The GOP’s Healthcare Flimflammery Is The New Big Lie

Summary

Podcast Summary: Bulwark Takes – "The GOP’s Healthcare Flimflammery Is The New Big Lie"

Release Date: June 1, 2025
Host: Sam Stein
Guest: Jonathan Cohn, Author of The Breakdown Newsletter

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Introduction

In this episode of Bulwark Takes, host Sam Stein engages in a critical discussion with Jonathan Cohn regarding recent statements made by GOP Speaker Mike Johnson about Medicaid reforms. The conversation delves into the veracity of Johnson's claims, the potential impact of the proposed bill on Medicaid and the broader healthcare system, and the implications for the national deficit.

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Speaker Johnson’s Claims on Medicaid Reform

Timestamp: [01:26]

GOP Speaker Mike Johnson appeared on State of the Union, asserting that the new bill will:

• Preserve and Protect Medicaid: Johnson claims the bill will maintain Medicaid’s role as a social safety net while making it "more common sense."

• Reduce Fraud, Waste, and Abuse: He emphasizes efforts to curb improper use of the program, citing that "one out of every five or six in Medicaid is improper" ([01:26]).

• Ensure No Coverage Losses: Johnson states, "No one will lose coverage as a result of this bill" ([01:26]).

• Targeting Misuse: He argues that the bill will remove able-bodied, working adults who do not meet work requirements, thereby preserving resources for the most vulnerable populations.

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Critical Analysis of Johnson’s Statements

Timestamp: [02:02] – [05:03]

Jonathan Cohn vehemently disputes Speaker Johnson's claims, labeling them as "bold-faced lies." Key points include:

• Coverage Losses Predicted by CBO: Contrary to Johnson’s assertion, the Congressional Budget Office (CBO) estimates that Medicaid cuts could result in over 7 million Americans losing health insurance ([02:02]).

• Misrepresentation of Medicaid’s Purpose: Cohn highlights that Medicaid was established in 1965 alongside Medicare to support low-income individuals. He criticizes Johnson for undermining the program's original intent by targeting its expansion under the Affordable Care Act (ACA).

• Dismissal of Legislative Actions: Cohn points out that the Medicaid expansion was a result of congressional votes, and dismissing it as illegitimate ignores the democratic process that upheld the program ([04:15]).

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Dissecting the Claim of Deficit Reduction

Timestamp: [05:03] – [07:33]

Speaker Johnson asserts that the bill will lower the deficit by $1.4 trillion over ten years through mandatory savings and does not increase the debt ([05:03]). Cohn counters this by:

• Challenging CBO’s Baseline Assumptions: He argues that the CBO's projections do not account for the extension of existing tax laws, making their deficit reduction claims misleading.

• Impact of Tax Cuts for the Wealthy: Cohn emphasizes that the bill includes significant tax cuts for the wealthy, which will exacerbate the deficit contrary to Johnson’s claims ([06:17]).

• Reallocation of Resources: He highlights a disparity where cuts to Medicaid and food assistance programs are offset by tax cuts for the richest Americans, effectively shifting resources away from those in need ([06:17]).

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Detailed Examination of Medicaid Cuts

Timestamp: [07:33] – [12:42]

The conversation turns to a line-by-line analysis of Speaker Johnson’s statements:

1. "There are no Medicaid cuts in the big beautiful bill. We're not cutting Medicaid." ([09:00])

   • Cohn’s Rebuttal: The CBO projects over $600 billion in Medicaid cuts, directly contradicting Johnson’s claim ([09:05]).

2. "We're strengthening the program." ([09:30])

   • Cohn’s Argument: Reducing coverage and imposing out-of-pocket costs for certain groups constitutes a weakening, not strengthening, of Medicaid. He cites data showing that Medicaid improves financial security, access to healthcare, and overall health outcomes ([10:15]).

