
Devil’s Cut | The Fineprint Of “The Big Beautiful Bill” They say the devil is in the details. Well, today Amy is joined by the Senior Director Of Federal Budget Policy at The Center For American Progress, Bobby Kogan. Together they dive...
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Amy McGrath
Foreign how do you manage to give to the rich, steal from the poor and massively add to the federal debt and deficit? You pass this incredibly destructive big beautiful bill. That's how so far this year we've seen a full on assault on our nation's health care from cuts to and medical research to undermining the nation's vaccine regime and other elements of public health. Now the big beautiful bill that the Republicans just ran through will cut Medicaid by $1 trillion and make major changes to that federally and state funded health insurance program. And that means that over 11 million people could lose coverage over the next decade. And this bill does this while adding an estimated $2.7 trillion to our national deficit. All under the banner of fiscal responsibility. Right. But we're going to dig in a little deeper into this legislation and why it is so bad, not just for the poor, but for the country as a whole. I'm Amy McGrath. On this Devil's Cut episode of Truth in the Barrel, we're exposing the ugly truth of the big beautiful bill with our guest, Bobby Kogan. Bobby is the Senior Director of Federal Budget Policy at the center for American Progress. He has previously served with the Biden administration in the White House, assisting with the American rescue plan and the Inflation Reduction act. And he was the chief mathematician and head of budget analysis for the Senate Budget Committee for, for many years. So that's who we have as our guest and we're really excited.
Bobby Kogan
Hey Amy, thanks so much for having me on.
Amy McGrath
Hey, welcome to the show, Bobby.
Bobby Kogan
My goodness, what top two weeks it's been.
Amy McGrath
Yeah, I would say for what you do, it's probably not a great past couple weeks. Let's start out, Bobby, if we can, with just your general description. If you could describe the big beautiful bill in one sentence, what would it be?
Bobby Kogan
Normally I need two. One sentence is quite literally it makes the poorest Americans poorer while making the richest Americans richer. And that is essentially unheard of in a single pieces of legislation. Normally, people who want to make the poorest Americans poorer either have the, you know, the strategy to make the richest richer in another bill or they're doing it in a sense of shared sacrifice. You might come and you say the deficit's really large and everyone's going to have to sacrifice a little bit. What's so unique about this bill is they make the poorest poorer to make room to make the richest richer while somehow still making the deficit larger. And that's basically unheard of.
Amy McGrath
Yeah, I mean, it's just unbelievable. Almost from A. From a public policy perspective, we've never seen anything like this, right?
Bobby Kogan
Yeah. The closest we got was the failed Contract With America. And it failed for a reason. Because I think the public. It's really tough to justify. As I say, I really think if they had come in and they said, listen, everyone's gonna have to give a little bit more, everyone's gonna have to take a little bit less because we need to work on the deficit, I think that that's a message that could have resonated with the American public. But, you know, even when Reagan. The previous largest cuts to Medicaid in US History had happened in the first year of the Reagan administration, the previous largest cuts to food stamps in history happened in the Clinton administration. But each of those were in the context of deficit reduction. And what's so unique here is that that's not it. They were literally doing enormous tax cuts to the rich at the same time. And it's just hard to say. You have to take a little bit less so we can give way more to the richest. And when I say, When I say to the richest, I mean, this bill literally gave more to the top.01% of America than the bottom half of America combined. So it's really heavily tilted.
Amy McGrath
It's terrible. Like, you know, those. Those folks need more yachts. Right. I mean, this is where we're at. But I feel like. And we know that the bill is wildly unpopular. That doesn't seem to matter right now. But there are a lot of people out there that don't fully understand, you know, how this is going to impact them. And so when we think about the cuts to Medicaid, obviously it's going to impact somebody. And we know that there's major changes going on with Medicaid with these work requirements. So can you talk about this and, like, why is this an issue for everyone, not just for the people on Medicaid?
Bobby Kogan
Yeah. So the reason it hits everyone is that it's going to cause a lot of hospitals and a lot of nursing facilities to close. A lot of. Of health care facilities rely on Medicaid dollars. People, you know, people are on Medicaid, they go. They go get procedures done. The government is going to pay for their procedures. If a whole bunch fewer people. We're talking, you know, 11 million fewer people are able to get health insurance, and that's a lot less money into these, you know, already struggling rural, you know, suburban, urban hospitals, healthcare facilities. And all of a sudden, even if you didn't technically lose your health insurance, you're in trouble if, you know, the nursing facility you rely on, the hospital you rely on is, is, is no longer functional. We've already actually seen some that were struggling. We have a lot of hospitals already that are struggling. Some have already said, okay, well that's it, I'm going to close anyway. That in the next few years were already a question mark, but now it's guaranteed. So we've already seen kind of the beating effects of this. So that's why it hits everyone. And of course it hits the 11 million people who are going to lose their health insurance because of this. And I should just say really fast. So I think, you know, work requirements are the sort of thing that I think plenty of people support in concept. But the problem is they don't, they don't actually work. Right. And so the, the states that have. Georgia is actually a great example. Georgia implemented work requirements recently. And this guy, Luke Seaborn was on, I don't know, a dozen ads for the governor. He, you know, he's, he was a guy on Medicaid. He works, he said, I work. Other people are moochers. I think that this is a great idea. And in the first nine months of it being implemented, he lost his Medicaid twice. Despite the fact that he changed jobs or anything, he is no longer supportive of the policy. Because what happens here is they put up a whole bunch of red tape. Almost everyone who like, so they're putting up new requirements and almost everyone who's on Medicaid already hits the requirements or is in one of their accepted classes. But what they now all of a sudden all of those people have to go through tons of paperwork that they are doing redeterminations all the, and so now with tons and tons and tons of bureaucratic red tape, people fall through the cracks. So it's not actually kicking off the people who you want it off. It kicks off all the people who are doing everything right. They're just failing to kind of, you know, go through the red tape and it doesn't even lead to higher employment. So it's just, it's just a massive all around disaster for the states that have even tried it. Now it's going to be mandated across the entire nation. That's why it's going to kick a whole bunch of people off. Not because all of a sudden we had a bunch of moochers, but because people who actually were doing everything right. Losing their Medicaid. Yeah.
