse. You can't really, I would suggest, get the kind of money that has been promised by DOGE even if you greatly ramp up fraud, waste and abuse.

You really have to go to the core of the benefits of these programs, and that is where I'm very wary of what the proposals are coming forward. So bottom line, if people who depend on these programs want to know, is my coverage safe? - can I continue to count on the services that I have counted on in the past? We don't know where this is going to go. What should people be watching?

Well, I would say for now, until they are notified otherwise, assume the services that you signed up for if you've just gone through Medicare open enrollment or if you are a member of your state's Medicaid program, the services, your provider, your drugs will continue to be provided - and use them.

I think it's very important, at the state level particularly, that legislators in red and blue states understand that if Congress begins to change Medicaid rules, payments about Medicaid programs, it will blow up every state budget in this country. Medicaid is one of the most important parts of every state's budget. They rely heavily on a shared partnership with the federal government.

And if those rules begin to change, everything else is at risk - economic development, the ability to fund education, the tax system. And states will be left in the really unfortunate position of having to pick and choose who gets to keep their coverage and who doesn't. As you have probably heard, Secretary Kennedy says that he can lose 20,000 workers, that's about 10,000 through cuts, another 10,000 through retirements and buyouts, without affecting the services that the agency provides.

This is an agency you have run. Do you think that can be done? Well, unfortunately, Amna, to me, it's another indication of how little Senator — Secretary Kennedy understands about this massive agency. HHS is intertwined with state governments, with local governments, with tribal governments. And it's not just about losing some nameless, faceless bureaucrat in

Washington, D.C. What the massive layoff will mean is that you lose expertise, you lose timeliness, you lose an opportunity to get not only the best products to market in a very fast manner, but a food outbreak that could occur anywhere in the country. That's part of the FDA's job, is that they work with industry to quickly get those foods off the market, so my kid doesn't get harmed by the peanut butter.

Here in the heartland, in Kansas, we're going to lose health employees from the CDC who have been working closely with our local health offices to monitor outbreaks, to keep vaccines up to date, to make sure that data is shared from state to state. Those employees are all over the country. They will suddenly be gone. We're going to go into hurricane and tornado season very shortly. The first people on the ground when a disaster hits are from the CDC.

They make sure the water is safe, so people can go back and relocate. We're talking about real impact at every point in the country. And, unfortunately, after six weeks, my guess is Kennedy has not only not visited the 13 divisions, but he really doesn't know or doesn't care what the people do. We should note that these cuts will now downsize the agency to some 62,000 positions that would remain. Secretary Kennedy has also made an economic argument for these cuts.

He has said that HHS is the biggest agency in the government. He said it's twice the size of the Pentagon with $1.9 trillion, suggesting that these job cuts could help to tame the budget. Could they? Do you see that point? Most of the money that is in the HHS budget goes out the door. It's the largest transfer of federal funds to states through Medicaid, childcare grants, mental health block grants, Agency on Aging, help and support, home health services.

So, this is not money that's hiring people inside of D.C. offices. It's money that really is essential to health services in every state in the country and in tribal governments throughout our land. So, cutting the budget really is not about people, as much as it's about really harming the services that go out to American folks.

If the personnel isn't there to make sure that Medicare payments go out on time, to make sure that people can enroll and get the health insurance that they're entitled, to make sure that the block grants go out on childcare and mental health services, those services grind to a halt. And it hurts everyday Americans who desperately need the health services that HHS helps to deliver.

We have also heard a top adviser to Secretary Kennedy make an argument that he says the agency has basically been failing in its mission to the American public. He points to rising rates of chronic disease, to lower life expectancy in recent years, and also a culture that he claims is too quick to medicate patients without addressing underlying causes for the disease. What's your response to that argument?

Well, I don't think there's any question America spends more and in some ways has a lower return on investment than most of our competitive Western European nations. We have a very expensive health care system, again, not because of HHS. Private insurers have a lot more overhead and a lot less return on the dollar.

There's been a real pivot since the passage of the Affordable Care Act in 2010 to preventive services, to look at the underlying causes of obesity and heart disease, to invest in healthier foods, more exercise programs, programs that actually do diabetes prevention, instead of waiting and treating the disease. I think those efforts are really important. I'd love to see us double down on prevention services and pay more to keep people healthy than treat them when they're sick. That's great.

But you can't tell the measles that is now breaking out throughout the country — we have our first measles cases in 15 years in Kansas, and it's an alarming rate of spread. You can't tell an infectious disease just to stop because we're going to focus on diabetes. We have to be able to walk and chew gum at the same time. We have to be able to do multiple things. Infectious diseases will come. Disasters will come. And chronic disease is here to stay. So all those efforts are critically important.

He is clearing out of agencies, from what I can read and ascertain, the top tier of expertise, not people who came in as politicals with one or another administration, but people who had been working in these fields for a long time. As you know, this is all part of the Trump administration's plan and agenda to try to cut what they call bloat in the federal government work force.

You have led this agency, so I have to ask, if there were changes you would suggest that need to be made at HHS, what would those be? What should change? Well, I think any good CEO, private or public company or government, looks constantly at ways to be more efficient. Can — are there redundant jobs? Can you put people together? I was amused by some of the suggestions that agencies work more closely together that are in very different locations. Some are in Washington, D.C. Some are in Atlanta.

And while that's an interesting theory, it's very difficult to conduct that mission. But constantly reviewing what can we do better and really keeping the consumer front and center, the patient front and center, what services can we deliver more timely and more effective to the American public, not where my grudges, where I want to dispute old and long-term scientifically proven vaccines, safety and effectiveness.

I mean, I think this agency is quickly, unfortunately, going off the rails with leadership who has a very clear agenda, doesn't know really what happens throughout the breadth of this organization, and is likely to do a lot of unintended harm by slashing expertise, slowing down approvals of vaccines and cosmetics and food and drugs, not being able to respond in a timely fashion to food outbreaks or natural disasters. We're going to be in a very vulnerable situation.

I'm sick and tired of too many people in this town, Tom, they keep talking about things in the future tense, like what may happen, the constitutional crisis that's coming, and you're like, "the constitutional crisis is now!" The vice President of the United States of America, a lawyer who knows constitutional law, he's saying that the president can ignore the judiciary, that the president is freed from the constraints of checks and balances.

That is an authoritarian takeover, that is a constitutional crisis, and we need everyone to take it that seriously. At the same time, Tom, politicians aren't gonna save us. The courts aren't gonna save us either. The only thing that can stop a tyrant and the tyranny that he's bringing is the people. And so until the people are out in force raising our voices together and really shutting things down, I don't think we're gonna see as much bravery as we need. The politicians are lagging indicators.

They get their bravery from the people, but first the people have to organize and fight back. And that's where the fire, the bravery and the opposition that we need is gonna come from. Yeah. Bernie Sanders once made the point to me that the way politicians work is they typically don't get out in front with a flag and say, "Hey, let's organize

a parade." Instead, they wait for a parade to naturally form, and when it's big enough and vital enough and active enough, then they jump in front of it with a flag and say, this is my parade. And so it's up to us to create that parade, essentially. So tell us what resources are over at socialsecurityworks.org or where you recommend people go to learn how to become part of that parade.

Definitely. And I'll just add one thing that I learned from Marion Barry, the mayor for life from Washington DC who is also MLK's left hand in the civil rights fight, he told me that the left often suffers from when the politicians want to join the parade, the left is like, "no, you get outta here. You weren't with us the whole time," and we can't do that. We have to actually be like, "oh, great. Wonderful. You're all welcome.

We'll just even pretend you're here the whole time," because that's how we build power—we invite people in.

So, if you go to social securityworks.org, you follow us on social media, the pledge campaign that we're running right now, we're demanding every member of Congress pledge no cuts to Social Security, Medicare, Medicaid, and we're running billboard trucks in every vulnerable toss up Republican district where they don't take the pledge, because at any one time, we only need three Republicans to stop this assault on our democracy and this theft of our earned benefits.

And there's what, 17 Republicans who in are in that category? Yes, it just in the cook report toss up. And then, you know, there's lean Republican, but these are extremely tight races, where these guys are, you know, their political future right now is very uncertain. That's why I brought up Jeff Van Drew. These are people who are saying you can't cut and destroy Medicaid. Like, I'll definitely lose my job. That's the calculus that we have to make, we work with that.

We need these members to be more afraid of losing their jobs to their constituents anger than they are of Donald Trump and the wrath that he can bring on Twitter. I try not to be emotional about the work that I do, because we try to get our facts right. We do a ton of research.

We try to be as prepared as possible for these conversations, but I have to say I was caught a little off guard because I did not know that America's 2 million plus federal workers all take this very specific oath of office. I actually just now, during our break, LG, I went to the OPM website, and I pulled it up and here it is. I'm just about to read the full oath of office. It says, "I will support and defend the constitution of the United States against all enemies, foreign and domestic.

That I will bear true faith and allegiance to the same. That I will take this obligation freely without any mental reservation or purpose of evasion. And that I will well and faithfully discharge the duties of the office on which I'm about to enter. So help me, God." Now all federal employees take this oath. I did not know that. LG, can you talk a little bit more about what taking that oath implies, regarding the meaning of the work that federal employees undertake?

You reading that oath, you can't see me, but I have goosebumps, because it hits the same every time. This is a serious job.

That phrase "to well and faithfully discharge the duties of my office," it doesn't matter who you are in the federal government, if you are early career talent who's just starting out in your career, or maybe this is your first job out of college, or if you are a 20-year, long-term veteran of the government, you walk into that job every day knowing you serve the American people, and you swear an oath to that—that is your mission.

The civil service, we were talking about this a little bit before the break, but it is a mission oriented and mission-based organization. I believe Arielle was saying we're not intended to work like a corporation. We're not here to serve stakeholders, we're not here for profit margins. We are here to serve a mission for the American people, no matter what the mission of each agency might be. And taking that oath, to me, just really solidifies how important that is.

And that's where you talk about the dedication and we're all saying, "we" still as civil servants, it's because you swear an oath into a group to take care of your neighbors. And the people down the street who maybe don't agree with you, but you're here to make sure that they get their services anyway. And I think that's a really important and sacred calling. Yeah. And it's distinctly different from private sector service, right? No one asks you to swear in oath.

I can't speak for all private sector companies, but it's definitely not common. I've never, just wanna know that any of the private sector companies I worked at that's probably a good thing. But yeah, because the job that we do is difficult. We are often underfunded, we are often understaffed, but everybody still comes in each day just determined to accomplish that mission no matter what, and I think the oath is the basis of that.

Getting back to some facts and figures here, back in January, we actually did a full hour on the history of the United States Civil Service, and even though 2 million plus federal workers seems like a really big number, I think, Arielle, as you'd mentioned before, it's basically less than 2% of the entire civilian workforce in this country.

But even more interestingly, we spoke with a professor named Donald Moynihan at the University of Michigan, and he did an analysis where he said that in the United States, A] our federal workforce is in fact of the same, if not smaller, than peer nations. And on top of that, the federal government already privatizes a lot of services, and he did analysis and found out that the U.S. has something like three to four private contractors for every single federal employee that we have.

For Arielle, the work that you were doing, there's three to four private contractors that are also getting paid for that same work. I wanted to lay that out. And Emily, let me turn to you, because your work was so specialized at Wright-Patterson Air Force Base, I guess the Trump administration, Elon Musk, et cetera, would say, if we're already doing that, why not further contract out the work that you were doing? And that may be a way to get more efficiencies for the federal government.

What do you think? Oh, I would argue that I wouldn't say that would be a very cost saving measure. In addition, should we have private companies that are seeking a bottom line, doing such important work for our American people? I would argue not. And we are talking to a lot of folks today and organizations that I would say should remain public. Yeah, I'll leave it at that. Tell me more though. I think we're all aware of how expensive the Department of Defense is.

It's such a huge chunk of our expenditures, and if we used more contractors, I would not expect that number to go down. When I watched the video that you sent me of that town hall that you were part of, it wasn't just you, that was the thing that I noticed. There were other speakers who came up and everybody had their story. This is so, so, so common.

The way that these stories touch people and the way that once people start telling their stories, all of a sudden they feel less alone, I feel like. They feel empowered to be able to, not just connect with each other, but advocate for each other and. I'm wondering how you see things shift sort of from the beginning of one of these sessions to the end. What is it that brings people together, makes them feel more connected, compels them to action?

Well, when you have a clear articulation of what Medicaid does for somebody or what it does for your community, I think it's easy to rally around that. And the point of telling stories isn't just to tell stories, right? Great, we heard a story, let's go home. Let's applaud whatever. That's, that doesn't do anything. Anything for anybody. Stories are a tool. Elected officials live in a bubble. Part of it is self-created, part of it's just natural part of the job.

And it's very easy to not experience or not understand the consequences of their actions. And granted, there's a lot of other forces at play, don't get me wrong. The way that capital controls the government is not ignorable. I think it's the fundamental part of this entire relationship. You still gotta put these stories onto the tip of the spear and drive it into that bubble. You gotta puncture it. You gotta penetrate it.

And so a movement that puts these people at the front of the line and brings them to the... like one of the things we're considering doing is taking over one of our electeds offices for multiple days, just having a nonstop cavalcade of people telling their stories over and over and over again to the elected or to staff continually. And then you video it, you film it, you put it out there. That does a couple of things.

One is, in the unlikely event the elected has a change of heart, that's the way you do it. Two is it demonstrates pent up demand, it de it demonstrates there are consequences to your vote, both in the literal human sense and also in the electoral sense. And then lastly, you build a movement around it. I hate casting on my hopes to electoral politics for a lot of reasons, but it is important to build that kind of force.