3. "It's intended for young, single pregnant women and the disabled and the elderly. But what's happening right now is you have a lot of people, for example, young men, able-bodied workers who are on Medicaid." ([11:23])

   • Cohn’s Counterpoint: Most Medicaid recipients are either working or have valid reasons (disability, caregiving) for their eligibility. The stereotype of able-bodied individuals misusing Medicaid is largely unfounded ([12:19]).

4. Defending Program’s Solvency: Johnson claims the reforms prevent Medicaid from becoming insolvent ([12:42]).

   • Cohn’s Response: Instead of addressing insolvency concerns, the bill’s tax cuts for the wealthy contribute to the deficit, making the claim hollow.

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Implications for Vulnerable Populations

Timestamp: [12:42] – [14:03]

Cohn underscores the negative impact of Medicaid cuts on vulnerable populations:

• Loss of Health Insurance: Millions of Americans, particularly low-income workers, stand to lose vital coverage, leading to increased financial and health-related vulnerabilities ([03:10]).

• Misaligned Priorities: The reallocation of resources from essential services to tax cuts for the wealthy reveals a prioritization misalignment, undermining the program's foundational goals ([06:17]).

• Public Backlash: Cohn anticipates that constituents will react negatively to the proposed cuts, emphasizing the human cost behind the political maneuvering ([13:49]).

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Conclusion

Sam Stein and Jonathan Cohn conclude the episode by reinforcing the misleading nature of Speaker Johnson's claims regarding Medicaid reforms. They stress the importance of accurate representation of policy impacts and the moral obligation to protect vulnerable populations. Cohn encourages listeners to remain informed and engaged, highlighting the need to scrutinize legislative actions that affect public health and economic stability.

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Notable Quotes:

• Mike Johnson ([01:26]): "No one will lose coverage as a result of this bill."

• Jonathan Cohn ([02:02]): "That's a bold-faced lie."

• Mike Johnson ([05:03]): "This is a $1.4 trillion over 10 years deficit reduction."

• Jonathan Cohn ([06:17]): "We're taking money and resources, the people who desperately need it, and giving it to tax cuts for the wealthiest people in America."

• Jonathan Cohn ([12:42]): "The money being taken out of Medicaid is around the same size as the money that's going to go to tax cuts for the wealthiest."

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Final Remarks:

Sam Stein encourages listeners to engage with Jonathan Cohn’s work, particularly his latest piece on RFK’s stance on Moderna’s vaccine for bird flu, and to support Bulwark Takes by subscribing and sharing the podcast. The episode underscores the necessity of vigilant analysis of political rhetoric and its real-world consequences on public welfare.

Transcript

[Sam Stein]

Hey, guys, Sam Stein here with Bulwark. I'm joined by Jonathan Cohn, author of our newsletter the Breakdown. He's got a great one this morning, but we're not going to talk about that. You should read that. Subscribe to that. Go on, substack. Share with all your friends. Get them to subscribe to it. We want the subscribers. We're here to talk about Rosbot, Mike Johnson, Medicaid and a series of egregious lies and misstatements, mistrusts, whatever you want to call them on our Sunday show docket. Before we get into that, subscribe to our YouTube feed, which is where you're probably watching this. All right, cone, first off, congrats. Your kid got married.

[Jonathan Cohn]

Oh, yes, indeed. Indeed. Yeah, we had a. We had a wedding last weekend and it was.

[Sam Stein]

That's awesome.

[Jonathan Cohn]

It was good to, good to be reminded of the good things in life. So, yeah, I'm very proud, dad. And they're super happy. So. Yeah, thanks.

[Sam Stein]

All right. I remember. Is this the one that I met when he was like a wee little lad?

[Jonathan Cohn]

Yeah, yeah. You were talking about the Red Sox. Yeah. He's still a Red Sox fan, by the way.

[Sam Stein]

Oh, I feel for him. I feel for him. It's been tough here. All right, let's talk Rasvat. He's on tv. He's on State of the Union this weekend. But Dana Bash, the pinpoint is, or the pressure point, I should say is Medicaid. And they're talking about going back and forth. Well, look, this bill you've put together that passed through the House, that's now awaiting action in the Senate. It has some sweeping reforms that constitute cuts to Medicaid. And he is just absolutely pushing back on it in ways that are egregious. Let's watch the video and then I'm going to get your reaction to it on the other side.