Amy McGrath
And, and you hear this a lot from the Republican talking points. Right? The best way to get health insurance is to quote, get a job, you know, and this, this is why they're selling it. We had a, a representative here in Kentucky who wrote an op ed talking about basically saying hey to his constituents. Don't worry about this bill. Nobody's going to, nobody who's deserving is going to lose their health care. It's only, we're only taking it away from the illegal immigrants. So don't worry, you know, and I just feel like that is just so false.
Bobby Kogan
It's completely false. So the estimate is that at max, about 1.4 million of the 11 million are undocumented, but it's actually less than that because it's 1.4 million are people who, they can't verify the documentation of. So of them, some of them are undocumented, some aren't. But that still means about 10 million people who are all citizens who are losing their health insurance. And as I say, of them are, a lot of them are actually doing everything right. They are working or in there. They're in one of those accepted classes that doesn't have to work, such as full time caretakers, caregivers, you know, people with disabilities, elderly folks. Right. A lot of elderly folks are on Medicaid as well. They're in people. There are people who under this law are supposed to be getting Medicaid and nonetheless are being kicked off. So that's one of the ways in which they're kicking a lot of people off. Another way is they're quite literally just giving states less money to run Medicaid. And since states have flexibility, what they're going to do is they're going to change their eligibility at the state level. That kicks more people off. And then the other thing that's bad, this one isn't technically kicking anyone off, but they're going to, there are some mandatory things that make it more expensive for some, some people on Medicaid to use it. So an example, let's say you make 20 grand, you're a single person to make 20 grand. You can be on Medicaid. In some states there might be a mandatory $1,000 to use your Medicaid. You didn't technically lose your Medicare, you have now been priced out of your Medicaid. If you have 20 grand, you can't afford to spend a grand using your Medicaid. So there's just tons and tons and tons and tons in this that are not actually going after fraud. It's not actually going after. We know that they're not actually interested in going after fraud because they, there's a part of the government that is dedicated to catching Medicare and Medicaid fraud and some of the workers that were doged. Right. So if they were really interested in going after Medicaid fraud, they wouldn't have dodged the anti, in Medicaid anti fraud unit. Similarly, you know, they do the anti tax cheat unit. They do it a whole bunch of anti fraud stuff. So it's not about going after fraud. It is just some zealous, I don't know what that has failed at the state level time and time and time again. And it's just going to lead to a whole bunch of people losing their Medicaid.
Amy McGrath
Yeah, I feel like, you know, when, when the Republicans have this talking points of hey, you know, it's, it's only undeserving people that we're, we're taking health care from. The, the fact of the matter is when you cut health care from people and you cut their insurance ability, they are not going to go get their prescriptions, they are not going to go get the tests that they need. You know, the, the annual mammogram, for example, that could, could show if you have, you know, pre cancer, breast cancer, for example, they will not go to the consultations that they can no longer afford that are the preventative medicine. And so when, when, when Joni Ernst comes out and, and says, you know, and somebody asks her in a town hall, hey, you know, these cuts, this bill is literally going to harm people and kill people. And she laughs at that and says, well, you know, everybody's gonna die. And I mean it, it, we're not being like overly dramatic here. When you say when you cut Medicaid by this much and you cut healthcare insurance the way our insurance companies, the way our insurance works in this country, people are not going to get care and people will literally be harmed and die because of this. I mean, I, I, I just, you got to say it, right?
Bobby Kogan
Yeah, that's right. I mean, and they accuse you of being hyperbolic if you say it, but these are, as you say, it's about a trillion dollars in Medicaid cuts. These are at least four times the size of what used to be the largest Medicaid cuts in history. If you kind of adjust for cost growth and population over time. So not only the biggest in history, but by far the biggest in history. And you have to believe that a trillion dollars of health care spending does something otherwise we wouldn't do it. Right. If it didn't do anything, we wouldn't we wouldn't do the program. So you spend a trillion dollars less on health care. Of those people, some of them are going to get ludicrously sick. And of the people who are going to get ludicrously sick, some will be able to pay some out of pocket, some won't. And of the people who can't pay any out of pocket, some of them will recover and some of them won't. Right. That's just basic logic. You have to believe that the health, you know, if, if the people saying that didn't believe in health care, they wouldn't be paying premiums right now. But they do it because coverage actually matters.