It isn't important to build that kind of power, and building it around people like this, bringing 'em to the front of the line, sharing those stories, building a coalition, this is a core part of it. It's a thing that keeps people motivated and keeps them coming back. And so integrating that fully into the force, I think is important. There's so much more to building power than just these kinds of things, but they are a critical part. You gotta do 'em.

That's something that is interesting to me as somebody who has a background in storytelling. And this is something that we have in common. You did a lot of like backyard wrestling stuff for a really long time, and so it was about putting on a show, capturing narratives, and engaging people. But there is a distance, of course, between simply being able to engage people and taking that engagement and using it to compel people to meaningful action.

And this is something that I've noticed a lot in I don't know, call it the liberal bubble of theater. It's like, "oh, if we just all stand up and we say that's enough, then surely this will stop it." So I'm so interested in the way that you bridge that gap, and I think you are doing it in a meaningful way.

I think that, getting people to tell their stories is one thing, but then finding the connective piece to have that story be something that reaches other people, that compels them to do something. How do you make that link? The purely operational nuts and bolts part of it is we have a series of forms floating around these town halls. When people feel compelled by the story, they can sign up. We bring them into a team that's entirely member directed and they plan the things they wanna do.

My job and the jobs of my coworkers is to keep them engaged and help build out things, help build out options to education, et cetera, but it's up to these people who come to these town halls and feel affected, want to move to act, to build out these teams and do things that contribute to this broader building out of power. So I talked about taking over the elected offices, that's the kind of thing they can do. Build this momentum, bring more folks in.

The stories are an activation tool as well as a thing you bring to the front of the line. People hear these stories and say, fuck it, I wanna get involved, whether they have a story or not. It's very easy to chalk things up to alienation by and large, and I think that's largely correct, but we don't understand how we live even within the neighborhood that we exist in.

This is a one of the rare things that reassembles us into understanding ourselves as being part of a cohesive whole, to an extent. It's only moments like that that you can get people to sign the dotted line and bring 'em out to a meeting and bring 'em to do something. And a good organizer, which I'm not saying I am, I'm a healthcare guy, but a good organizer can tie those things together into a variety of clauses.

Wisconsin right now has a state election for Supreme Court, which happens on Tuesday, which I don't feel amazing about. We had a big one two years ago. Democrats won it, got us new voting maps, which have changed the entire composition of the legislature. We've got another one of those coming up as well as a case about Act 12, which is the Scott Walker Bill that destroyed public sector unions. And so this election will determine the shape of the state for years to come.

And a lot of people that came to these town hall meetings are being turned out to go knock doors, and not all of 'em do. It's not a, it's not like in a completely mutable population, but it's part of putting people into a broader coalition. If you share this worldview, if you feel affected by these things, here's all these options available to you to go out and do something with it. And people do react to that. People do respond.

It's the job of my coworkers to help put together those ties, to bring people in for multiple causes and keep 'em there for the long term. We've just heard clips starting with TED Ed exploring Franklin D. Roosevelt's New Deal detailing its comprehensive policies to combat the Great Depression. All In with Chris Hayes discussed how Trump employed a strategy of spreading blatant falsehoods to undermine trust in democratic institutions like the electoral system and Social Security.

Consider This covered the significant costs and challenges of Medicare and Medicaid, including fraud prevention efforts and concerned over potential cuts to benefits. The PBS NewsHour discussed the severe impact of USDA funding cuts on food banks across the US. Another clip from The PBS NewsHour focused on the potential negative effects of Secretary JFK Jr.'s plan to cut 20,000 workers from Health and Human Services.

The Hartmann Report discussed the urgent need for grassroots activism to counteract the current constitutional crisis and authoritarian threats, highlighting the role of mobilized citizens and the necessity of inclusive political organizing. On Point delved into the significance of the oath taken by American Federal workers, highlighting their mission-driven duty to serve the American people and the unique challenges they face compared to the private sector.

And finally, The Worst Of All Possible Worlds discussed how sharing personal stories at town hall meetings can create a strong sense of community, drive advocacy, motivate political action, and integrate individuals into broader movements. And those were just the Top Takes. There's a lot more in the Deeper Dive sections.

But first, a reminder that this show is produced with the support of our members, who get access to this show ad free, as well as early and ad-free access to our freshly launched other show, SOLVED! That's all caps with an exclamation point, which features our team of producers discussing a carefully curated selection of articles and ideas to then solve some of the biggest issues of our day in each episode. Members get the podcast of SOLVED!

free each week without ads before it goes out on the Best of the Left YouTube channel. We also do a special members-only section at the end of the show. So to support all of our work that goes into Best of the Left and have SOLVED! delivered seamlessly to the new members-only podcast feed that you'll receive, sign up to support the show at BestOfTheLeft.Com/Support (there's a link in the show notes), through our Patreon page, or from right inside the Apple Podcast app.

And as always, if regular membership isn't in the cards for you, shoot me an email requesting a financial hardship membership because we don't let a lack of funds stand in the way of hearing more information. Now if you have a question or would like your comments included in the show, you can leave a voicemail or send us a text at 202-999-3991. We're also findable on the privacy focused messaging app Signal at the handle bestoftheleft.01, or you can simply email me to [email protected].

Now, as for today's topic, there are so many potential ways to come at today's topic that I found it genuinely difficult to narrow it down. Ultimately, I've decided to go with the big picture. Now, the moral philosophy that underpins so much of the reasoning behind the conservative desire to deconstruct social safety nets is, I think, as immoral and anti-human as anything that exists within the Overton window of acceptable political argumentation.

And of course, there's a dual motivation going on here. One is the simple capitalistic greed that drives the rich to want to extract as much as humanly possible from the poor. But that is still, thankfully, outside of the Overton window, so we don't hear much about it. That motivation still lies beneath the surface. But the other element has its roots in the deeply oppressive Protestant work ethic that has haunted the New World since before the founding of the nation.

But let's actually work backwards to that. Now, it's a truism that no one lies on their deathbeds regretting that they hadn't dedicated more of their time to their work. But that idea is also backed up by hospice nurses with decades of experience speaking with dying people as they reflect on their lives. Looking back, they see more clearly the kinds of truths that we all already basically know, but tends to ignore.

The point of life is to love and be loved, connect with those around us, contribute, make a difference, et cetera, et cetera. Those who have spent their lives making lots of money frequently do so at the expense of all those things that really matter. They've neglected or actively cut off relationships over money and bitterness. They've failed to apologize and reconnect for reasons they can't even remember. And they end up ending their lives wealthy, but alone and unhappy.

This is the predictable result of a society that prizes work and personal wealth over community and connection. But look, humans are complicated. We also get joy and satisfaction out of accomplishments, out of having ambitions and working toward them. So the ideal society wouldn't be one of infinite leisure. There's a balance to be struck here. We do get value out of doing work.

Now, the conservative arguments against social safety nets and comfortable retirements that have made their way into the Overton window of acceptable thought, revolve around this ancient but backward idea that because putting in work and effort is fundamental to human survival, and that we do derive some satisfaction from work well done, that it must be the ultimate good, and practically the only thing worth pursuing.

And at worse, that it is practically a sin to waste time on leisure when there's work to be done. All of this has metastasized into a culture that is overworked and burnt out while reaping fewer rewards than the same work would've provided several decades ago, all while the insufficiency of our social safety net has forced people to accept this basic fate of "work or die" because it feels like there aren't other options.

The conservative argument goes that safety nets reduce the motivation for people to work. It's the old "safety net becomes a hammock" argument, which would be bad for society, so the best thing to do for everyone, but also just coincidentally the best thing to do for very rich people who profit the most from people's labor, is to restrict or eliminate social benefit programs. But let's use another metaphor.

And I need to give credit to Producer Deon who said this on a recent episode of SOLVED!, our new show on the Best of the Left YouTube channel that you might have heard of. Deon said that instead of focusing on a mostly imaginary group of people who might misuse a social safety net, let's think about the actual intended purpose of a safety net. Now, a safety net is something you might put under a tightrope, so imagine yourself walking on a tightrope.

Would you feel more or less free if there were or were not a safety net? In which scenario would you feel more emboldened to take risks? If what we want is a dynamic society in which people feel empowered to follow their passions, rather than settle for whatever they can get out of desperation, the existence of a safety net is what allows people to take chances. To strive for something beyond their immediate grasp.

The ability to fall knowing that we will be able to get back up is the only thing that allows for the kinds of risks that can lead to greater things for people financially, as well as creating more of a cushion, that allows more room for people to create for themselves the kinds of balance between work and the rest of life that will help us avoid those deathbed regrets that are all too common.

Without a social safety net, the only people with the kind of security to take risks are those who already have money. They can provide their own safety net. Now, why would a society that claims to believe in the entrepreneurial spirit want to limit themselves to entrepreneurs who get their starts because they were born into relative wealth, while the poor end up destined to remain so?

Once you dissect the acceptable reason that they give for wanting to cut social programs, that it's ultimately good for everyone, you see that the high-minded arguments for this greater good and personal virtue are all built on bullshit, and lead people into the lives of "the grind." They end up working out of necessity, but believing that it's virtuous. And often translating that sense of virtue related to work into a life that neglects what the dying come to realize is the real value of life.

So if that reason crumbles to dust when challenged, all we're left with, really, is the greed of the wealthy, who stand to profit more if they can continue to either convince or force people to work the maximum hours for the minimum pay and benefits. The math is not complicated to understand. And people absolutely hate it because we all intrinsically get the balance that is required between necessary and, yes, even gratifying work, and all of the other parts of life that are even more important.

Some amount of work is fine. Too much work is too much. And their goal in cutting social safety net programs is to make "too much" feel like a virtuous necessity. Don't let them fool you. And in the meantime, reach out to that friend of yours who you haven't had the time to connect with because you've been too busy. And now we'll continue to dive deeper on three topics today.

Next up, section A. Social Security followed by section B, general Cuts and Section C, Medicaid and Health and Human Services. I'm not sure most people really understand social security, and I think it's important for people to understand it. I view Social Security System as I. An insurance program. Um, how far, how far wrong am I on that? And you got it right. Actually, a lot of people think of it as a retirement investment program. Apparently, uh, our friend Elon thinks of it that way.

that's not what it, what it is. I'm all for people saving money, uh, and having. All kinds of investment accounts, but particularly 4 0 1 Ks and health savings accounts and so on, that's not what social security is. Social Security, as my grandfather said, is insurance against, uh, destitution in old age or in disability, uh, or from the loss of a, uh, of a parent. Uh, it's fundamentally, it's just like your homeowner's insurance.

Your auto insurance or even your health insurance, you buy insurance. You spread out the risk. When you need to, uh, need payments either because you're of your age or because of a disability, uh, or something like that. The people who currently are paying premiums pay for that, but it's not a Ponzi scheme as Elon. Decided to call it, uh, that indicated he either doesn't understand what social security is, or he doesn't understand what a Ponzi scheme is.

I, I also look at it as a, besides being an insurance program, it, it's also a contract. Um, I don't want to take it to the level of it being a social contract, but I think it's a contract where if you pay in and you work the requisite number of years, which is 10 years or 40 quarters, uh, upon. A certain time, you then are able to, uh, receive some retirement benefits. So I, I see it as kind of twofold.

Insurance and contractual Yes, no. So yes, social security, uh, a lot of people, uh, kind of shy away from the term social contract, but it's. You as a worker and other workers represented by the government, basically, uh, you pay your fair share, you expect to get your fair share of benefits. Yeah, so, so, so there's sort of these dual elements of it.

Now, I know that a lot of people are, are pretty freaked out, the Republicans have made, and, and matter of fact, president Trump in his, uh, speech to the joint session of Congress made that, um, comment that there were like, I don't know, three. 5,000 people over the age of 150. Did you watch that speech? And if you did, I'd love to know what your reaction was to it, because I think what the president was saying clearly, clearly was misleading.

Well, I did watch the speech and I'm not gonna comment on, uh, my views overall. I'll just on social security. Yeah. Uh, someone misled, someone misled him on that, he seemed to say that there was this large number of people get over getting benefits over the age of 150. There is nobody getting benefits in that category. First of all, uh, when you reach a, when the records show that you reached 115, your benefits automatically stop and they will reach out to you and say.

Show us that you're still alive. Okay. Yeah. Gotcha. Okay. So it's just mechanically impossible. But secondly, the reason it appears that way, and this is the problem with what the kids and I do mean kids, um, if you consider a 19, 20, 20 1-year-old a kid, which I do, uh, uh. When the kids go in and don't really understand something, they make mistakes and they have not had enough experience to say, wait a minute, that doesn't compute.

They're, they also don't take the time, you know, the, the Silicon Valley, uh, thing work fast and break things well, they work fast and they don't ask, uh, well, why would it show up that there're that many people that old? Well, it's because. Social Security had one of the first totally computer based systems for doing people's benefits. It's written in a computer language that was invented 50 or 60 years ago, invented actually by a team led by the first female admiral ever, Grace Hopper.

Uh, and. There was no setting in that language to insert the date when people, uh, when people were born. So they made up a date, uh, as a default, and they picked a date sometime in the 1880s so that people wouldn't get confused. Yeah, yeah. There was no default date. If you had a date, you, it was okay, but there was no default date. Yeah. So, so one would characterize that, and I've characterized it. To the dismay of some of my listeners as in effect what would be called a coding error.

It, it, that's exactly what it wa was. And it's not that it was somebody's fault, it's that the code at that point did not allow for a default date. And so the, all the people who had signed up for Social Security before there was computer code were listed on this date in 1880. Okay. Uh, and.