[Mike Johnson]

This bill will preserve and protect the program's the social safety net, but it will make it much more common sense. Look, one out of every five or six in Medicaid is improper. We have illegal immigrants on the program. We don't have. We have able bodied working adults that don't have a work requirement that they would have in TANF or even snap. And those are something that's very important to institute. That's what this bill does. No one will lose coverage as a result of this bill.

[Sam Stein]

I saw you on Twitter before I summoned you to YouTube. You seem perplexed, angered, rageful. What is it about that that's wrong?

[Jonathan Cohn]

Yeah. So I mean, here we have the Director of the Office of Management Budget saying there are no coverage losses in this bill. I mean, that is, that's not just misleading, that's not out of context. That is a bold faced lie. And we're talking, you know, left is right, up is down, zebras are chickens. I mean, this is just not, there's no universe where this is true. The CBO has estimated that from Medicaid alone. And remember, there's Medicaid cuts here, there's cuts to Obamacare here, that we are looking at more than 7 million people losing health insurance. And actually, just to be clear, Medicaid is actually bigger than that. It's just that some of them will find their way to other forms of insurance which will be not as comprehensive. So you're looking at the number of uninsured Americans rising by more than 7 million people. I do not understand how an official United States government can get up there with a straight face and say there are no coverage. I mean, like them, he may want to justify them, fine, own it, argue for it, but pretend they're not real.

[Sam Stein]

And his, his justification or rationalization, which Mike Johnson also talks about, and we'll get to that in a little bit, is that, well, you know, it's people who shouldn't be on Medicaid to begin with, so they don't count as coverage losses. Is that more or less what he, what he's trying to get at?

[Jonathan Cohn]

I mean, that's one of the arguments they make. And in Mike Johnson, when he was on, I think Meet the Press, that's where he started. And you've heard that a lot. Well, this is not who Medicaid is for. Well, so let's stop and talk about Medicaid for a second program. Right? It was established in 1965, same bill that created Medicare. It was for low income people. Over the years we've had debates, Congress has had debates. You may recall there was a really big argument in 2009 and 2010 about something. You were there, I was there, you know, over the Affordable Care Act. And the outcome of that debate was, hey, we want to get closer to a universal coverage system and we're going to build on Medicaid so Medicaid will cover more people. I mean, we had that debate. And again, if they don't like that, if they think, well, that's, we don't want that, fine, then say that. But don't say this is not what Medicaid is for.

[Sam Stein]

That's true.

[Jonathan Cohn]

This is not what Medicaid is for.

[Sam Stein]

They're treating the act of Congress and then relatedly and. And subsequently the act of state houses and governors as illegitimate acts, as if the expansion of Medicaid happened almost illegally and therefore should be undone. But that's not actually the case. We voted. Our elected representatives voted for this policy, which resulted in this expansion. So it is kind of interesting. They just sort of say, well, that never really happened or it shouldn't have happened, as if those votes don't matter. That was not the only Russell Vaude thing that you were angry about. There was another one about the bill, the big beautiful bill's impact on the deficit. He says it lowers it by 1.4 trillion. Not true.

[Mike Johnson]

This bill doesn't increase the deficit or hurt the debt. In fact, it lowers it by $1.4 trillion. What, what some of the watchdogs have done is they have used CBO's artificial baseline, which doesn't allow and assume that current tax law will be extended because of sunsets that are in the law. They don't do that with suspending is totally something that would be foreign to any common sense person who comes and looks at how we budget in this country. And so when you, when you assume the extension of, of the President's tax relief from 2017, this budget or this bill and is really a reconciliation bill, it's not really a budget bill. It is using a budget process. This is a $1.4 trillion over 10 years deficit reduction. It's $1.6 trillion in mandatory savings. Obviously, we have a little bit of spending in there as well for border and defense, but that is the biggest mandatory savings package that we have seen since the 1970s, 1997. It's very historic.