Amy McGrath
Well, in the costs will go up for everyone. Right. And so can you, can you explain why? Because they're ending the expanded Affordable Care act, they're ending the subsidies in this bill. Right. And so the costs will go up because people will not get preventative medicine. And then they will have to go more into the emergency rooms. Can you talk about how that cost trickles down a little bit?
Bobby Kogan
Yeah. So the Supreme Court has said that if, you know, if you end up in the emergency room with life saving care, they have to cover you. And right now these folks are covered under Medicaid. You show up. Not only is it cheaper because it's cheaper to do preventive stuff. As you said, it's easier for me to go get something checked out and then do a simple, easy procedure instead of waiting until it's a life saving intervention. It's much cheaper to do it that way. But second of all, if you do it kind of under the current metric or the previous metric, all of those things were paid for, whereas now the hospitals are being hit in both ends. They don't get the income from doing the procedures that was all covered. And now they're still covering people in the life saving care now completely uncompensated. That's the double whammy to hospitals of why they're in so much trouble is they're out the income and then they still have to do some of the procedures to that ends up, you know, that just ends up ripping away costs from hospitals. And then in addition to that, by changing the pool and changing kind of how much money is into the system, the estimate is that people's premiums are gonna go up pretty meaningfully just because of kind of less care going in. So makes tons of people worse off because it costs more to get the same coverage. And then also it might be harder for them to get coverage depending in your area. If all the hospitals in your area close. It doesn't. Yeah, it just doesn't, it just doesn't matter if you technically are covered. So you're paying more and getting worse and getting worse outcomes for it.
Amy McGrath
And that's especially true, we know, in rural America. Yeah, I mean, this is, this is gonna, this is gonna hit. But one of the things that strikes me and people have been talking about is this bill almost disproportionately hits red America.
Bobby Kogan
Yeah, that's right.
Amy McGrath
A lot. And so my response to that is, well, they probably won't see the effects soon. So my question to you, as you know this, and you're an expert on this, is, when will we begin to see the real effects of this bill's passage? And these cuts to Medicaid, for Medicaid.
Bobby Kogan
Most of them are starting after the midterms. That was, I believe, a deliberate strategy. But yeah, so for mo, some of the cuts are immediate, but basically the real meat where we start to see tons and tons of people kicked off is starting in 2027 and getting worse. Some states might get waivers to partially delay. So I would expect, you know, one in five people in America are on Medicaid. And so everyone is going to know someone who gets hurt, but you might not really know someone who gets hurt until 2027, 2028, 2029. It was the same thing with ACA repeal. And you know, they were trying in 2017, depending on your definition of pre existing conditions, somewhere between a quarter and a half of Americans have pre existing conditions. It was the same argument then. Everyone knew someone who was going to be hurt. And this is the same way. It might be a close friend, might be you, it might be a family member, it might just be someone on your block, but everyone, or in your apartment, but everyone knows someone who's going to be made worse off by this and for what? Right? Like, it's not. To me. I think what's so and inexcusable about the bill is that you just can't justify harming the most vulnerable people in America in a bill where you are helping the richest. You're asking that Americans to tighten their belts, that the richest Americans can loosen their belts. And I just, that's, I mean, as you say, the bill is really, the law is really unpopular. That's why the more people learn about it, the more they hate it, because you can't, you can't seriously justify that.
Amy McGrath
And yeah, and there's, there's that deliberate strategy of, well, these won't happen we won't see the effects until, you know, 2027, after the midterms. Harder for people to put two and two together for blame as the costs rise and the care goes away and all of that stuff. So we got to keep talking about it because, you know, this. There's a. There's a reason this is happening. Yeah, an unprecedented takeaway from, you know, everyday Americans.