It doesn't impact benefits at all because as I say, there's automatic cutoffs and in general, social security has the master death list where almost every death that occurs in the United States is reported to Social Security. I. Right. I learned that the other day as I was doing some research on it, I did not realize it's an obligation of funeral homes to file a report of someone's passing. I was unaware of that. that's absolutely right. That is a major source.

But state, uh, medical examiners and departments of public health are also required to report. Okay. Now I assume that if there's some people living in the, the wiles of Montana and someone passes away and there's no, uh, I, I, I guess it's conceivable that someone could be buried out on the back 40, um, and a, and a and a nice, um, you know, headstone there. But, but the government would not know that.

So there, there could be, theoretically a handful of people here or there, but those people, if they were getting social security checks. Every month for someone who had not been reported, had passed, and if they were crazy enough to cash those checks, they're involved. They're, they're, they're committing fraud against the government cashing a check on behalf of someone other than themselves. Correct. I. They would end up in, in federal court charged with a crime.

I wish I had better news, but, um, basically as, uh, as bad as you think it, uh, is, it's, it's worse. Um, the damage that Elon Musk and his Doge goons have done, the Social Security Administration is truly catastrophic. We're already seeing service disruptions currently, and those service disruptions will just get worse and worse and worse, both in terms of cascading failures. So the failures building on each other, uh, and the fact that they're not stopping, right? They keep.

Putting in new things, uh, to collapse the system even faster. For example, um, closing offices, firing people, and then disallowing a lot of services to be done by the phone. Mm-hmm. Pushing more people into the offices, which will overwhelm the offices. The offices were already creaking under the weight of just 10,000 baby boomers, uh, entering the system every single day, uh, while at 50 year historic low staffing levels. That's before Elon Musk, um, got there with his chainsaw.

Um, so these are surgically designed changes that will push millions of people into a system that they are closing offices. They've already closed 45 or scheduled 45 for immediate. Um, and over the mid and long term, you know, they have instructed GSA to close all of the offices. Um, they've pushed out thousands of workers or fired thousands of workers. Uh, but over the mid or long term, uh, they have a memo, uh, that's been put together to reduce the workforce by 50%.

Uh, you know, and then, uh, the Doge guys, Elon Musk, they're like, oh, don't worry, we're just gonna replace everything with ai. What they're saying is you're not gonna be able to get through to anyone, uh, when your check doesn't get deposited or doesn't show up. Uh, and you know, if you don't believe me, like go listen to, uh, what lutnick, the Commerce secretary, why'd he go on television and say, you know, oh, if his mother-in-law didn't get her check, she wouldn't complain.

The only people who would complain about a missing a a payment are fraudsters. I mean, you understand what's going on there. Yeah. Tom, they're trying to scare people, uh, into not, uh, you know, reaching out if they don't see their deposits, they're getting people ready to not receive their benefits.

And then at the confirmation hearing for the Social Security Commissioner Bisignano, who by the way, uh, it runs a monopoly payment processing company that is just happens to be perfectly set up, uh, to take over some of the functions of, uh, a social security system that's been smashed to smithereens by.

Uh, Elon Musk. Wow. But at his, uh, confirmation hearing, you know, uh, Senator Warren asked him, you know, if somebody doesn't get, uh, their check or, or, or is $5,000 are removed from their bank account, which has happened already, you know, is that a benefit? Cut? And Bisignano was like, I don't know what to call that. Mm-hmm. Uh, and otherwise just, you know, denying and diminishing, uh, you know, what is actually going on. And then just straightforward lying to Senator Wyden.

Uh, when Senator Wyden asked, are you working with the Doge wrecking crew and Elon Musk? And he is like, no, I'm not. And he dub he asked again to make him say it twice, and then I. Revealed that he has, uh, whistleblower information that in fact, Bisignano is working hand in glove with Elon Musk. Uh, and so this is a commissioner who, if confirmed, will just accelerate the destruction, uh, at Social Security.

So, um, I wish that I could tell people that, you know, it's all gonna be okay, that your benefits are secure, but it's, it's not. Um, and we need a massive response, uh, from the American people to not just stop, but to reverse course. Because what's already been done will lead to service disruptions. Well, they've already laid off a whole bunch of people, right? They haven't, they've closed offices and I don't wanna get like, too into it.

If you go to our social media, you'll find enormous number of news stories that have dug into it. But Tom, a lot of it is actually they, they went in, uh, and they, uh, shut down offices or they combined offices. Uh, massive amount of reorganization in a way that, um, centralized power, uh, that now the Doge people, the goons themselves, are set to take over those offices with the express, uh, purpose saying, you know, oh, well we don't need people, uh, to help beneficiaries.

We don't need people to answer questions. Um, they're gonna, we're gonna replace this with ai. And it's just, that's bs, right? Yeah. They're just, they're making things up. And what they're really doing, and I think it's pretty clear to everyone, uh, is they're raking the system. They're destroying social security. They're causing the problem so that they can then throw up their hands and say, now you niv need to give us the legislative authority to act with a simple majority in the Senate.

And that's how they get their hands on our benefits, which are otherwise, um, protect that the big. Our benefits. Right, right. That's how they, they cut our benefits for everybody, uh, and get their hands on the, so the Social Security Trust fund, which was created by Reagan in what, 86? 83. The pre-funding of this trust fund was done in 83 under the Reagan reform. Thank you. But trust funds have long been a part of the Social security system.

The current Social Security Trust fund is sitting on, uh, over two and a half trillion dollars. And that is gonna, you know, serve us well until 2035. And then it's going to go back to something like a pay as you go system. 'cause most of the boomers will have passed on. Um, and, but the problem is that starting in 2035, we're gonna see some significant shortfalls in revenue. And the easy solution to that is to have billionaires pay the exact same percentage.

Of income tax for social security that bus drivers and people who work at McDonald's do. And that is something that is absolutely intolerable to billionaire Donald Trump, the 14 billionaires in his cabinet, and the billionaires who fund the Republican party.

So, uh, in order to prevent the simple solution of simply billionaires having to pay into social security taxes, it looks to me like they're going to try to break social security so that they will then have a rationale to privatize it, hand it off to whichever big bank gives the largest contribution to Republicans in Congress and be done with it. Is that a, a reasonable analysis in your mind, Alex? It is.

I have one thing to just add, which is when the trust fund was done in, in 83, it actually projected out solvency till 2060, which is when the baby boom generation will life expectancy really and truly dead. Yeah. Yes. But what's happened is that we've lost 30 years of that projected solvency because of the billionaires. Because since 1980 and the great divergence, which I know you talk about a lot, when all the productivity gains and wages have gone to people above the cap, right?

So people only pay in on the first $176,000 of income right now. And since the eighties, all of the money has gone to people above that. So they're not paying any of that new, that money into social security. That's what caused it to move down from 2060 to 20 into the 2030s. Uh, so the billionaires caused the problem not just by not paying the same rate as the rest of us on all of their income, but also by gobbling up all of the income.

Social Security has been overwhelmingly popular and under vehement attack from some quarters since it began and for decades. Elite News Media have generated a standard assessment. It's the most popular program. Hence the third rail of politicking, and also based on willful misreading of how it works, it's about to be insolvent any minute. The latter notion sitting alongside corporate media's constant refrain that private is always better than public, just. Because like efficiency and all that.

Now in this, frankly, wild only losers care about caring for one another and shouldn't the richest just control everything? Moment. Social security is on the chopping block for real. Still as ever. The attack is rooted in disinformation, but with a truly critical press corps, largely missing in action. Myth busting might not be enough.

A lot of us are in a kind of blurry, holy heck, is this really happening mode, but titrating out what is actually happening today is important set aside from whether courts will eventually rule against it or how it might play out in what is happening News. I'm reading at Truth Out via Bloomberg that three individuals representing private equity concerns have shown up at the Social Security Administration. How weird is that? What can that possibly mean?

It's horrible, and if you can believe it, it is even worse as soon as. Donald Trump was inaugurated on January 20th. The Doge guys, the Doge boys, was young as 19. Were swarming all over the Social Security Administration, as you said in your introduction. There has been a small group of people completely outta touch who wanted to do away with social security from the beginning. They've always been defeated, but unfortunately, they now are in control of the White House. It's Donald Trump.

It's. Despite all his lies in the campaign that he wouldn't touch Social Security, he proposed cuts in every one of his budgets in his first turn. It's Elon Musk, who unbelievably called it the biggest pom d scheme in history, which is such a slander. And it's Russell Roy, who is the director of the Office for management and budget. Architect of Project 2025, and what we're seeing is Project 2025 on steroids.

So you've got private venture people there, you have Doge, guys stealing our data all in an effort to undermine our social security system. Well, the line is that, oh no. They're not attacking social security itself, just fraud within it. Now, the bad faith is palpable, but what is your response to that notion that it's really just the fraud that's under attack.

Well, as, as you said, I wrote a book called The Truth About Social Security, and one of the zombie lies is one of the ones you mentioned, but they all say, oh, this private sector is so much more efficient and so much better, and blah, blah, blah. Actually, social security is extremely efficiently run. Less than about a half a penny of every dollar spent is spent on administration. The other more than 99 cents is back in benefits. That's so much.

More efficient than you find with 401k for private sector insurance. Or you can get 15, 20% administrative costs and hidden fees and so forth. And that's also with ipro payments, which not just fraud. There are a lot of. Overpayments Underpayments, which we've done because Congress has made it also difficult to administer and some of it's just impossible to avoid. But the 99.7%, 99.7% of Social Security benefits are paid accurately to the right people on time in full and about 0.3%.

And again, there's much more. Payments in the private sector, but at that 0.3%, the overwhelming amount of that are what are called improper payments, overpayments and underpayments. So for example, social security requires to get your benefit, you have to be, have been alive every day of the month before. Now I think that's wrong. I think you should get. Proportion of payments, but that's not how the law works.

So if you die on the last day of the month and you get your payment on the third day of the following month and the money is put in your account, that's an overpayment. Now, it doesn't just sit there as soon as the federal government realizes that the person that died the last day, they go in immediately, usually within a day or two and take that money back. But that. Mainly overpayments.

Underpayments fraud is vanishingly small, and the way that fraud is caught is first we have an Inspector General. Donald Trump fired the Social Security Administration, inspector General as soon as he got into office and frontline workers, and they've been. Firing and and inducing all kinds of workers out, who are the ones who would catch the fraud. So although they say they're going after fraud, waste, and abuse, they are creating. So much waste.

They are abusing the workforce and through that, the American people and they are opening the door to fraud. Unfortunately. Well, you know, I have seen, uh, leftists take issue with the. It's my money idea on Social Security because actually it's an intergenerational program. Now, choosing that as a point of emphasis in the current context is a choice that I have thoughts about. But do you see meaningful confusion about.

Whose money is at stake here and whether workers paying into it today are truly entitled to it. Here's where the confusion is. I don't think there's confusion on that point. I think most Americans, which is why the program is so wildly popular. Recognize that these are benefits they earned. It is deferred compensation you, it is part of your earnings, so you have your current cash compensation.

You have deferred compensation in the form of pensions, whether it's a pension sponsored by the employer or 401k, or a defined benefit plan, and US social security. You also have what are called contingent benefits, which are disability insurance survivors benefits. Those were all earned. What is the misunderstanding? And this is again, people like Elon Musk and others who are just spreading lies about this program, or, oh, there are all these.

Immigrants are the undocumented people are stealing our money. That is a lie. Those people who are undocumented are unable to receive Social Security and even when they be, if they become documented and can show that they have made contributions, they still don't. And I think this is wrong, but they still don't get the benefits they have earned, but. Americans are here paying in. It is an earned benefit.

And when Elon Musk and Donald Trump say, oh, there's fraud and we're gonna cut the benefits, they are cutting your benefits and people should keep hold of their wallets. More than half of the people who receive social security count on it to put groceries on the table and keep a roof over their heads. We're talking about people in their seventies, in their eighties, in their nineties, people who often have mobility challenges, people, people who struggle.

And what's happening right now at the Social Security office is they're saying in effect. Nobody really to answer the phones, so that means you gotta find somebody to get you down to a Social Security office. Oh, whoops. They closed that Social security office, so you gotta travel, what, two hours, three hours to be able to get to another Social Security office.

When you get there, we're hearing about lines that are 50 people long, with two people in the Social Security office to try to help answer questions. Office closes. Before people even have an opportunity to get up and ask their questions, and that is repeated over and over and understand this, social security is not charity. It's not some giveaway. It is something that people earned throughout.

All of their working years on a Promise from America that said, you pay into that system and then when you retire, you can count on those benefits solid. They will be there for you and instead. What Elon Musk and Donald Trump our co-presidents are doing right now is effectively cutting the benefits that people were promised. And they are making people suffer all across this country. It is wrong. Yeah. Well, maybe some of 'em should find a billionaire as a son-in-law and they can be fine.

Yeah. They won't have to worry about the check that would, that would help them out. Did you get any sense from uh, Mr. Bisignano today? That he would exert any independent control over this, that he would be responsive or do you see him as essentially a kind of doge stew Jaic. You know, look, we raised, I raised the question directly. I pointed out the places where if you make enough cuts in service, you have effectively cut the benefits.

And we all know you can't cut those social security benefits without coming right here to Congress. Right? Only Congress can cut the benefits, but you can backdoor cut them. And he admitted that. Yep. That is the law. And so cutting. For example, the number of people who work at the Social Security Administration can turn out to be effectively a cut in benefits. So I said, will you at least commit to rehiring the people who've been cut, get social security back up to the level?