[Jonathan Cohn]

Again here, you know, it'd be nice.

[Sam Stein]

To just make up numbers and be like, yeah, you know, it's this, it's that. And just like, you know, maybe we're.

[Jonathan Cohn]

In a simulation and there's like another simulation where they've passed a bill that actually cuts spending and raises taxes enough to reduce the deficit. I don't know, it seems like an interesting universe. I'd like to go visit it. We do not live in that universe. That is not this simulation. In this version of reality, this bill explodes the deficit. And it does so because of these tax cuts that are heavily, heavily weighted to the wealthy. And, you know, there's a chart running around which, if you haven't seen on social media, where the CBO basically said, okay, here's the money we're taking from the Poor. And here's the money we're giving to the rich. It's basically one to one. It is a literal truth to say that the money, if you look at the amount of money that is now being taken out of Medicaid and food assistance is right around the same size as the money that's going to go to tax cuts for the wealthiest people in America. So this is literally taking money and resources, the people who, who desperately need it. And we can talk about why and what, you know, it's going for to people who are the, you know, do having, who make the most money, who are the, at the highest end of the income scale.

[Sam Stein]

Okay, let's finally, let's finally dissect the Speaker Johnson statement. We can go line by line. Maybe here he' Meet the Press. Now he, he is like, I'll give him credit, he's pretty smooth at this stuff. I mean this just rolls off the tongue. And so much of this is so not only misleading, there's some, there's something like, almost like maddening about it because of the way he frames it and just the absolute opposite intentions. But let's just, I'm going to read it and then we'll go through it. So here it is. They ask him, you know, does this not cut Medicaid roll? No. And you can underscore what I'm about to tell you. There are no Medicaid cuts in the big beautiful bill. We're not cutting Medicaid. What we're doing is strengthening the program. We're reducing fraud, waste and abuse that is rampant in Medicaid to ensure that program is essential for so many people, ensure that it's available for the most vulnerable. It's intended for young, you know, single pregnant women and the disabled and the elderly. But what's happening right now is you have a lot of people, for example, young men, able bodied workers who are on Medicaid. They're not working when they can. That drains resources from the people that need it most. And so what we're doing here is an important and frankly heroic thing to preserve the program so that it doesn't become insolvent. This is not going to hurt rural hospitals, he says for good measure. All right, where do you want to begin? You want to go a line through line?

[Jonathan Cohn]

I mean we could. Yeah, let's go, let's go line through line.

[Sam Stein]

Here we go. Okay. There are no Medicaid cuts in the big beautiful bill. We're not cutting Medicaid.

[Jonathan Cohn]

The Congressional Budget Office and every single independent analyst who's looked at this would beg to disagree. There are more than $600 billion in Medicaid cuts.

[Sam Stein]

Speaker Johnson, are they not cutting the program to pay? They have to cut the program. They got to pay for the tax cuts.

[Jonathan Cohn]

Right. I mean, that's the whole reason they're doing this. So of course it is cutting Medicaid. Okay.

[Sam Stein]

All right. What we're doing is strengthening the program.

[Jonathan Cohn]

Well, you know, if strengthening means weakening, sure. I mean, it's going to cover fewer people. And, you know, we have data on this, lots of research on this. We know that Medicaid, it makes people, it makes you more financially secure, it gets you better access to healthcare. And we've got really good data now coming, which we didn't for a while showing. It makes you healthy. You know, it keeps people alive longer, it improves health. So, you know, the program is going to be. I know to me, if you're taking that away from people so now that they're more likely to have financial problems, they're less likely to get healthier, they're more likely to die early. I mean, I guess maybe this is a subjective judgment, but to me that sounds like a weaker program.

[Sam Stein]

Sure. We're reducing waste, fraud and abuse that is rampant in Medicaid to ensure the program is essential for so many people to ensure that it's available for the most vulnerable.