Bobby Kogan
Every single hospital that. So the estimate is hundreds, you know, somewhere between a few hundred and maybe close to a thousand rural hospitals and rural nursing facilities will close because of this. And anyone that was on the line is out income because of this period, full stop. Every single hospital in America is going to be losing money because of this. Every single one will be worse off. So if you were on the edge, this is going to be what puts you over. And I think there's a lot of accountability that's going to, you know, it's not. It's on the people. It's on, you know, it's on everyone to talk about it and draw the connection because if we stand any chance of undoing the harm, it's going to be with a lot of accountability. And as you say, it does disproportionately hit the red areas. That's true for the. That's true for the Medicaid where, you know, red areas are disproportionately on Medicaid. That's true for a lot of the nutrition assistance, also the largest nutrition assistance cuts in US History. And that's true actually of the rescission of a lot of the IRA funds and the Inflation Reduction Act. We did a lot of direct spending that was supposed to do projects disproportionately in red states. That was a political decision by the Biden administration to try to help gain bipartisan support. And that bet turned out to be wrong in this case. And they just took a lot of dollars out of red states. I think the closest we can think about is in 2009 in the recovery Act. Some, you know, some districts passed up the money because it was tied to Obama. And, you know, it's what, you know, spiting your constituents in. In a political battle. But the real losers are the people, right? I mean, the point. Yeah, the point of government life is unfair. And there is a lot that we cannot do to address that. But the purpose of government is to help ameliorate some of the hardship. There's a lot that it can't do. Government is not going to be the solution for tons and tons and tons of things. But the purpose is to help, you know, kind of help the citizenry. Right. It's to help America succeed. That's the purpose of government. And this goes in the opposite direction. It does not actually help your constituents. It does not actually help America. If you take away people's health care, it doesn't actually help America. If you take away people's food, it doesn't help America. If you take away jobs. Right. What helps America is investing in the middle class. That's what actually helps America. That's what helps the constituents in this bill is the opposite of that. Putting more yacht money for a billionaire is. Is not investing in America.
Amy McGrath
Yeah, no. So, Bobby, you're sort of an expert also in how this was passed. And not everybody understands Congress and the rules. The Senate rules can often be tricky. Right. To understand. And so can you help us piece together what the Republicans had to do to pass this bill?
Bobby Kogan
Yeah, it's funky. You know, it's. No one cares about process. But normally in the Senate you can filibuster something. And so what that means is it's very hard to get legislation passed because you need 60 votes rather than 50. You need 60% of the Senate in agreement. That's of the many reasons that very little gets done in Congress. That is near the top of them. But they did this special process that is an exception. If you go through what's called budget reconciliation, you can Pass with only 51 votes instead of 60, but you have to stick to the rules. And what was unique this time around was they did not stick to the rules. They have stories that they told themselves about why they technically did or, you know, whatever, but you are not allowed to increase the deficit over the long run in reconciliation. There has not been a reconciliation bill in history before this woman's done that because the rules are very explicit. Robert Byrd, longtime senator from West Virginia, after the first kind of couple reconciliations, he created what was known as the Bird Rule to really limit the scope in his words. He said the point of reconciliation is to be about bipartisan deficit reduction. And so one of his rules is that you just, you can't do long term deficits. And they broke that rule by effectively hiding from the Senate parliamentarian, refusing to get her ruling. So that then when they did it anyway, they did it without consulting her. And then they had the presiding officer just assert that there was no problem. And that way they could claim that they didn't overrule her because they had basically hidden from her and avoided this ruling. Also, they could break the Rules, you know, and for what? For, for tax cuts. Right. Because that was, that was, you know, that was the thing. You can't do permanent tax cuts and reconciliation unless you pay for them. And while they did have the largest Medicaid cuts in history, and while they did have the biggest food stamp cuts in history, the tax cuts were so, so large that nonetheless it was trillions of dollars. And the estimate is that they had a couple of temporary provisions that are set to turn off, wink, wink, nudge, nudge. But, you know, when they, that was to make the score, the cost look artificially cheap. The estimate is that when all is said and done, the single cost, $4.7 trillion over the decade and far more than that kind of, you know, in the future. And so they, you know, basically, I think the way people ought to think about this is that this was many steps or large steps towards going nuclear. Nuking the filibuster, which insider term for saying, we're going to change the Senate and make it look more like the House. There are pluses and minuses to doing it this way. But I think what's so notable is that this wasn't done, you know, if you're thinking like, okay, we're going to blow everything up to get what we want. It's not like they blew everything up to get, you know, as a way to deliver, you know, to save people from dying. It's not like they blew everything up as a way to put more money in the hand, you know, in the hands of poor, hardworking Americans, the working class. They blew everything up to do tax cuts for the rich, permanent tax cuts for the rich. And for better or for worse, the Senate will look different from now on.
Amy McGrath
Yeah. And when I, when I ran for Congress back in 2018, I remember talking to folks, you know, out on the campaign trail about what was happening in the first Trump administration. And I've always said that the only major piece of legislation that was ever passed in the first Trump administration was a big fat tax cut, you know, for, for the rich. Now we have a big fat, another big fat tax cut for the rich and taking health care away and all of these, these, you know, slashing all of this important stuff like FEMA and the State Department and all these other things. But you hear this, a frequent long standing Republican talking point, that is tax cuts will pay for themselves. And has that ever been true?