At least where it was frankly, still wasn't enough, but at least where it was and. All we heard is blah, blah, blah. Think about it. But he did not make that commitment. And why? Because he is in league with Donald Trump and with Elon Musk to cut Social Security for millions of people across this country who depend on it. The millions of people who don't have a billionaire son-in-law. You know, one of the most unnerving stories we see in the first two months is the use of this agency.

To, to, as a sort of weaponized political tool against citizens. I wanna, I wanna just ask you about this, because there was this story in Maine mm-hmm. Where basically the Governor of Maine challenged the president on, uh, one of his executive orders. They had a kind of, you know, testy exchange in the White House.

And then subsequently Maine found out that the program that automatically enrolls your newborn in the hospital with a social security number had been terminated with no notice, and you now had to go with your newborn to an office to get that social security number. And it looked like it was a reprisal. And now we have confirmation.

The man who's running Social Security, Leland Eck, who's sort of the Doge officer there, said he had ordered the move to cancel this after watching Janet Mills means Democratic Governor Clash with Mr. Trump at the White House. I was ticked at the Governor of Maine for not being real cordial to the President, Mr. Eck said. Mm-hmm. Mm-hmm. And then he said that he owned it and he was, you know, he, he was sorry and he, he won't do it again. But I am astonished this happened.

And do you have any confidence it won't happen again? No, I do not have confidence. It won't happen again because it is the mindset of the Trump administration and that is that this government is to be run for a handful of billionaires and people with power and everyone else can just eat dirt. That is the view of the Trump administration. We're feeling it right now in the Social Security Administration, but we're feeling it everywhere.

That Elon Musk goes with his magic chainsaw to fire people, to do it in ugly ways, to undermine the kind of obligations that we have passed here in Congress, uh, to get rid of the consumer agency, to try to shut down the Department of Education, uh, and why it is all in service. To government that works better for the rich and the powerful.

This is all leading toward the Republicans, Elon Musk and Donald Trump, and the Republicans here in Congress who wanna push through a big tax giveaway that's gonna cause $4.7 billion, go mostly to billionaires and billionaire corporations, and they wanna pay for it on the backs. Of seniors on the backs of little kids, on the backs of people with disabilities, on the backs of veterans, on the backs of just hardworking people all across this country.

That is the ultimate battle, and this story at Social Security right now is just the most visible picture of what's going on. Martin O'Malley, uh, said a few weeks ago now, uh, or maybe a month or so that, that he was concerned that we might see the system actually collapse over, I think he said the next, uh, 90 days or so. Now, at the time he said that. Uh, Eric Kingston. I, I, I sort of sounded like hyperbole at the time. Mm-hmm.

But with more and more of these, you know, reported problems, should we in fact be worried that O'Malley was right about those warnings? That it could collapse? That checks might stop going out and, uh, you know, is that a real concern? I believe that is a concern. And what it is, what it involves is. That is Doge has been, and President Trump have been stripping social security of its expertise and historical memory. Mm-hmm. Uh, they've taken the, IT.

They've taken the folks who do it, who, which is the core of the structure of the system. Mm-hmm. They've moved most of them out, and they put in Doge people who have no understanding of social security for the most part. Beyond that. They've eliminated. All the offices that produce reports about how people are being affected by changes in social security, they just sent a memo out to every Social Security employee. Do not answer any inquiries from congressional offices, right or from reporters.

That's nuts. It's supposed to be a free country. Mm-hmm. They're trying to turn it some way, but, uh, it's, they're trying to control the information and you know, to some extent they're doing a good job by cutting off everything. Yeah. They've put people in charge of. Uh, changing, uh, the computer structure. Mm-hmm. And it's act, it has to be a disaster. Uh, Elon Musk has the hubris to say they can do it in three to five months.

I think most of the time, most people who've looked at it seriously have said it does need to be changed, but it has to be done over a five year period. Uh, yeah. And, and, and not by folks who don't know how to program COBOL as seems to be the case with these Doge Bros. Uh, and that yeah, that's an interesting story too, because SSA worked hard to get a top level COBOL person 'cause that's more or less people who started with COBOL a long time ago. But it's a very functional system still.

They work to get someone and one of the first people who was RIF. It was that expert in COBOL that they brought in. They, it's everything you listen to is horrible. They're moving people like that. If they can't fire them, they're moving them into claims offices, meaning. I say this claims is really, you know, a claim, a social security claims person. Mm-hmm. Is very important. Right. It also takes two to three years to train them.

You just don't throw someone into the job and you just don't get rid of all these folks 'cause you're in the middle of training them and you have to bring more people on. Uh, yeah. I mean, what they seem to be doing, even while you know, Donald Trump has claimed. For years, oh, he's not gonna touch Social Security. And yet they seem to be firing, uh, thousands of employees.

Uh, laying them off, moving them around as, as you suggest, you know, suggesting well, we're, we're, maybe we're cutting administrative. You know, work and services and so forth, but not actual benefits. Is there any reason to feel any better about that? Is there an actual line between, you know, benefits that people receive and the costs of, of running the program? I. I don't believe I'm, I'm sorry to say, and I feel really bad about this because I is just, what we're facing is so bad.

I don't believe anything they say, for the most part, when it comes to social security saying they're not gonna affect people, it's not gonna hurt them. Well, the. The slowdown in processing is gonna double the time people have to spend to get disability benefits if they're appealing. The system, right now it's about 230 days. It's probably gonna about double 400 plus days. Wow. Now, think about that. You become a disabled per worker. Mm-hmm.

You can't work, but you've gotta go through this process for a year and a half. And yet here's Mike Johnson house speaker Mike Johnson on, uh, mm-hmm. A Thursday after Republicans in the US House just voted to move forward with Trump's legislative agenda. These enormous cuts across the entire government to largely make way for enormous tax cuts for corporations. Mm-hmm. And the wealthy here was, uh, here was Mike Johnson. Today the president has made clear Social Security, Medicare, Medicaid.

We'll, we'll not, uh, take a hit. Will not take a hit. Professor, can you decode that for us? Yeah, I can. It's a boldface lie. They've already taken a hit. We pay for our social security bene for our, the administration of social security. We pay for that. But in spite of that, they've cut the administrative funding for social security over a fair number of years.

And now we're, you know, really moving into a very difficult area that affects the experience people have getting social security that's already affecting it. Last time around the president said, oh, we're not gonna touch Social Security. Uh, and then he started saying, well. People who get disability insurance aren't really social security beneficiaries or something. Mm. I'm afraid they're gonna go after the disability program.

Mm. Mercilessly lots of reviews, lots of bar barricades to continuing or getting benefits. They don't have, I don't think they have respect for citizens or people who have need, and they don't have respect for young people either. And what I'm gonna say there is. Not only are they cutting the social security of people like me who are in our seventies. Mm-hmm. Or not in cutting, but causing these problems. Right. But we have a huge crisis we ought to be looking at.

We have a lot of crises, I'm afraid. Yes. This is a kind we should be looking at, which is about half of today's workers. Uh, under 67 will not be able to maintain their standard of living in retirement if you count the cost of healthcare. Mm-hmm. It's prob in long-term care, it's probably about two thirds. That's a crisis that needs to be adjusted. And you, and what they're doing is stripping away the one thing you can count on Social security.

Yeah. Fortunately is not the only thing they seem to be stripping away. Here's, here's Elon Musk. This is, uh, last month, uh, talking about quote entitlements. So I, I guess he's talking not just about social security here, but maybe Medicare and Medicaid as well as the, as, as, as the best things that need to be, uh, slashed from the federal budget. Because most of the federal spending is entitlements. Um, so.

That, that's, that's like the big one to eliminate is that's the sort of half trillion, maybe six, 700 billion a year. To eliminate most of the federal government. Uh, the spending is, uh, entitlements. That's the big one to eliminate. And that's the guy, Elon Musk, uh, who is running all of this for the president of the United States. Yeah. And is lying constantly about people 150 years old getting benefits. I just about. Dishonesty in the system.

Uh, it's, you know, it's basically an attack on the, on the institution and it's gonna be, it's a very dangerous one because for them mm-hmm ultimately, I hope because broad, there's huge support across the country. It's independent of political party, uh, demographic, religion. Americans like love their social security. Yep. The data that we have tells us they don't want anything cut. They do wanna see the cap scrapped.

They also, if necessary, and if it would help increase some benefits, they would be willing to pay a little more money. Uh. Gradually increase the payroll contribution. They'd like to see the cost of living adjustment fixed. 'cause it's a little less than it would've cost people with disabilities in the old. They'd like to see people who've worked long and hard to get a benefit. That's at least the level of poverty from social security. And there are other things, caregiving.

They also wanna see family leave. These things can be done without causing i, a large financial problem at all. During the State of the Union address, he talked about, you know, how many people are over a hundred years old getting benefits? How many people over 200 years old are getting benefits? How many people over 300 years old are getting, these are all lies or wild exaggerations.

But the point was to say, just like they do with voting, by the way, oh, there's voter fraud out there, so let's make it harder to vote. Oh, there's social security out, uh, fraud out there, so let's make it harder for people to get on Social Security. It's really, I mean, this is a, this is an old strategy that Republicans have used forever. This is just the first time they've had the, the guts to actually do it right out in front of the public.

We've seen these death by a thousand paper cuts sort of thing, or you know, ever since the Reagan administration, the staffing at the Social Security Administration on a staff per payee basis or staff per budget basis or even an absolute numbers is lower now than it has been in 50 years. Because you know, every time there's a Republican in the White House and they submit a budget and it gets passed, it's got cuts to the Social Security Administration staffing in it.

And so far social security's been able to sort of keep up, although it does take like, I think it's 183 days on average to process a Social security disability claim. And they're saying now that's gonna be between two and four years. And keep in mind, Leland Dak, the guy who is in charge of social security, was like this low level dweeb in the Social Security Administration.

Who, who, uh, stove piped some information up to Elon Musk and his people about where in the Social Security Administration, he thought that you could find some fraud or some waste, and it was probably those two and 300 year old people who don't exist. Right. These, this was, this was, these are programming errors, got nothing to do with fraud or abuse or waste or anything like that. But this guy passed this information along to, to Elon that he could use to attack social Security.

And so they made him the director of the entire agency. He was just a low level dweeb, and now he's running the place. And what is he doing? Well, he just, he just laid off a whole bunch of employees and, uh, you know, he, he laid off 12% of the 57,000 workers at Social Security. And what is the result? Well, this is, this is from, uh, yesterday's Washington Post.

Or perhaps it's today's, it was published last night and I quote, the Social Security administration website crashed four times in 10 days this month blocking millions of retirees. I would add, by the way, we're only 25 days into the month, um, blocking millions of retirees and disabled Americans and logging into their online accounts because the servers were overloaded in the field.

Office managers have resorted to answering phones at the front desk as receptionists because so many employees have been pushed out. But the agency no longer has a system to monitor customers experience with these services because that office was eliminated as part of the cost cutting efforts led by Elon Musk.

The agency is engulfed in crisis according to internal documents in more than two dozen current and former agency employees and officials, they go on to say, for now, the agency's run by a caretaker leader in his sixth week on the job who has raced to push more than 12% of the staff out. Of the staff of 57,000 people, he has conceded that the agency's phone service quote sucks and acknowledged that Musk's US Doge service is really in charge of the Social Security Administration.

Senator Angus King, the independent, uh, senator from Maine said in an interview quote, what's going on is the destruction of the agency from the inside out and it's accelerating. He said, I have people approaching me all the time in their seventies and eighties, and they're beside themselves. They don't know what's coming. And then it goes on this again. This is the Washington Post.

Today, Leland Eck, the accidental leader, elevated to acting commissioner after he fed data to Musk's team behind his boss's backs, has issued rapid fire policy changes that have created chaos for frontline staff. AK has pushed out dozens of officials with years of expertise. Others have left and disgusted. The moves have upended an agency that has been underfunded for years. Calls have flooded into congressional offices.

The A A RP, the American Association, retired persons announced on Monday that more than 2000 retirees a week have called the organization since early February. Double the usual numbers with concerns about whether the benefits they paid for during their working careers will continue. Social Security, it turns out, is the primary source of income for about 40% of older Americans, and this is, this is the exact same strategy that they've been pursuing over at Medicare.

In 2003, George W. Bush pushed through legislation, the Medicare Reform Act or whatever it was called that that created, you know, the Medicare Part C had been on the books for a while. It was put on the books, I believe, during the Clinton administration as a neoliberal experiment. Let's, let's experiment with a private corporation offering some Medicare. Benefits, but it was George W. Bush in 2003 who really turned it into what we call Medicare Advantage today.

Gave it that name, allowed private insurance companies to use the word Medicare. And what did they do? Oh wow. We're not going to expand Medicare to include vision, even though your eyes are part of your body. We're not going to expand Medicare to include your dental, even though your teeth are part of your body and have a huge effect on your overall health. And we're not going to expand Medicare to include, uh, hearing, even though hearing is part of your health.

But we will allow Medicare Advantage plans to offer those three benefits. In other words, we're gonna break Medicare so that the Medicare Advantage private corporate for-profit option looks better. Well, that's what they're doing to Social Security right now. They're breaking social security.

And I, you know, I. I, first of all, I told you like three weeks ago, actually, I told you several years ago, but, but in particular, three weeks ago, two, three weeks ago that this was coming, they are going to quickly break Social Security. That's stage one, stage two.

That shoe has not dropped yet, but it will as predictably as the sun coming up tomorrow, and that is that in, in the House of Representatives you are going to see introduced as legislation probably sometime next week, legislation to, to offer private investment retirement plans to individuals as an alternative to social security, where the Republicans are gonna say, Hey, you know, young people, if you wanna opt outta Social Security, you don't have to pay in any longer.

