By a one vote margin (215-214), on May 22, the MAGA Republicans in Congress passed a budget reconciliation bill that delivers to President Trump his most cherished prize: tax cuts for billionaires. To do so they have cut at least $715 billion in health care spending mostly from Medicaid; $300 billion from the Supplemental Nutrition Assistance Programs (SNAP); and, roughly $500 billion from Medicare. This is a morally corrupt and unambiguous attack on the most vulnerable in our nation, and literally trades health and health care for millions of Americans in exchange for tax breaks for a few hundred of the very richest Americans. It is far from “beautiful.” 

According to economist and former Secretary of Labor, Robert Reich, should this bill become law, the impact would be that the richest of the richest (the 0.11%) will gain roughly $390,000 a year. Conversely, it would cost about $1,000 a year for those earning less than $17,000 annually. For those earning between $17,000 and $51,000, the cost would be about $700 a year.  

Health care is a basic human right, and even our current insufficient coverage is supported by the progressive tax structure that we have had since the 1930s: the more you earn, the higher your tax rate. Regardless of your position, regardless of the balance in your bank account, the color of your skin, or your zip code, most of us can agree tax cuts for billionaires is not a policy priority. Especially when it comes at the expense of health care for the most vulnerable.

More than two million Arizonans receive health care through Arizona’s Medicaid, the Arizona Health Care Cost Containment System (AHCCCS, pronounced like “access”). AHCCCS is already at work to “cut costs” of the program by instituting additional work requirements, particularly targeting seniors between 54 and 65 years of age. 

The Arizona Mirror recently provided a sobering perspective on this from New Jersey Democratic Congressperson Frank Pallone, the ranking member on the House Energy and Commerce Committee. Referring to the 98% of Georgians eligible for Medicaid who were nonetheless unable to prove that they met the standards, Pallone said, “It’s not that they weren’t eligible, it’s that the state of Georgia put too many barriers in the way of them being able to qualify,” Pallone said. This is where Arizona is now headed: make enrollment so challenging, people who need the services simply give up.    

While it does incorporate many carveouts for vulnerable people, the Georgia experience does suggest that many sick people will end up in emergency rooms at a later stage in their illness than is safe.

You don’t have to be a policy expert to know the outcomes will include: 

1. An increase in the uninsured. Approximately 550,000 Arizonans might lose Medicaid coverage, especially if the state cannot compensate for reduced federal funding.
2. Increased patient morbidity. Simply put, people will be sicker than they have to be. When a patient has concerning symptoms, earlier medical care leads to better outcomes. 
3. Stress on community health care systems. Hospitals and clinics will experience higher uncompensated care costs. 
4. Economic Loss. For every $1 billion cut, Arizona could lose over 36,000 jobs and $3.7 billion in economic activity. 

All Americans, including all Arizonans, deserve better. Unforced errors in health policy like these will be repaired when our elected representatives prioritize the well being of our neighbors and our communities, instead of focusing on tax breaks for billionaires. 

The problem is not really one of policy differences; it is a difference of values. When we elect representatives who reflect our values, we will see legislation that seeks to provide quality, affordable health care for everyone, especially the most vulnerable, due to either low income or poor health status. 

Unfortunately, that’s not the case currently. In Washington, and here in Arizona, the legislative branches of government seemingly seek only to reduce taxes on the wealthiest Arizonans. As Paul Wellstone noted, “We all do better when we all do better.” And that’s especially true regarding personal and community health.

Deborah Howard served as a Special Assistant at the U.S. Department of Labor and worked at AARP, as well as Blue Shield of California. Howard is a candidate for the Arizona House of Representatives, LD27.

Nelson Morgan is a retired University of California at Berkeley faculty member and research scientist, and is the former director of the International Computer Science Institute. He is the author of “We Can Fix It: How to Disrupt the Impact of Big Money on Politics”, with a foreword by George Lakoff.