Bobby Kogan
No. What they argue is that they say if your tax rate is too high, if it is, you know, just an example, let's say you're taxing 100% income beyond a certain point. They say, well if you lower it from 100 to 90, people might work a little bit more. You have no incentive. So there's got to be some level at what you know, for which that's true. What we're at, nowhere close. And it's not just me saying that 100% of even semi reputable groups have found that, you know, no one, no one finds that it pays for itself and no one even finds that it comes close to paying for itself. And I'll give an example. Pen Wharton, the Penn Wharton Budget Lab is run by former Bush admin guys and they find that when you take into account the changes in the macro economy, the change on, the change in whether it boosts the economy and how it affects interest rates and everything, they say that taking that into account makes the bill more expensive, not less expensive. So it anti pays for itself. When you take that into account, it anti pays for itself. No one believes that this is getting remotely close to paying for itself. And just to put this in perspective, like if I give, if I spend a dollar to give you a dollar and you spend that dollar. Exactly. It would have to generate a huge amount of economic activity for the tax revenue of that to then feed back in. It would have to, it would have to basically be generating many, many, many, many, many times. It's, you know, it'd have to be a multiplier many times. And there's just nothing that does that. That's okay. We do all sorts of things that don't pay for itself. Almost nothing pays for itself. The very few things that actually pay for themselves are the anti fraud efforts. Like you know, when, when you spend money go auditing billionaires. That pays for itself multiple times over. When you spend money auditing doctors who are, you know, are stealing from Medicare, that pays for itself. But basically nothing pays for itself. And that's okay. It is worth it to say it doesn't pay for itself. When I give a starving child food and you know, like it's good for the economy, it partly pays for itself in terms of long term dividends, but it doesn't pay for itself. One to one, we still think that's okay. They have somehow switched and it's because they, it's because, you know, they cosplay as these debt hawks and deficit hawks. They have gotten so into this idea of themselves as deficit hawks. They have to pretend that it pays for itself and it doesn't. And it doesn't get close to, I'VE.
Amy McGrath
Always said, you know, in modern era, the Republican Party is the opposite of fiscal hawkishness, you know, and, and so my, my question to you is, after this, this bill is now passed, do you think in the future Republicans will put less emphasis on reducing the deficit? Because, I mean, this is just like a shameless flip flopping. Right? Yeah. I mean, with regards to these deficit hawks, totally.
Bobby Kogan
I mean, a lot of them have debt counters at the top of their websites. Right. You go to Mike Crapo is the senator who is the head tax senator. And so he was the one who wrote many of the tax provisions over in the Senate side. And at the top of his website he has a debt counter and he wrote the provisions that have added trillions of dollars to the deficit. And if you ask them about it, I mean, you can make this up.
Amy McGrath
It's like the very guys that have been hawkish about the debt, they go. And they're the worst offenders.
Bobby Kogan
Yeah, that's right. You know, and I think you have to go back to the 90s to find the Republican caucus really caring about the deficit. Reagan did, in his first year in office, he did by far the largest tax cuts in all of history. And when I say by far, I mean, if you were to kind of translate them on an apples to apples basis to today, they'd be a $21 trillion tax cut. So really large tax cuts. And despite the fact that he did big spending cuts, the debt basically tripled under Reagan. And so partway through Republicans, even Republicans said, this is way too much debt for me. And so after that, Reagan basically raised taxes in almost every single year of his, of his term. He basically, by the end had undone roughly half the tax cuts. And then George H.W. bush, despite saying, read my lip note with new taxes, said, you know what, I got to do this too. And then Bill Clinton, you know, further increased taxes and cut spending. So you had, you had basically 10 years of bipartisan deficit reduction. And then you get to this century and the Republican Party this century has been one of giant tax cuts again and again and again and again. And that's why we are where we are. It's true that Medicare costs more than it used to. It's true that Social Security costs more than it used to, but we used to have a tax system that was on track to pay for it. If you went back to the Clinton era, like taxing and spending schema, it's true that Medicare spending will be going up and Social Security spending would be going up, but our taxes were on pace to keep track with that for forever. So we wouldn't have a long term debt problem. The issue is we cut a bunch of taxes that disproportionately went to the rich.
Amy McGrath
Since I think Bush won. Every single Republican president has added to the deficit. Every single Democratic president has reduced the deficit. Either they were given, you know, a load, but by the end of their, their term, they had reduced it. And so this, this notion that Republicans are the fiscal hawks as just a bunch of, of total BS in my mind.
Bobby Kogan
Yeah, we see again and again they, they might care somewhere deep, deep down, if you dig enough, but if given the choice between lower deficits and lower taxes, they pick lower taxes every single time. We have seen that every single time they've ended up in the presiden century period, full stop. Given the choice between the two, they pick lower deficits every single time. Then they decry it. And you saw some of them, in trying to justify it, some of the Republicans said, well, this is just the first step. And the response was, what do you mean it's the first step? It's going in the wrong direction.
Amy McGrath
The giant leap in the wrong direction. And wasn't it Donald Trump back in like 2016 who said on the campaign trail that he was going to get rid of the deficit altogether and start and fix our debt? I mean, it was such a joke then to me when I was teaching actually at the Naval Academy and I was teaching for part of my course just the basics of the federal budget. And it was a joke because he was saying that very thing, we're going to cut taxes, but we're not going to cut any of the federal budget. And so the math, I mean, you're a mathematician at a higher level, but the math just didn't work, even at an elementary level. Right?