You can pay into this program. It's run by Citibank or Wells Fargo or whoever gave us the largest campaign contribution this week. Or whoever took us on the best junket to, to Thailand. This, this is an organized plan. They, they did it with, they did it with Medicare.

More than half of Medicare recipients are now on these scam programs, the Medicare advantage scam that are run by private for-profit insurance companies, where suddenly people who thought they were on Medicare in many cases, you know, they, they, the doctor says, oh, you've gotta have an MRI. And they discover that no, the insurance company says, Nope, we're not gonna pay for you. You can't have an MRI.

80% of the, of the time that the for-profit insurance companies turn people down on Medicare Advantage.

If they protest, if they appeal the appeal overturns the original, no. In other words, this is just, you know, these, the Medicare Advantage is a scam for a bunch of insurance companies to make a huge, we're talking hundreds of billions of dollars a year in profits, which they then share to the, you know, with their shareholders and their, and their senior executives and the Republican politicians who made them rich.

And they want to, they desperately wanna do the same thing with social security. There's a lot more money in social security than there is in Medicare. And here it is from Emily Peck over at Axios this morning. The Social Security Administration is rushing cuts to phone services at the White House, requests some of the most vulnerable Americans, including people who are hospitalized, kids in foster homes, and those living in remote areas will face more hurdles applying for disability benefits.

Acting. Commissioner Leland Eck said the changes will be made in two weeks, although he said it would usually take two years to implement these kinds of changes. You get what's going on here? I mean this, this is, this is the deconstruction of the New Deal and the great society. They're going after those programs that Democrats put into place, the 1930s and the 1960s, they've already taken down a bunch of 'em. They want to take down all of them.

They literally wanna take us back to the 1920s and nobody's calling it out, which just blows my mind. Now entering section B general cuts. This wasn’t just in Washington, D.C., where thousands turned out. Thousands rallied in San Francisco and over two dozen cities around the country. Scientists, well, they described themselves, many of them, as “mad scientists.” That’s scientists who are really mad. [Emma] , talk about the organizing campaign and what’s at stake right now.

Yeah. So, I’m coming at it from a graduate student perspective, where I’m currently looking at what my thesis is going to look like over the next three years, and realizing that a lot of the ways that I’ve originally kind of thought about my science are being impacted by these current executive orders and budget cuts and kind of the censorship of science that’s happening right now.

And so, that, I think, is where a lot of people are coming at, is looking at what they’re doing and the impact it has on communities, and then looking at also how that’s being taken away right now. Emma, you’re a cancer researcher? I am. So, talk about the level of the cuts, whether we’re talking about NOAA, the climate scientists, people like Dr. Michael Mann, whether we’re talking about basic cancer research.

And also, how is this affecting your colleagues, older and also students, whether they can trust staying in basic science? Yeah, definitely. I think we’re seeing right now kind of a — orders saying, like, which words you can and can’t use in your grant proposals. And so, I am coming from a breast cancer perspective. I study breast cancer. I study women’s health.

And right now you’re not able to really put into proposals that you are studying women or females or looking at barriers or looking even at how race can influence cancer outcomes. You mean you can’t say words like “barrier” — Yes. — “race,” “women” in the grant proposals? No. That’s the current advice, is grants are getting flagged for having language that is containing those words. You know, it’s really interesting.

One of the beneficiaries of the National Institutes of Health may have an interesting father. Mother Jones is reporting that the Vought family, as in Russell Vought, the head of the OMB, but more significantly the — considered the architect of Project 2025, his daughter had cystic fibrosis. They credit a cystic fibrosis drug, Trifakta [sic] , for helping their daughter’s treatment. That research for [Trikafta] was funded by the National Institutes of Health.

Talk about the significance of basic research when it comes to — I even think about the child who President Trump honored in his congressional address, a young man, child, who has cancer, pediatric cancer. Yeah. So, the National Institutes of Health fund a lot of basic research that’s really critical in providing kind of the scaffold for these treatments later on.

And so, when we’re looking at cuts to the NIH, we’re looking both at cuts to the workforce and the opportunities available to scientists, but we’re also looking at kind of the impact long term of losing these basic science projects that really have the opportunity to drive cures for people like individuals with cystic fibrosis and cancer. And a lot of these, they’re not — it’s incremental steps over time, is how science works.

And so, the basic research, it might not seem immediately impactful all the time, but as you compound these findings over years and you have scientists continually working to find cures, things do happen, and we get to these treatments that are very transformative for the people with these diseases.

Health and Human Services Secretary Robert F. Kennedy Jr. recently announced that HHS would no longer allow public comments in the rulemaking process, ending a policy of a half a century to involve public opinion in HHS decisions. Your response? I think it’s very important to have the input of scientists and people who have personal interest in these topics.

I think their comments are really useful in making sure that our policies are informed by science and rooted in evidence and have the ability to really drive progress. I think when we have kind of a unilateral decision-making power, we’re maybe losing out on perspectives that are really critical and just making sure that science is able to help the people that need it most.

Emma, I also wanted to ask you about scientists around the world and warnings your institutions, whether we’re talking about universities or independent labs — in our next segment, we’re going to talk about a young former graduate student who has a green card, has just been taken by ICE. We’re not sure where he is. But the warning that was put out to people on visas around the world who work at — in your world, at scientific establishment in this country?

Yes. So, we had a lot of discussions leading up to the event on March 7th about how we could best include international scientists and not put a target on their back, because we know that there’s currently this order where visas can be canceled, and you can kind of face repercussions that you would not face as a citizen if you’re on a visa. And so, we wanted to make sure that there’s a way to productively engage.

But I think it became even more severe when we did have that post put out, where President Trump did allege that you, if you partook in an illegal protest, you could face significant repercussions to your visa. And so, I think that is harmful right now, because science is such an international endeavor. America is such a land of opportunity for young scientists.

It brings so many scientists over from other countries for training, that then go on and make significant impacts, both in the U.S. and in their home communities and worldwide. And so, we really want to make sure, as well, within Stand Up for Science, that we are speaking to the perspectives of international students and those who might not currently have a voice because of these orders. Where do you go next? Where is this rally that attracted thousands across the country?

That’s what we’re currently trying to figure out. And so, we are a group of early-career scientists. None of us have done significant political organizing in the past. And so, we’re kind of taking a step back and looking at what matters to people right now, what are the best places. We want to make sure that we’re taking into account all perspectives, because we are right now — this was something that was put together very quickly. It had impact. It has momentum.

And now how do we use that to really drive change Planned Parenthood is a health system that literally sits in the middle of the public health system and tries to strengthen it. Many patients that come to Planned Parenthood, we are the first point of entry into the healthcare system broadly.

And the fact that Governor McMaster would want to deny patients access to care, when, you know, many times we are the only safety net — the safety net of the safety net — there providing care, just seems completely bonkers to us, as well. And talk about what that care is. It goes way beyond abortion. Oh, of course it goes way beyond abortion. It is STI testing.

It is access to contraception, wellness exams, breast cancer screenings, gender-affirming care — everything that someone would need to live a full and free, sexually healthy life. And I think that, you know, again, in many cases, it is — there’s primary care being provided in Planned Parenthood health centers. It is just basic healthcare. And to have a state try to deny that is what this case is about, using levers like Medicaid.

Already South Carolina bans abortions after six weeks of pregnancy? Correct. Can you talk about Texas? In 2021, Texas terminated Planned Parenthood from its state Medicaid program. Talk about this precedent and also what it means if the conservative-majority Supreme Court rules in favor of South Carolina. Yes, so, you know, look, we have states that have taken various measures to attack Planned Parenthood and remove us from their state Medicaid system.

And the impact of that, again, is on the patients, right? This isn’t about Planned Parenthood. This is about whether or not the patients have the right to use their health insurance in order to get access to the care of their choice, of their choosing, from their provider. You know, what will happen if the Supreme Court decides to rule in favor of South Carolina is that more states will act like South Carolina and Texas.

Many of those states that have enacted the most restrictive abortion bans will very likely try to remove Planned Parenthood from its ability to — or, patients’ ability to use Medicaid to go to Planned Parenthood. So it could have very devastating consequence on the patients throughout those states and their ability to get high-quality care that we believe they deserve. And can you explain what the powerhouse Christian legal group Alliance Defending Freedom is?

This is the group that brought the case against Planned Parenthood in South Carolina. Yes. So, this is, you know, a group that — should be no surprise — was incorporated in Amarillo, Texas, so that anytime they can bring a lawsuit, they can go directly to Judge Kacsmaryk, who is the only federal judge in the Northern District of Texas, a very friendly anti-abortion judge that, you know, has clearly opened his court to these kinds of cases and supporting them.

We are before that court right now on a false claims case, a meritless case where not only has Texas kicked Planned Parenthood affiliates out of the Medicaid program there, they are also suing to recoup resources back to the state for all of the other services that have been provided, in a bogus lawsuit that is intended to try to bankrupt Planned Parenthood.

And I think that, you know, we are watching just a patchwork of very Christian nationalist and anti-abortion organizations work with this, you know, new structural advantage that they have, both with the administration as it currently stands, the Supreme Court, and the kind of patchwork of a judicial system that has been coopted by right-wing judges.

The Trump administration is withholding tens of millions of dollars from nine Planned Parenthood state affiliates that provide contraceptives and other vital reproductive care, predominantly to low-income and people of color. The providers received notices this week stating their Title X funding was being temporarily retained due to “possible violations,” they said, of

Trump’s policies against DEI — diversity, equity and inclusion. Health and Human Services has given the providers, which operate dozens of clinics nationwide, including in Indiana and Kentucky, 10 days to comply with Trump’s demands to eliminate DEI initiatives. In a letter, HHS pointed to mission statements and other public documents that highlight the clinics’ commitment to Black communities as supposed evidence of their noncompliance.

Alexis McGill Johnson, you’re the CEO of Planned Parenthood. Your response? I’m a CEO of Planned Parenthood. I am a Black woman. I am, you know, someone who cares deeply about reducing disparities in healthcare in communities, as we all should. I can’t think of any American who would believe that the color of your skin should dictate what kind of care you get. And that is what Planned Parenthood stands for.

No matter who you are, no matter where you live, no matter what your ZIP code is, no matter how you identify, no matter your documentation status, we are there to serve you and ensure that you get high-quality, time-sensitive care. And so, I think about the work that Planned Parenthood providers do every day, the way they have been able to leverage a critically important, long-standing program like Title X to fund access to contraception and support communities.

And the idea that the Trump administration would take those resources away, to suspend those resources because Planned Parenthood is committed to improving health outcomes in community, that is essentially what they are saying.

What they are not saying is that this is, you know, just another one of the dozens of attacks that Planned Parenthood is facing, as people who want to use any means that they have to deny access and resources to Planned Parenthood because they are trying to advance their anti-abortion agenda. So, are you sticking with DEI at these clinics, or the clinics? You know, each affiliate is going to make their decisions about how they enact improvements to health outcomes. But at our core — right?

— at our core, reducing disparities, health disparities, in community is what we do. And I think that’s really important for us to move away from, you know, just these trigger words like ”DEI” and actually talk about what those words mean and what they mean in practice for community — right?

— ensuring we have representation of everyone, so that we have people who speak the same languages as our patients, so that we can give them the best care, that we have an ability to improve outcomes and ensure that people are getting the right resources to do so, and that, you know, everyone is actually seen — not just seen by a doctor, but literally seen for who they are and what they want. That is what I have in my healthcare system I go to.

I know when I walk into my provider, they know who I am. They are able to see me and understand my particular needs. And I think everyone in America deserves that. And I can’t imagine that this administration would be very popular in trying to deny other Americans that same right. And finally, we just have a minute, but with Planned Parenthood under assault, you have also had a lot of victories.

Among them, in Wisconsin, Judge Susan Crawford, who once represented Planned Parenthood as an attorney, trounced Brad Schimel, the judge who was funded by, among others, the richest man in the world, Elon Musk. The significance of this, and other victories that you consider so important at this very fraught time?

Oh, Wisconsin was such a shot in the arm, I think, for this movement, for so many movements, because I think what it shows is that the good people of Wisconsin, the good people of America do not want to be bought. They want to do what is right. They want the ability to make decisions, to continue to vote for freedom and to ensure that their representation reflects that in their state.

And I think, you know, all of us looking to Wisconsin have a lot of hope about what is possible right now as we fight back with this administration. You know, I also think — I mean, and the practical implications of that, right? We have a state that has voted in support of reproductive freedom, and to have a state Supreme Court to affirm that is going to be really important.

It’s also going to be really important as we approach, you know, in five years, the year 2030 and we hit a redistricting year, and so that we’re able to kind of start to fight back structurally in the space that we are in. I’d also point you to Missouri, Amy. The people of Missouri voted to enshrine — to actually flip a ban, abortion ban, in November.

And it’s only been within the last month that the Missouri clinics have been able to provide access to abortion, because even when you win, you still have to defend it with the state AG and the statehouse, that may not be favorable. So, that is the work that we have to be reminded of, that even when we win, we have to defend those wins fiercely and remind — remind these electeds what we want and who we are and how powerful we will be to ensure that we get to maintain our freedoms.

CDC historically has also been a, a training ground to train future epidemiologists, future scientists, future leaders in public health. The IS would program would be an example of that, but many of the public health staff and leaders in state and local health departments around the country have on their resume having worked at CD, C and EIS. Let's talk about what's been happening recently. Can you give us an overview? Sure. It's difficult to, to give an overview view because it's complicated.

