Polls and politics look grim for One Big Beautiful Bill

Modern Healthcare – Friday, June 6, 2025
By Michael Mcauliff

The last time congressional Republicans tried to make significant cuts to healthcare, it turned out to be highly unpopular. A new poll and recent events suggest they are trudging down the same path as they clamor to deliver President Donald Trump his tax cuts.

Trump and the GOP majority in Congress are trying to pass the One Big Beautiful Bill Act of 2025 to enact $3.7 trillion in tax cuts, paid for in part by more than $1 trillion in healthcare cuts, predominantly from Medicaid. They aim to finish their work by July 4.

Most Americans believe the tax-and-spending-cuts measure would cause people to lose health coverage, negatively affect healthcare providers, and make it harder for their families to get and afford care, according to survey results the nonpartisan health policy research institution KFF published Friday. The organization conducted the poll from May 5-26.

Respondents appear more concerned about others than themselves, the survey shows. While 54% say the bill would be bad for them and their families personally, 71% think it would harm providers and 72% said it would make people uninsured, KFF found. Although Democrats and independents expressed unfavorable views at much larger margins, a sizable minority of Republican voters did, too.

Recent analyses suggest they are right to be worried about these consequences, despite Trump and GOP leaders continually insisting that taking $1 trillion out of the healthcare system would have no detrimental effects on anyone.

The House-passed version of the legislation would end coverage for 10.9 million people, including 7.8 million who would lose Medicaid, the nonpartisan Congressional Budget Office concluded in a report released Wednesday. Tighter eligibility checks for health insurance exchange subsidy applicants and related polices would cause 900,000 marketplaces enrollees to become uninsured, according to the CBO.

In a separate report issued Wednesday, the CBO combined the effects of the One Big Beautiful Bill Act with Trump and Congress allowing enhanced exchange subsidies to expire at the end of the year. Under those circumstances, 16 million people would become uninsured, the agency projects.

Researchers from the University of Pennsylvania and Yale University painted an even more morbid picture Tuesday. According to their study, the One Big Beautiful Bill Act and the larger subsidies disappearing would lead to 51,000 preventable deaths.

Republicans are aware of the political perils of taking away healthcare, not least because their failed efforts to repeal the Affordable Care Act of 2010 eight years ago contributed to Democrats taking the House in the midterm elections.

This political predicament was vividly highlighted last week, when constituents at a town hall meeting with Sen. Joni Ernst (R-Iowa) made the lawmaker visibly uncomfortable by declaring people would die because of the tax bill’s Medicaid cuts.

Ernst tried to brush off the heated complaints by declaring, “Well, we’re all going to die. For heaven’s sakes, folks.” The comment quickly went viral, and prompted one would-be Democratic challenger, state Rep. J.D. Scholten, to hasten his entry into the race to unseat her next year.

“Sen. Ernst’s cruel dismissal of Iowans fearful of losing their healthcare is why I decided to challenge her,” Scholten said in a statement. “The Big Beautiful Bill will only cause untold damage to our rural towns by gutting our nursing homes and hospitals. Iowans are now calling her ‘Joni Hearse’ as a result.”

Senate Minority Leader Chuck Schumer (D-N.Y.) kept up the pressure Thursday when took to the Senate floor to rebrand the Republican legislation after Ernst’s comments, accompanied by a large poster board highlighting them.

“That quote tells you everything you need to know about this plan: callous, clueless and careless,” Schumer said. “They might as well call it the ‘We’re All Going to Die Act,’ after what the senator from Iowa said. At least that name is more honest.”

Ernst’s office did not respond to a request for comment, but the senator posted an apology video on social media that has been described as sarcastic.

“I made an incorrect assumption that everyone in the auditorium understood that, yes, we are all going to perish from this Earth,” Ernst said. “So I apologize. And I’m really, really glad that I did not have to bring up the subject of the tooth fairy, as well.”

Despite the flippant answer, KFF found significant numbers of Republicans, including some who identify with Trump’s “Make America Great Again” movement, who are worried about the bill’s impact. And they make up a large part of the population likely to be affected, either by the tax bill or by diminished marketplace subsidies.

According to the survey, 45% of marketplace enrollees are GOP voters — including 31% who associate themselves with MAGA — and 20% are independents, compared with 35% who are Democrats. For Medicaid, 27% are Republicans — including 19% who self-identify as MAGA Republicans — 36% are independent and 37% are Democrats.

The high number of Republicans and independents depending on federal healthcare programs and worried about the “big, beautiful bill” has not gone unnoticed by Democrats.

Democratic campaign operations have already begun running ads in swing districts and states, and lawmakers are emphasizing the threat to healthcare in competitive races and elsewhere.

Sen. Elissa Slotkin (D-Mich.), who narrowly won election last year, had a town hall meeting planned for Friday in her former House district, where GOP Rep. Tom Barrett holds her old seat.

And the Democratic Congressional Campaign Committee and Democratic Senatorial Campaign Committee circulated a memo Thursday that drew heavily on external and internal polling about how worried voters are.

Messages focused on healthcare cuts are “consistently the most effective,” the memo advises candidates.

“The more voters learn about the Republican plan to slash healthcare and food assistance to pay for a massive tax giveaway to billionaires, the more strongly they oppose it,” the Democratic campaign arms said in a statement announcing the memo.

“Midterm backlash is continuing to grow against the GOP as they push forward with their toxic agenda — and Democratic candidates are positioned to build on that energy to flip seats and retake the House and Senate in 2026,” the DCCC and DSCC said.

The National Republican Congressional Committee and National Republican Senatorial Committee plan to counter these tactics by emphasizing tax cuts, immigration and other issues, according to a memo they distributed to GOP candidates May 22.

“House Democrats just gave Republicans a generational opportunity to go on offense. Their unanimous vote against the ‘One Big, Beautiful Bill,’ a landmark package delivering tax relief, government efficiency and border enforcement, handed us the clearest contrast in years,” the NRCC and NRSC wrote.

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