Bobby Kogan
That's right. It just doesn't. I mean, you have to be either willing to deliberately lie to your constituents, which I think the President is, or you have to not really be even doing a cursory glance. And I just say, I mean, part of the issue, some of these people believe there's just ludicrous amounts of waste or fraud going on in the government. And you even saw the interview with one of the Doge guys who said, yeah, I went in, I was ready to find tons of fraud and I found some, but there was just way less than I thought. And that's because, I mean, over 70%, not counting the interest we do, the interest we pay, if you kind of take that out, over 70% of what we do is payments that go to people. That's your Medicare, that's your Social Security, that's your Medicaid, that's your snap. And then of the remaining kind of less than 30%, about half of that is defense. And if you take that out, the rest of it is like biomedical research and other R and D. It's our infrastructure and it's the people who run the government. So there's just not that much room.
Amy McGrath
It's not Bobby. And you even talked about the fence. I mean, a lot of our defense budget is payments to our military, right?
Bobby Kogan
Yeah.
Amy McGrath
The Milpurs accounts for being in the military.
Bobby Kogan
The Milpirs accounts are a massive, massive, massive part of it. And you can have a discussion about having more or fewer people, but again, that's. I think people deliberately conflate fraud with stuff that I hate. And I think that elision is used as a way to justify cuts that Americans rely on. Right. You know, you say, well, why are we. Why are we doing X, Y or Z? And sometimes there's a really good reason that maybe you haven't thought of, and sometimes there's a really bad reason. But regardless, that actually doesn't mean that this payment to a starving child is fraudulent. You know, like one example that we did, that's really, really, really ludicrous. So there are currently work requirements on food and food assistance. And in this, they really made them a lot stricter. First of all, for the first time ever, they're going to have them hit kids before, before today or, you know, before this bill, even if you weren't working, if you had kids, you weren't going to have any less money. But now they say, okay, well, if your kids are 13 or younger, then you're exempt. But 14 or older, not like teenage boys eat a lot of food or anything. Then there's, then there's less money coming for you if you lose your job. There's an exemption if the economy is bad enough. But that bad enough exemption, the unemployment rate has to be 10%. And I don't know. To the listeners, if you remember the Great Recession, I remember the Great Recession really, really, really well. A lot of my friends were graduating. I was a little bit younger, so I graduated kind of near the tail end of the Great Recession. But I remember people with master's degree degrees fighting to get a job at a hotel. You know, I have a master's. You say, I'll take some job, any job in that recession, which was cataclysmic. And wages were Stagnant for years and years and years and years. The unemployment rate got above 10% in one month once. So if you have Great Recession level unemployment, you are still considered a moocher if you have lost your job. So under this bill, they say you lost your job because the unemployment rate is Great Recession level. You are a moocher. And now there's less food for your 14 year old like that. It's just, I mean, they're just unbelievably strict. They actually apply.
Amy McGrath
It's cruel.
Bobby Kogan
Yeah, it's totally cruel. They actually apply it to veterans too. Right. In the Fiscal Responsibility act, we exempted veterans from it and they applied to veterans. They just. It's cruel is the right word. It's cruel. It doesn't make, it doesn't even make sense. Even if you support, you know, if people who supported the policies underneath all got together, they wouldn't do it this way. It was, it's cruel, it's callous, and it's because they're not, they don't really care about those people. Right. Like that's, that's just what, that's not the point of this bill. The point of this bill was to help the very richest, well, the people.
Amy McGrath
That help them the most get into office. You know, sadly. But, you know, I have two, two important questions for you to finish this up. One, this may be tough, okay. But is there anything positive in this legislation?
Bobby Kogan
Yeah, I mean, if you, if you want me, in my fit of bipartisanship, if you want me to lift up the things that I think are the, you know, the smartest things within this, this is actually a continuation of the 2017 tax cuts. But so part of this was they made, they made some of the tax cuts in 2017 temporary. And so part of this bill was continuing them. They switched, they got rid of the personal exemption and then they boosted the child tax credit. And so depending on if you were rich or poor, you either came out slightly ahead or slightly or slightly behind, you know, per kid. But basically that change made it so that if you were a poor person with kids, you came out ahead. If you were a rich person with kids, you came up behind. So that was actually a good change within it. And then they have, actually, they've set this up in a pretty dumb way. But under. They have, and it's called Trump Account. So it's pretty lame. But they are giving it's. And it's a temporary provision. So, you know, but, but now for every kid who's born, there's A thousand bucks deposited, you know, in a high, high yield bank account for you. It's kind of a dumb thing about how it gets dispersed. You can only get so much, you can't touch it and then you can get only so much at this point and then to get at that point. So there's a lot of bureaucratic red tape around it. But the idea of giving every, you know, a grand for every single kid in America, that then can, then can grow, that's a, that's a good thing. And if they made that provision better, that will be an equity increasing thing that would, you know, help, you know, help deal with the fact that a lot of people aren't able to, aren't able to afford college, aren't able to afford first payments.
Amy McGrath
Yeah. You know, meanwhile they cut their health care and.
Bobby Kogan
Yeah. So of course the poor come out. Yeah. Way behind in this bill. But if I, if I were looking for, is there, are there any, are there any kind of silver linings here? There, there are a few. And I guess what I would just say is if you have a thousand page bill, there are going to be a few silver linings. Unfortunately, they do not make up for.