But with the new administration first, about a month ago, uh, it was a broad restructuring firing of staff at CDC, mostly younger staff, for example, in training programs like I was talking about. But acutely on April 1st. In addition, HHS took a very serious step of announcing about 2,400 positions lost at CDC across the breadth of the agency.

Most people think of CDC as an agency that works in infectious diseases, and it does, but CDC is actually the nation's public health department and so has. Longstanding programs and chronic diseases and environmental health issues and birth defects, disabilities, and it's really in that part of CDC, that non-infectious part that apparently most of these reductions were made, although built as efficiency gains.

It's very difficult to, to understand that because essentially entire programs, including the scientists, the laboratorians were eliminated. It's frustrating and I'm. Um, difficult to talk about the specifics because this has also been done unfortunately, with a bit of secrecy, and so there's been no official list public by HHS of the exact positions that have been eliminated. And instead that's had to be compiled mainly by those individuals who were affected, who have spoke it up.

And so some of what you and I are gonna have to deal with today is not knowing with precision. All of the information we'd like to know. What do we know about people and programs that have been cut at at this point? Like what is clear? So it, it does seem like CDC is divided into what are called centers. That's the subdivisions of CDC. It does seem like about 75% of the centers have been profoundly affected by this with a somewhat. On its face, random dissolution of programs.

For example, in the Environmental health center, the lead poisoning programs that respond to lead crises around the country seem to have eliminated. The asthma program has been eliminated. The. Workers that investigate cruise ship outbreaks have been eliminated. Another part of CDC is called niosh. It's the National Institute Institute for Occupational Safety and Health, dealing with worker safety issues.

Almost all of that appears to have been eliminated except for one congressionally mandated piece that deals with the World Trade Center, a huge loss, tobacco, uh. Leading cause of chronic disease death in this country. The tobacco part of CDC, the Office for Smoking and Health seems to have been eliminated. The sexually transmitted disease Labor laboratory at CDC that is unique in its ability to identify new sexually transmitted disease pathogens.

Those laboratories have been fired a fair amount of HIV. Appears to have been eliminated the HIV prevention programs, both domestically and globally, as well as, uh, apparently much of the work that goes on with HIV surveillance, tracking the HIV epidemic around the country, oral health programs, a fair amount of birth defects and disability. Let me go on though to say that beyond just these reductions in personnel, I think one of the things that's most frightening to me is that.

Much of the leadership of CDC that was present two weeks ago is no longer there. When you start going through the different centers, even though centers have not been eliminated, the center directors have been told they need to resign or be. Reallocated to the Indian Health Service in Alaska or somewhere. So that applies to the center directors for the HIV, tb, STD, and Viral Center for the Chronic Disease Prevention Center for our CDC D'S Global Health Center. Those are all gone.

The NIOSH Center director has been asked to lead the, the director for the Center for Forecasting, analy Analytics has been asked to leave. The Birth Defects Center director has been asked to leave, and that's on top of. Resignations that occurred in the week before this happened, including the center director that governs all the infrastructure monies that go out to state and local health departments. The principal deputy at CDC resigned.

The injury and Environmental center directors are still there, but their centers have been devastated by this, and so their ability to lead is much more diminished. In addition to the center directors, the immediate office of the director that essentially provides the leadership for CD. C has also had. Most of its leaders leave, including the leader for the Office of Communications. Communication activities had now been centralized at HHS.

The Chief operating Officer has left the head of the Office of Equity, has left the Office of Program Planning and Evaluation Director resigned. The Office of Science Director resigned. The Washington DC office of CDC Director was asked to leave Freedom of Information Act. Alito was asked to leave. I could go on, but I, I. Making the point that this is really almost a decapitation of leadership at CDC that has accompanied these reductions.

That's a really important point because I know we see these big numbers of, of layoffs, which in and of themselves are shocking, but to know that so many of them layoffs, resignations, people being asked to leave are in leadership positions is really crippling for an organization of this size. I mean, having worked with them for so long, what can you tell us about the, the expertise that's now been lost? Well, it's, it's irreplaceable.

The expertise that, that's lost and I'm not sure I understand the reasoning behind this, but absolutely no warning was given to leadership that this was about to happen, and leaders were asked to leave within 24 hours of being no notified, and so there was no opportunity for planning.

I. For continuity of operations for the agency to say, with these drastic leadership departures, what is it that we need to be doing to make sure that we can continue to do, to do our jobs, that that opportunity is gone as well as the expertise that could have informed how CDC could best manage these reductions. So it's a crisis. It's a crisis in the agency right now. Let's talk a little more broadly.

You know, you mentioned before that the CDC C'S core mission is, you know, infectious disease surveillance and, and, and some of the, some of what has been talked about is that the CDC is returning to its mission. That was in some of the communication that went out. Where does that fall in all of this? Yeah, I, I, I, um, respectfully would, would. Disagree with your notion that C'S core mission is infectious disease control. That's how CDC was founded back in the 1940s.

But the CDC today, the CDC stands for centers, plural for disease prevention and control, and much if not most of what CDC does that's most important to the American public is not in infectious disease outbreak identification. Instead, it's work across the range of those conditions that are causing the most preventable death and disability in this country. Infectious disease is certainly important. That's how CDC tends to get in the news.

But most of what they do is quietly working with state and local health departments and universities around the country attacking the leading causes of death and. Chronic diseases, tobacco, obesity in environmental issues like lead poisoning and asthma and birth defects and disability and injury and violence prevention. That's really the value add that CDC has. I'm not trying to say the infectious disease part isn't important.

It is, but equally, if not more important is the rest of what CDC does, and that's been most affected by these reductions. What are you most concerned about? Well, this is really the worst damage that has been done to public health in this country since I've been working, and I worry most about two things. Number one, I. Unless reinstated, it's irretrievable. And so we are facing a crisis not only today, but indefinitely into the future.

And many of the effects are gonna take time for their effects are known. It's gonna take a while for smoking rates to start going up or for blood poisoning to start affecting kids again. But that is coming and I'm concerned about that. Second, and equally important in my mind, you know. Public health in this country is a joint federal, state, local responsibility.

But I don't think that most people realize that over three quarters of CDC D'S budget goes out to state and local health departments all around the country to universities, to community-based organizations. And so this is not just a. Problem for a federal agency. Instead, it's a problem for our public health system and for the ability of health departments to serve every community in our country to operate effectively and and to do what it is that people expect them to do.

With all that's happening right now, with all the changes that are happening, it's difficult to get attention to any particular issue. I would just, you know.

Request that those people who are con concerned about public health, who are listening audience, for example, um, to speak up on this, to, to, to let our leaders know what they think, in particular, to express concern about really the future of the public health system in this country that's been and is going to be profoundly affected by what we're seeing happening right now.

I just wanna play a little bit for all of you of one of the many things that President Trump has said about the massive reduction in the federal workforce. It's part of a push, he says, towards improved government efficiency. We have to make our government smaller, more efficient, more effective, and a lot less expensive.

This is the constant line that the president, that Elon Musk, that everyone associated with this really large reduction in force is giving, that the federal government is bloated, the size of the workforce is too large. It can get the same work done faster and more efficiently with fewer people. Emily, do you have a retort to that? Oh yes. I would say this, all of these ways of attacks of firing civilians and federal employees are not going to make the government cheaper in the long run.

I would say. Why? One aspect of the DRP is that position really ceases to exist, but what doesn't change is the size of our mission and the work that we need to accomplish every day. So I wouldn't be surprised if they could possibly need to hire an outside contractor, which would be a lot more expensive than what we could have done as an in-house civilian. Okay. Arielle, same question for you. CMS is huge, right?

Aside from the Department of Defense, Health and Human Services is the largest expense, essentially, other than social security, that the federal government has. Arguably there's room for squeezing some efficiencies out. What do you think? Medicare and Medicaid are already very efficient programs. Overhead in the private insurance market is 15% to 20% of administrative costs for running a health care program. In the public sector it's around 2%.

So you can already see that we are much more efficient than the private sector. There are ways to make things more efficient. But it's not through blanket, untargeted firings. First of all, I have now been paid for six weeks that I haven't done any work, because of how they fired me. So that's not efficient. Secondly, they didn't give us time to do any sorts of handoffs.

So I was working, and I had no opportunity to pass off the work that I was doing or the emails that were threads that were in my inbox to anyone else, before I lost access to my computer. So that's not efficient. When I was working on a program that was intended to improve efficiency in Medicaid and improve outcomes, I know that Donald Trump and Elon Musk don't like to hear this, but to change public policy and to make it work better, takes time and evidence.

You don't want to just do across the board changes that you think might work. You want to make sure that a policy idea does have the results it's intended to have. And so that takes time and expertise. And then once you know whether or not it's effective, you scale it, or you end it, if it's not effective. And in these large unconsidered cuts, we aren't doing things in a way to make them more efficient.

Passing legislation to reform the government to maybe get rid of some onerous, outdated reporting requirements or whatever. That takes time. You have to change the law to do that, and they aren't doing the hard work that requires. So I just don't think that what they're doing will make anything work better. I want to lean on your experience in the private sector before you came to work for the federal government.

Because a lot of people look at what the three of you described about, the sudden notice, the immediately getting cut off from IT systems, et cetera. And they say, I've been through that a bunch of times working for corporate America. That's just how it works. You get walked into a room, if you're lucky and someone says, Nope, you are surplus to requirements, now you are being downsized, and they just walk you straight out of the building.

So I think folks may come to this conversation with perhaps not that much sympathy on that front, just saying, federal employees have been insulated from the realities of the private sector for a long time. And, welcome to our world. Yeah, I get that maybe that's the expectation. I do think that I have two responses to that.

I was working in public service, and the idea is that you're not working on behalf of a company's bottom line, but instead you're working on behalf of the American people to serve them. There's like this social contract that's in place, is that in exchange for less money and less flexibility, you have stability. People make that trade off every day, because they value serving the American people.

But when you erode that contract, or that social understanding that we've long had, between the tradeoffs of working for the federal government and the tradeoffs of working in the private sector. Why would anyone want to go work for the federal government? Because we already know that the opportunities are more lucrative. Yes. Maybe more risky, but more lucrative in the private sector.

And I just worry that in the way that they're handling this, no one in their right mind would go work for the federal government, and that is a loss to the American people, not to me. Yeah. Yeah. Point well taken. Because one of the things that has long been thought about is that you want the best people to be able to do the kind of complex enacting, the kind of complex policy that the federal government is charged with doing. Now, LG, let me just be blunt here.

Because again, I'm trying to reflect on what listeners may be thinking. Why would the Office of Personnel and Management even need an office of communications? Like what does that actually have to do with serving the American people? Yeah, I can understand on one hand where that might be coming from, but the Office of Communications does a lot to make sure that the American people, the press, other agencies, other stakeholders know what our agency is doing.

Our agency dealt with workforce policy for the federal workforce, and that can be hard to understand. OPM is essentially the HR arm of the federal government, so we worked with concepts and products like health care retirement, and anyone who has worked in health care or retirement, or employment and performance management, that can be complex.

So we did a lot of work to translate that really complex policy and those complex actions to people, so they understood what their government was doing for them. In addition, when we would have questions from press, public, anyone who wanted to reach out to our agency to get more information, it was our responsibility to respond or make sure that we were working with the various subject matter experts to get that information and be able to translate that for folks, so they know what's going on.

In addition, we had folks who worked to make things accessible. So folks with disabilities who may not be able to just listen to a radio show, go online to read the latest memo, or the latest policy. My team worked to make those accessible so that people with disabilities would be able to have the same access to this really incredible and important information. The Department of Health and Human Services on Thursday announced that it plans to lay off 10,000 employees.

As part of a major restructuring plan and shut down entire agencies within HHS, including ones that oversee billions of dollars in funds for addiction services and community health centers across the country cuts at those agencies like the Food and Drug Administrations Centers for Centers for Disease Control, national Institutes of Health. And the centers of Medicare and Medicaid services will result in a cut of some 20,000 federal jobs at the agency.

The Department of Defense has already cut more than 17,000 probationary employees, though a federal judge has ordered that. It was done unlawfully by the Trump administration and its. Elon Musk Dobros and has ordered the Pentagon to restore those jobs. The administration has said that the IRS will see layoffs of as many as 6,700 workers likely to severely impact the amount of revenue that the federal government will bring in. But few other, if any federal agencies are facing as many job cuts.

As the Department of Veterans Affairs at the beginning of March, according to an internal VA memo, the new leadership under Donald Trump said that it was planning a reorganization that includes cutting over 80,000 jobs. From the agency that provides healthcare and other services for millions of American veterans, the memo instructs top level staff to prepare for an agency-wide reorganization this August to quote, resize and tailor the workforce to the mission.

Revised structure, whatever that means. It also calls for agency officials to work with White House's Department of Government Efficiency or Doge, to move aggressively while taking a pragmatic and disciplined approach. To the Trump administration's goals, quote, things need to change, said Trump's Veterans Affairs Secretary, Doug Collins, in a recent video posted on social media, adding that the layoffs would not mean cuts to veterans healthcare or benefits.

Well, that seems like a lot of layoffs. Is it possible they would not result in loss of care or benefits to veterans? This administration is finally going to give the veterans what they want. Collins said in the video, president Trump has a mandate for generational change in Washington, and that's exactly what we're going to deliver in the va. He said, veterans have already been speaking out against the cuts at the va, where more than 25% of the VA's workforce is comprised of veterans.

But from layoffs at the Department of Veterans Affairs to a Pentagon Purge of archives that documented diversity in the military, veterans have been acutely affected by Trump's actions, AP Reports this week.