[Jonathan Cohn]

Right. So, I mean, this is the argument they've been making for a while. So we're not cutting Medicaid, we're just getting rid of the waste, fraud and abuse. And look, does Medicaid have waste, fraud and abuse? Of course it does. Every program does. Every corporation does. It's human nature. And if they want to, you know, look at places to cut waste and that, you know, doesn't take, you know, care away from people who need it. Hey, more power to them. They get bipartisan support for that. What they are really doing, though, is they are throwing up administrative hurdles, making it hard to sign up for the program, making hard to stay on the program in a way that they know and we know from past experience is going to cause people who are eligible for Medicaid, who belong on Medicaid to lose that coverage. And they are also, by the way, like they are, have some straight up cuts. I mean, one of the changes they're making is telling people, certain groups in the Medicaid population who that going forward they're going to have to pay out of pocket costs that they don't have to pay now. I mean, that's a Cut. That's a benefit cut. That is a straight up benefit cut.

[Sam Stein]

All right, here we go. Keeping, keeping the train moving here. It's intended for young, single pregnant women and the disabled and the elderly. But what's happening right now is you have a lot of people, for example, young men, able body workers who are on Medicare, Medicaid. They're not working when they can.

[Jonathan Cohn]

Most people on Medicaid are working and if they're not working, they have a reason like a disability or some kind of caregiving responsibility. Number of people who are able bodied and not working is quite small. And actually if you start to dive into that group, you'll find a lot of people who are, are, are, are sort of in between jobs and they, they, they deal in the sort of, you know, low income workforce, et cetera. And, and so I mean, this idea that you have this like population sitting around watching tv, that's not true. And if you don't really make sense if you think about it, it's not like a cash benefit.

[Sam Stein]

Right.

[Jonathan Cohn]

All you're getting is access to health care.

[Sam Stein]

Yeah. It's like, I'm going to get my Medicaid check this week and I'll just hang around.

[Jonathan Cohn]

Oh, I can get extra colonoscopy. Right.

[Sam Stein]

So I mean that teacher's own, Jonathan, you know, I'm collecting colonoscopy, I use for sure. All right, last line here. That drains resources from people that need it most. And so what we're doing here is an important and frankly heroic thing to preserve the program so it doesn't become insolvent.

[Jonathan Cohn]

So if they're so concerned about insolvency, perhaps they want to think about not having this massive tax cut for the wealthy that's going to drive up the deficit. But I also want to talk about the sort of deserving part. I mean, this is their, this is like the argument that another one is arguing with him make for a while. Well, you know, we're giving insurance to this working age population. It takes away from the elderly and the disabled. And so first of all, there's no evidence of that at all. There's no, there's no, there's no, people have looked into this. There's no evidence that like if you, you know, give to the working age population, then you're going to take away from these others. But also this gets to the sort of broader point of why Medicaid was expanded in the first place, which is that, you know, before the Affordable Care act expanded Medicaid to this group, there was a large group of people who were working but low income and had no way to get insurance. They couldn't afford it. They were working in low wage jobs. They had seasonal jobs. And these were very deserving people. They need health insurance. And this was the way to get health insurance for them. And if you don't believe me, go ask Speaker Johnson if he cares that he would lose health insurance, or Ross Vaught if he cares if he would lose health insurance. They would scream in five seconds and they would say, I deserve health insurance.

[Sam Stein]

Well, Johnson knows this for sure and because his members are going to back home to their town halls and people are freaking out and then they're saying, well, everyone dies. Don't worry about it.

[Jonathan Cohn]

We're all gonna die.

[Sam Stein]

All right, cone, thank you so much, man. Appreciate this. People. It's not the subject of his piece, but you should read his piece this morning. It's about RFK pulling the Moderna vaccine for bird flu because of MRNA technology, which he's just Adam and Lee Gantz. It's a must read piece. Check that out. In addition to watching and sharing this video. Thank you for subscribing, thank you for listening. We really appreciate it and we'll talk to you soon.