Amy McGrath
The very, very dark story, the 995 pages of shit. And then you've got the five pages of goodness. I also want to ask you, and then sort of on that note, if Democrats can win power again, which I really, really hope happens for the good of the country, what needs to happen here? Because like, we worked really hard to try to get this not to happen. But you know, look, Trump won the presidency. He's surrounded by lots of people who don't know what they're doing, lots of ideologues. We know that he lies all the time because he said he wasn't going to touch health care and now he's touching health care. He said he wasn't going to add to the debt and the deficit and now it's ballooning even more. You've got the Republican House and the Republican Senate that have pushed this thing through. It's terrible for our country. What do we do about this?
Bobby Kogan
Yeah, it will be an uphill battle. There is so much damage that they did. I mean, it is that the affirmative cuts are, you know, around one and a half trillion dollars of stuff that will be difficult to undo. So you have to, you have to get a trifecta. Right. Dems need to win the House and the Senate and the presidency to have any hope of undoing this. And then you need it to be sufficiently Large, that you can afford to pay for it. Because we will be using the, we will be using the mechanism. And while Republicans broke the rules to not pay for it, I, I don't think Democrats will want. I mean, it's a question for the Democratic caucus. Will they stick with Republicans in the new norm and then themselves add to the deficit, or will they say, no, no, no, no, just because they're being irresponsible, we're not going to be irresponsible. And so it's a lot of stuff. And then you are struggling to find pay force. And then presumably they have. The new president will have an affirmative agenda for themselves as well. In addition, on doing some of the harm here, they might say, and I also want to do X, Y and Z. So now all of a sudden, we're struggling. I mean, we saw the Biden administration had an ambitious agenda, but it really struggled to find offsets for what it wanted to do. And what they sent over to the House, the House then whittled down the offsets, and then when it sent over to the Senate, the Senate further whittled down the offsets. So you need, you need to win, you need sufficiently large margins. So that just means a lot of organizing at state levels. It means lots of people running in districts and hoping we do really well and then electing the people who are willing to lose their seats over it. I think Governor Wallace actually said it right, where he said, you win elections to use your political capital and burn it. Right. That all the people who get elected and say, oh, now the number one most important thing is never losing. That's not true. The number one most important thing is helping your constituents. And so you need people who are willing to risk losing their jobs over delivering for the American people.
Amy McGrath
Yeah. Serious people that are willing to put country above everything else and just don't have enough of them right now. I should have asked you this at the very beginning, but I'm going to ask you at the end here because I forgot. But it's interesting to me. You have a background as being a mathematician, right?
Bobby Kogan
Yeah.
Amy McGrath
So how did, how do you go from being a mathematician to working in public policy? How did that unfold?
Bobby Kogan
I took what I thought was going to be a gap year after college. I thought that I was going to maybe do astrophysics grad school or something, but I was really burned out. So I volunteered on some campaigns. I ended up volunteering on Tim Kaine's senate race in 2012. And I found that it was really rewarding and That I talked to. I can't. I don't know how many people I talked to over all those months, you know, so I ended up working field, as a field organizer for him. I don't know if I said volunteering, but anyway. But I was. I was a, you know, field organizer, and I found that it was really rewarding and I wanted to do more of that. And so then the question was, is there any way, shape or form that I could use my degree in math somewhere in politics? And so ended up at the Senate Budget Committee and as their numbers person. And so I think there are a lot of people in politics who deliberately do bad data, do data crimes. They'll deliberately lose context. Right. So one of the things, I think Texas governors always love to talk about all the jobs that they created, but, like, the Texas population has grown up. So then you want to control for that. And you say, well, how are you doing relative to your growth in population? Oh, it turns out you're doing worse relative to that. Oh, so you were actually bad, not good. So, you know, you always want to make sure you can. You can correct for the compounding.
Amy McGrath
We. We need to do a show on that. All of the, all of the graphs that people put out that are out of context, I mean, you could pretty much find. I always tell my kids, you can find anything on the Internet to, like, back up whatever you think. You could pretty much find any data point and take it out of context. And then, well, so that's what they did.
Bobby Kogan
That's how they pretend that their tax cuts paid for themselves. They said, well, the amount of tax revenue that the federal government is taking in goes up every year. So it paid for itself. You're like, well, you know, every year there are more people, and every year there's inflation, and every year there's economic growth. So obviously, the amount of raw tax dollars that we take in goes up. The question is, it was gonna. It went up like this. How did we think it was gonna go up? So that's number one. And then number two, sometimes Republicans will be extra clever and not account for the. They'll look at the 2017 and 2018 projections compared to what actually happened.
J.J. Harris
Wow.
Bobby Kogan
As they love to point out, there was a lot of inflation in 2021, 2022. So you actually have to correct for that when you want to do the comparisons as well. So there are tons and tons and tons of misleading things that you can do. And so I figured that's how I could actually be helpful, how I could be Helpful was to basically trying to correct a lot of data crimes and trying to say, well, if you give context and do this. And I, you know, I think I developed a reputation for being a straight shooter about that. A lot of people disagree with my priors, but they're not going to disagree with my numbers. And anyway, so that's how I got into it. I said, I think I really love this. I think it matters. I think using my, you know, put my heart and soul into it is the right thing to do. And hopefully turned out the answer was, yes, I could do this. I could try to do the stuff I was actually good at, which was math.