With the Republican president determined to continue slashing the federal government, the burden will only grow on veterans who make up roughly 30% of the over 2 million civilians who work for the federal government overall, and often tap government benefits that they earned with their military service. Quote, at a moment of crisis for all of our veterans. The VA's system of healthcare and benefits has been disastrously and disgracefully.

Put on the chopping block by the Trump administration said Senator Richard Blumenthal, the top Democrat on the Senate Veterans Affairs Committee. At a news conference last week, Blumenthal announced a series of so-called shadow hearings by Senate Democrats. To spotlight how veterans are being impacted by all of this. Veterans are outraged. Said Senator Tammy Duckworth, an Illinois Democrat who's an Iraq

veteran and former assistant secretary at the va. Quote, they said Donald Trump promised to watch out for them. The first thing he does is fire them. In fact, nearly six in 10 veterans voted for Donald Trump last year according to AP Vote Cast. Yet congressional Republicans are standing in support of Trump's goals, even as they encounter fierce pushback, including from many veterans. In their home districts, quote, they've cut a lot, but understand this essential jobs are not being cut.

Said Congressman Ma. Mike Bost, the Republican chair of the House Veterans Affairs Committee during a tele-town hall last week, noting that he is working directly with the VA's secretary. Uh, Doug Collins. We're all kind of wondering what's next said dan Foster, a Washington State Army vet who lost his job when the VA canceled a contract, supporting a program that educates service members on how to access their benefits and VA programs.

Others are angry that they have been portrayed as dead weight and cut from jobs that they felt played a direct role in helping veterans get healthcare. Democrats are already pressing their Republican colleagues to show their support for veterans in negotiations to allow passage of a Republican government funding bill. Earlier this month, Democrats secured a vote to amend the package to include language that would protect veterans from the federal layoffs.

That amendment failed on party lines with Republicans voting against protecting veterans. Democratic Senator Ruben Gallego of Arizona, who is also a veteran, said he was unsure whether veterans would shift their political allegiance or not, but he said it is at least clear veterans are quote pissed. Last week, the nation's largest progressive veterans nonprofit organization, vote Vets launched a multi-platform six figure ad campaign targeting house districts.

Around the country before next year's midterm elections, calling out Republican veteran members of Congress for being complicit and dodging their constituents. As Elon Musk's Doge fires veterans across the country, the ads according to the group will target Republican Congress members. Don Bacon in Nebraska, Jennifer Kiggins in Virginia, John James in Michigan, Scott Perry in Pennsylvania, and Zach Nunn in Iowa.

The campaign includes billboards calling out the representatives for supporting Musk and the Doge Bros for slashing thousands of veteran jobs and. It also includes 62nd video ads to run in those members, districts like this one featuring a group of veterans sitting in a circle and telling their stories of being downsized by Elon Musk. I was at Barnes and Nobles with my two children, four and 10, and my husband. And I received a text from my coworker and he said, have you seen the email?

I I, I served in the military for over 33 years, just accepted a new position in the va. Come into the office. Fire up my computer and I come back and there's an email sitting there for me. I knew then. I knew what was coming. I have not had a single negative performance review in my 10 years. It feels like veterans are being personally attacked by Elon Musk. I did not put my life on the line for some tech bro, billionaire from South Africa to come in here and try to destroy our country.

We are gonna bear a lot of this. A lot of this costs with rising cost inflation. I'm literally donating plasma to buy eggs and our Congress person does absolutely nothing. Stop Elon's War on Veterans. Now. And finally, section C, Medicaid and Health and Human Services. Robert F. Kennedy Jr. Of the Kennedy Empire is our newest United States Secretary of Health and Human Services. He's a Nepo baby. He's an anti-vax activist and a self-proclaimed brain worm landlord.

So naturally, I'm sure a person like him hasn't said anything worrying. Right. Every black kid is now just standard put on Adderall, SSRIs, benzos, which are known to induce violence. Not true, and those kids are going to have a chance to go somewhere to get reparented to live in a community where there'll be no cell phones, no screens. You'll actually have to talk to people. All right? A lot to unpack here. First of all. No, both parts of that sentence are lies and not based in fact or science.

Second of all, whenever white people talk about re-parenting or sending children of other races away from their parents to be reeducated. This should raise some red flags. I know we all feel inextricably bound to the hellish influence of technology in our lives, but gathering all of the black kids, taking them away from their parents, where God knows what is going to happen to them, where they will have no contact with the outside world, doesn't really seem like the best immediate solution.

In addition, this suggestion for black children on these medications which were prescribed by doctors mind you being sent away to be reparented, uh, away from their families. Sounds eerily familiar to people who know anything about US History Residential schools in the United States were boarding schools designed to forcibly assimilate indigenous children into Euro-American culture, beginning in the early 19th century and continuing through the late 19th and early 20th centuries.

These schools operated under the motto, kill the Indian, save the Man. And the idea that by removing indigenous children from their communities, they would be healed from their quote Savage ways. The US government and religious organizations collaborated to remove native children from their families, prohibiting them from speaking their native languages.

Practicing their traditions or maintaining connections to those communities cut off not only from their families and their culture, but also the outside world. By the 20th century, attendance at these schools was often mandatory and indigenous families who resisted risked imprisonment. Many of these schools remained operational into the late 20th century with some persisting into the 1980s and the devastating effects of which still impact indigenous communities today.

It's amazing that we still exist as Native American people. That was not the intent. You know, the intent was to. To destroy us as native people. Generations of Native Americans lost their language, their culture, and their spiritual practices. Survivors of these schools often struggled with PTSD, depression and substance abuse, contributing to cycles of poverty, addiction, and mental illness.

And the role of the US government and Christian organizations in the abuse of these indigenous children has led to deep distrust in these organizations. Understandably, and some of you out there might be saying, well, that's not what RFK said he was gonna do. We're gonna be frolicking in fields and picking our own fruit. Yeah. I don't give a fuck what his intentions are. The road to hell was paved with good intentions.

Mama, when you are talking about taking kids away from their parents for quote. Re-parenting, you are taking away that child's cultural upbringing. You're taking them away from their community. And if the point is to take away their phones as well, how are these children supposed to defend themselves from any abuse that might take place? They can't take videos, they can't document anything.

And their kids, how are they supposed to hold adults accountable if there's no one there to vouch for them? And like, I mean, I hate to say the obvious, but why is he specifically targeting like black children? I wonder. First of all, black children are not the only children that are prescribed these medications by doctors.

Um, again, there's nothing wrong with your child being prescribed Adderall if that's what they need, but that's also like not the only section of children being prescribed these medications. Like he's just saying the quiet part out loud. But uh, shocker. That isn't the only worrying position that the current health Secretary has about black people. Let's bring back that quote from earlier.

Now we know that, you know, we should not be giving black people the same vaccine schedule that's given to whites because their immune system is better than ours. This was brought up during his hearing before the Senate confirmed him and he defended it. He defended this position saying it's science. What different vaccine schedule would you say I should have received? I mean, the, the, the Pollina article suggests. That blacks need fewer antigens, uh, than this is so dangerous.

So you get the same measles vaccine, Mr. Kennedy, with all due respect, that is so dangerous. Your voice would be a voice that parents would listen to. That is so dangerous. I will be voting against your nomination because your. Views are dangerous to our state and to our country. I mean, do you think science is dangerous senator? But believe it or not, by saying it's science doesn't actually make it science.

And this is why you should always check your fucking facts because the scientist that ran this fucking study and published the paper. That he pulled this supposed scientific fact from, basically said that RFK doesn't know what the fuck he's talking about. Other experts say Kennedy's response to Also, Brooks was based on a Mayo clinic study that examined racial differences in the immune response to vaccinations.

But the study's author, Dr. Richard Kennedy, who is not related to the nominee, told NPR that the data doesn't support changing the vaccine schedule based on race doing so he said would be twisting the data far beyond what they actually demonstrate. Guys, grandpa got out again, and if you haven't discovered this yet, the reason why this is so worrying is because this was the eugenics movement in the United States. Again, not too long ago.

The eugenics movement was a dark chapter in public health and social policy, and it has slowly started to creep back into the public sphere. For those that don't know, eugenics is the belief in improving the genetic quality of human populations through things like selective breeding and social interventions.

So this involves the cheeky little practice of getting rid of all the people with disabilities or mental illnesses or people that are poor or have quote, undesirable traits, which just so happened to be all the traits of people of color and Jewish people at the time. Huh? I, I, I wonder why eugenics is like racism and ableism and classism had a. Fucked up little baby.

And this movement was popularized right before the Nazi rise to power and was later used as a tool for the Nazi regime, not only in establishing their racial policies and promoting a quote perfect Aryan race, but also included limiting medical access and vaccines to the groups they wanted to exterminate. Since Joe Biden issued a sweeping vaccine mandate last week, right wing media and politicians wasted no time in deploying the Nazi comparisons, calling the move fascist.

Totalitarian authoritarian and involving swastikas and the Nuremberg Code, there's only one problem. The Nazis didn't actually issue a vaccine mandate. In fact, Republicans would've found much to like in the third reichs vaccine policies, which was very much in line with their current recommendations. Above all it relaxed requirements for compulsory vaccination that had been in place in Germany for decades at that point, and went with a voluntary approach.

Instead, we even have records of private discussions of Adolf Hitler and his Nazi colleagues clearly showing that. Far from viewing vaccine mandates as the key to their genocidal goals. The opposite was the case. They knew that withholding compulsory vaccination and other German public health innovations would help kill more of the undesirable, inferior people who they wanted to rid from the world.

And I think the important thing to remember here is it doesn't matter what RFK says when he's enacting policies and stirring up vaccine speculation and anti-VAX rhetoric. These are the results that occur. Low income communities, communities with less education, these are the ones that are going to suffer due to anti-vax rhetoric. Long-term, this has been his goal. Limiting vaccine accessibility has been his goal. He literally gets paid. Millions of dollars to aid an anti-VAX rhetoric.

He is making bank off of people suffering and dying when they don't get vaccines. Okay? First and foremost, vaccine skepticism is already higher in communities of color than it is in white communities, and part of that is because historically the systems of government have not protected people of color in the same way they've protected white people. In fact, there's a long history of.

Systemic and medical violence that has occurred against these communities, including things like forced sterilization. We've also seen things written into textbooks claiming that black people have a higher pain tolerance leading to black patients enduring unnecessary pain or being experimented on. So we already know what he wants to do with black children, but RFKs, radically regressive ideas don't stop there.

He wants people with drug addictions to go to labor camps disguised as what he is calling. Wellness camps. Now, some of you out there might not have any compassion for drug addicts, and we would have disagreements about that, but you might be surprised to know what RFK Junior actually qualifies as drug addicts. RFK considers anyone who takes medication for anxiety, depression, A-D-H-D-B-P-D, schizophrenia, and any psychiatric condition. A drug addict.

So basically, if you take any regular medication prescribed by your doctor for a diagnosed psychiatric condition, that makes your otherwise difficult life easier to manage. Sorry, you're a drug addict also. This is a quick reminder. In here that RFK is, uh, not a doctor and not certified in any capacity in the health field.

In fact, he's been called out by doctors, psychologists, sociologists, and other medical and health professionals for not only being full of shit, but for actively spreading misinformation and direct. Harming communities because of it. And while that he said that he doesn't plan on forcing people to go to these camps, he's part of an administration that also said they were only going to deport criminal offenders, and they're now going after permanent residents and US citizens.

So pardon me if I don't fucking believe you. Health care policy is notoriously complicated. So to start this all off, can you give me a very quick primer on Medicaid? Who does it cover? How do you qualify and who pays for it? So Medicaid is a major health insurance program in the United States. It covers about 80 million people. It is jointly paid for by the federal government and the states. And the way you qualify is by falling into a certain category.

So Medicaid is a little different from Medicare. Medicare is the program for seniors. You qualify by being over 65. Medicaid, you have to have some kind of eligibility criteria? So you’re under a certain income, you have a disability, you are a kid under a different income threshold. You’re pregnant. There’s all these different eligibility categories. They vary a little bit state to state. They’ve changed a lot over the past decade.

But basically you have to have some kind of need that the government has decided, yes, we’re going to have these people qualify for the Medicaid program. So it’s not just poor people, right? I think that that’s kind of the assumption, but it’s such a bigger program than that. Yeah. And it’s especially grown over the past decade since Obamacare. One of the big things Obamacare did is it expanded Medicaid to cover anyone under a certain income. The very wonky threshold is 138% of the poverty line.

I think that hovers around like 17, $18,000 a year for an individual person at this moment. And it also covers a lot of things. You might not expect, nursing care. Some people might be surprised to know that Medicare, the program for the elderly, actually doesn’t cover much nursing care. So a lot of people end up having their nursing care paid for through Medicaid. It covers children up to about four times the poverty line, so that’s definitely getting into middle class.

It’s a really reaching program that’s, you know, covering one in five Americans right now. And Medicaid has also been a political target of Republicans for decades. Why? Yeah. You know, there’s a number of arguments right now. And the ones I’ve heard kind of reporting in areas that supported Donald Trump heavily is, you know, a frustration with government dependance. The idea that people didn’t work for their benefits.

You know, in the United States, we have a health insurance system where typically you get your health coverage at work. So I do hear this argument in kind of Republican circles about, you know, these people aren’t working. Why should they be getting this coverage and that they’re just kind of relying on a government handout? Versus doing the work they should be doing to get a health insurance plan. Yes. Those babies got to get them in the mines.

Yeah. I mean, one thing I would even add about the adults on Medicaid, the vast majority of them are working already. Right. They’re working. But, you know, maybe they’re a rideshare driver. Maybe they’re at a low wage job. They’re working, but they’re not earning enough, and they’re not getting offered health insurance at work, which is how they ended up on, you know, a government program.

Right. And yet, even as Republicans have vilified Medicaid, as you mentioned, as a handout as welfare, they’ve failed to make the kind of drastic spending cuts to the program they say they want. Why? They’re in a tricky spot. I mean, you see this this kind of fracture right now between Republican rhetoric and what they’re actually proposing. So there’s definitely in the House budget, they’re aiming to cut roughly $880 billion in cuts over a decade.

That works out to about 10% of all federal Medicaid spending. But there’s also this kind of hesitance among Republicans because they know so many of their voters rely on these programs. You’ve had Steve Bannon out there saying, don’t touch Medicaid. You’ve got, you know, Josh Hawley, someone who’s not known for his liberal politics, saying, don’t touch Medicaid. And I think it boils down to the fact it’s really hard to claw back benefits.

We absolutely saw this during the Obamacare repeal debate. Once people are using a program and it turns out Medicaid is actually very well liked, the people on Medicaid give it very, very favorable remarks. That makes it really tough for legislators to, you know, just take 10% of the spending away on a program like that. Yeah. Let’s let’s get into the budget. How are they looking to get those major savings from Medicaid? Yeah, I mean, that’s a wonderful question.

And I would like better answers to. All we have right now is kind of a list of proposals they’re thinking about. One of the ones I’m pretty sure you’re going to see pass this Congress is a work requirement, basically requiring people on Medicaid to file paperwork showing that they’re working, or that they’re looking for a job in order to earn benefits. But you mentioned that most people on Medicaid are working. So it feels like that’s not going to get you to 880 billion.

That just is a thing that sounds good. Well it’s well it definitely doesn’t get you to 800. It does get you to about 100 billion. We’ll get, you know, the small share of people who are not working might no longer have Medicaid, but there’s also just going to be some natural attrition, right? When you put up more things you have to do and forms you have to fill out, you’re going to see people fall off of Medicaid.

When you’re looking for those big cuts, like when you really need to get 880 billion out of the program. There’s kind of two that jump out at me as the ones that would get you there. One that’s really floating around. We’re working on a story about it right now is dialing back the funding for Medicaid expansion. This is part of Obamacare that expanded Medicaid well beyond the populations, you know, traditionally covered.

People who are disabled, who are pregnant, children in low income households to anyone who earns less than a certain amount. And you can, you know, shave about I think it’s about 500 billion out of Medicaid spending by reducing the funding for that specific program. So that’s kind of getting you there. The other big one, it’s circulated in conservative circles for a year, is doing some kind of cap on Medicaid spending.

Sometimes, like a per capita cap, that is a certain amount you get for each beneficiary. That would be a really big change from how Medicaid works now, where there’s no limits on a per person spending. You get the medical claims you pay them. This would put a firm limit that could be a pretty big cut. It all depends on like where you set that, you know, ceiling for spending, how big of a cut that one becomes. But those are ones kind of circulating in the mix right now.

Yeah. I was thinking about how during Trump’s first term, he saw some of his lowest approval ratings ever around the time he tried to repeal the Affordable Care Act, Obamacare. I mean, his approval rating was lower after the failed ACA repeal than it was after the insurrection. So why do you think that was the thing that voters seemed to really hammer him for? I think it’s personal, right.

You know, more personal than the insurrection is the idea like, oh, I’m not going to be able to go to the doctor. I’m not gonna be able to take my kids to the doctor. I’m going to have to think about, do I have the money to actually see someone? I think it just really hits people in a very deep, personal way that a lot of issues don’t. So even though you have this big lofty, you know, $880 billion goal now, there is a true question with, you know, some of the worry you’re already seeing.

The rhetoric around not cutting Medicaid about whether they can actually, you know, achieve those levels of cuts and kind of get their party behind them. Do you think that Medicaid is a harder political target than Obamacare is or was? Yes, I think so, because it’s it covers so many people. Again, like one in five Americans are on Medicaid. It’s a huge middle class program at this point with the way it funds nursing care. And I think it’s less polarizing than Obamacare was.

I mean, Obamacare always had Obama in the name and tended to kind of divide along party lines, whereas Medicaid, I think, generally enjoys more support among Democrats, but it doesn’t have that same kind of um political division built into it in the way that Obamacare did. And I think Trump seems to know that because we saw evidence with his win in 2024 of a major political realignment happening along economic lines, he was able to make big gains with middle and low income voters.

But those are the voters, as you’ve mentioned, who are more likely to depend on programs like Medicaid. What specifically could these cuts to Medicaid mean for those voters who maybe took a chance on Trump? Yeah, I mean, they could mean losing your health insurance. So there’s about 20 million people who are enrolled on the Medicaid expansion right now, and a lot of them are in red states.

You’ve seen a lot more conservative states signing up for the Medicaid expansion since the last time Trump was in office. So, you know, these are places like Montana, Missouri, places that, you know, do not tend to vote for Democrats quite as much. If Congress decides to dial back the funding. It’ll be the states who have to come in and fill that budget hole. And it’s a massive, you know, billions of dollar budget hole.

I don’t think a lot of states are going to be able to find those kind of funds. So it really could come down to, you know, not having health insurance anymore. Coming down the pike, 600 to $880 billion worth of cuts, and this is all part of. The broader plan to make America healthy again, I guess. Um, I'm wondering if you could speak a bit more to what that plan is, how it's being executed and why it's being executed in the way that it's.

I mean, I wish I had a more like complex answer, but it's class warfare, uh, that's being built by picking on people who are most vulnerable and therefore whom they calculate have least of a chance of fighting back. The budget calls for a $4.5 trillion tax cut, half of which, um, is funded by cutting back government programs. Half of that comes from cutting Medicaid or other adjacent Medicaid programs.

They're making the gamble that people on Medicaid are too diffuse and too powerless to force a a, a vote otherwise, which is the same gamble they made with the a CA in 2018 and it didn't work. Um, so, you know, that's my silver lining is that we were able to stop these, the a CA cuts seven years ago, and that model might work again for Medicaid. Realistically, you know, I, I anticipate some, there might be a cut of some sort, right?

They do have unilateral power, so I think we're fighting for a 10% cut versus a 1% cut. Both of those are catastrophic, don't get me wrong, but it's the difference, be it. It's the difference in the lives of millions of people about whether to stay in these programs. And so the shape of the cuts are still to be, to be determined. There's a lot of ways they can work it through a lot of accounting tricks, a lot of implementation, a lot of architecture.

But at the end of the day, any cut to Medicaid kicks people off the program and closes facilities that depend upon Medicaid payments. Half of rural hospitals in the US are more or less underwater, and Medicaid's the only thing keeping them afloat. We already see like a, a wave of, of rural hospital closures and closures of hospitals and clinics in low income areas.

You know, people in, in rural areas and people in poor neighborhoods have a lot more in common, um, than, than, than they might suspect. It's the same forces acting in both either places with low volume of care or low income patients. Overly index on Medicaid to keep themselves afloat.

Just for people who might not be entirely familiar with how Medicaid actually works, this is a series of federal grants that are made to the state level, and it's generally up to the state in terms of how they administer those funds. Right? So right. At the end of the day, these cuts are going to be administered differently in different states. Correct? To an extent. That's a good thing to bring up. So. Let's contrast it with Medicare.

Medicare is an entirely federally funded, federally run program. Everything that happens in Medicare happens in Washington DC and they take care of everything. Medicaid is jointly funded by the federal government and the state government and is administered by the state. So in different states, the federal government pitches in a different amount. In Wisconsin, it's 60 40, 60% federal of 40% state. Um, in other places it's, you know, 70, 30, 50, 55, 45, et cetera.

I think nationwide, it's like 69, uh, 21. Uh, that's, that's the breakdown. So the federal government is targeting that 60% or in nationally 69%. Uh, that's the money that that's gonna get cut here. But yeah, they'll, they'll say, okay, Wisconsin, typically we give you $6.6 billion this year. We're giving you $5.6 billion. A 10% Medicaid cut shakes out to, uh, $1 billion fewer from the federal government to the state of Wisconsin.

And in every single state, Medicaid funding from the federal government is the largest pool of federal money that they get. This is a massive part of every state budget because healthcare is expensive and there's a lot of. That's why I think we need a Medicare for all. Um, but this is like a massive chunk of federal money that states use.

And so in Wisconsin, at least, just 'cause I have those stats on top of my mind, the state government would need to spend an additional $1 billion just to keep Medicaid where it is now. And we don't have that money, you know, our entire rainy day fund is $4 billion. And there's a lot of other things pulling of that because Wisconsin is a emaciated state. In New York, uh, the projected cuts would pull $10 billion from the, the, the state budget.

Like these are massive cuts, even on a small level because of that funding program. And so the federal government can say, okay, you know, we're gonna cut back that funding by doing A, B, or C. And then the state implements it, or the state has to kind of maneuver around, um, the, the, the avenue set there. A lot of this is frustratingly ambiguous because things haven't been determined yet.

They kind of, like the dog caught the car and said $880 billion, which is important note is over a 10 year period, which is about how much Medicaid spends per year, $880 billion. Um, and now they gotta figure out how to, how, how to do that math. And I don't think they figured that out yet because it's politically, they, they're learning that it is politically very dangerous, um, to cut Medicaid.

Is there any particular reason that they've gone with 10% or is it just we need to do some austerity? So here's a number. I would guess it's because, um, it's a nice, easy number. Medicaid spends $880 billion a year, so cut it by 10% over a 10 year period. Um, it's just nice math. Cool. So. In terms then of the immediate. Impacts.

We've talked a little bit about what that could look like, rolling back, uh, particularly provision of care in rural areas, some of these specialized programs that deal with specialized populations. Uh, what are other things that could happen as a result of these cuts? Sure. So, I mean, they could open up the ability for the state to restrict who's on Medicaid. Um, Medicaid eligibility requirements were greatly expanded under the Affordable Care Act in 40 states.

Um, in 40 states, if you have under 138% of the federal poverty line, um, as your household income, you are eligible for Medicaid full stop. And then there's like bonus programs on top of that for disability children, et cetera. Is that just in Wisconsin or is that everywhere? That's in all states. That's, uh, in Wisconsin. We don't have expansion in Wisconsin. We cap out at a hundred percent. Got it. And we're the, we're the most generous non-expansion, um, state.

Medicaid was rolled out as a, as part of, uh, assistance for families with dependent children, A FDC, which was turned into TANF, uh, under the Clinton era, but it was like an extension of state welfare programs, which is why this whole thing is run by the states. And for a long time, states could determine who was eligible and who was not. There are two consequences for cutting Medicaid that are non-negotiable, completely like what's gonna happen? Totally predictable and unavoidable.

People will lose their health insurance and facilities, which depend upon Medicaid to. Break even will close. Now, the particular manner by which it's determined who loses their health insurance and which facilities close is largely up to the conversations that are, that are happening now, and then the resulting conversations that states have. We don't necessarily know the criteria, how that's how it's gonna shake out. One thing that's passed around a lot is work requirements.

A model that has been shown to be ins insanely and effective and not cost efficient. Penalizes people, not who aren't working, but who can't handle filling out forms every month. 'cause they're pretty byzantine and there's no, it's really hard to, to submit those, submit those documents, estimated that work requirements would kick I think 5 million people off Medicaid, which is a lot.

There is no way to finagle a cut that doesn't result in a similar number of people losing their health insurance. That's the breaks. And so the choice Congress is forcing states to make is. Either raise taxes, spend money they can't afford to, to, to match or cut their Medicaid program. That's it. There is no other option. There's no work around, there's no hack. And what that looks like is a thing we will discover together over the course of the, of the, the next few months.

When I hear that, and I'm sure when you hear that as well, the immediate impulse in my gut is, oh no, and I'm afraid, and there's something I think overwhelmingly I. Disabling about the fear sometimes if you let it really sit there. And this is the thing that I come back to time and time and time again as we are facing down the various tendrils of fascism and the mundanity of the way that, uh, austerity just sort of ruins our collective society.

And so when you find yourself in those moments, I, I, I, I wonder what is it that you do to keep yourself from freaking out? That's a great question. I'm trying to figure that out myself. Yeah. Um, I mean, I won't lie, I feel like shit basically all the time. Yeah. However, you know, you can do a couple of things with feeling like shit. You can stay in bed and roll around or you can get out there and try to like, help build the thing that pushes back. Right. We are living in a declining empire.

I think it's more or less irrefutable at this point. It's the tagline of our show case studies in the pop culture of a dying empire. But you, you've gotta. I don't know. You got to, um, it's, this is, this is life or death for a lot of people, but it's coming for us next. Yeah. You know, we're all temporarily healthy. We're all temporarily able bodied at some point. A car accident, a pregnancy, a, a rabid raccoon, fucks up your healthcare, fucks up your life.

So fighting for Medicaid now is a way of fighting for yourself later. That's going to be it for today. As always, keep the comments coming in. You can leave a voicemail or send us a text at 202-999-3991. You can now reach us on the privacy-focused messaging app Signal at the username bestoftheleft.01. Or simply email me to [email protected].

The additional sections of the show included clips from Nightside, The Hartmann Report, CounterSpin, All In, The BradCast, Democracy Now!, Public Health On Call, On Point, Happy Pancake, What a Day, and The Worst Of All Possible Worlds. Further details are in the show notes. Thanks to everyone for listening. Thanks to Deon Clark and Erin Clayton for their research work for the show, and participation in our bonus episodes of SOLVED!

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