Amy McGrath
Well, it's super important to communicate that to people because one of the things we know about sort of the human brain is when you get too many zeros, you just check out 1 trillion to many people is kind of the same as 1 billion. And how is that really different than 1 million? It's a little bit more than 1 million, but not that much. We don't get it. You need to see it in a graph, kind of. You have to see a pictorially, I think, unless you're a mathematician. And so what you do in communicating your knowledge to America is so important. And so I really thank you for being on the show, for the work that you do and clarifying some of the craziness that we're seeing right now.
Bobby Kogan
Well, that was a very, very kind compliment and it was my pleasure. You know, huge, huge fan of yours for many years now. So if I can ever be helpful again in the future, I'd certainly be happy to.
Amy McGrath
Well, thanks for coming on. Bobby Kogan from Center for American Progress and what a great show. Love to have you back on sometime.
Bobby Kogan
Great. Looking forward to it.
J.J. Harris
This is one of the most spectacular venues with all kinds of character and hospitality, scenery.
Bobby Kogan
These people in this Kitty Task valley, they love when you come to see what they have to offer.
Unknown
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J.J. Harris
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Truth in the Barrel: Episode Summary – "Devil's Cut | The Fineprint In The Big Beautiful Bill with Bobby Kogan"
Podcast Information:
Episode Details:
In this compelling episode of Truth in the Barrel, host Amy McGrath engages in a deep-dive discussion with Bobby Kogan, an expert in federal budget policy. The focus is on the recently passed "Big Beautiful Bill," a piece of legislation that has sparked significant controversy due to its profound impact on Medicaid, federal debt, and the American healthcare system.
Amy McGrath initiates the conversation by highlighting the critical aspects of the bill:
Bobby Kogan succinctly encapsulates the essence of the bill:
“Normally I need two. One sentence is quite literally it makes the poorest Americans poorer while making the richest Americans richer. (02:25)”
He emphasizes the unprecedented nature of the legislation, pointing out that it simultaneously harms the most vulnerable while favoring the wealthy, all without achieving deficit reduction.
The discussion delves into the multifaceted consequences of Medicaid cuts:
Bobby Kogan explains:
“...a lot of hospitals already that are struggling. Some have already said, okay, well that's it, I'm going to close anyway. (07:34)”
He further critiques the implementation of work requirements, highlighting their ineffectiveness and the bureaucratic hurdles that lead to unintended disenrollment of eligible individuals.
The bill’s claim of fiscal responsibility is critically examined:
Bobby Kogan articulates the contradiction:
“...they make the poorest poorer to make room to make the richest richer while somehow still making the deficit larger. (03:07)”
He underscores that this approach is virtually unheard of in legislative history, where deficit reduction typically involves shared sacrifice rather than disproportionately favoring the wealthy.
The legislative maneuvering required to pass the bill is dissected:
Bobby Kogan details the procedural strategies:
“...they have large tax cuts to the rich, permanent tax cuts for the rich. (20:22)”
He highlights how this sets a precedent for future legislative processes, potentially weakening the traditional checks and balances within the Senate.
The episode scrutinizes the Republican narrative of deficit hawkishness:
Bobby Kogan provides historical insight:
“...after Reagan, basically raised taxes in almost every single year of his term. (27:33)”
He argues that the current administration's actions are a continuation of this trend, undermining claims of fiscal responsibility.
The long-term repercussions of the bill are forecasted:
Bobby Kogan warns of the widespread impact:
“...every single hospital in America is going to be losing money because of this. (17:26)”
He emphasizes the need for accountability and sustained advocacy to mitigate these effects.
The conversation concludes with strategies for Democrats to counteract the bill:
Bobby Kogan outlines the challenges ahead:
“...you need people who are willing to risk losing their jobs over delivering for the American people. (40:52)”
He calls for dedicated public servants committed to prioritizing constituent welfare over political survival.
Amy McGrath and Bobby Kogan wrap up the discussion by highlighting the critical importance of informed and accurate data in public policy debates. Kogan shares his journey from mathematics to public policy, emphasizing the necessity of transparency and truth in legislative processes.
“...trying to correct a lot of data crimes and trying to say, well, if you give context and do this. (43:08)” – Bobby Kogan
The episode underscores the urgent need for informed advocacy and the dismantling of misleading narratives that undermine the welfare of millions of Americans.
Conclusion: This episode of Truth in the Barrel provides a thorough examination of the Big Beautiful Bill, revealing its detrimental effects on Medicaid, the federal deficit, and the broader American healthcare system. Through informed dialogue with Bobby Kogan, listeners gain a clear understanding of the bill's implications, the legislative strategies employed to pass it, and the pressing need for accountability and policy reversal to safeguard the nation's most vulnerable populations.