• As House Republicans prepare to begin voting on their big policy blueprint this week, one of the programs they’re targeting for major cuts is Medicaid. The federal healthcare program covers around 80 million Americans, mostly people living near or below the poverty line. While President Donald Trump has endorsed the House’s budget plan, he has also said that Medicaid is ‘not going to be touched.’ Sarah Kliff, investigative health care reporter for The New York Times, explains what the proposed Medicaid cuts would mean for actual people.
• And in headlines: Trump had an awkward meeting with French President Emmanuel Macron over Ukraine, Trump officials continued to sow confusion over an email demanding federal workers justify their jobs, and the president picked right-wing podcaster Dan Bongino as the next FBI deputy director.

• Check out Sarah’s work – https://www.nytimes.com/by/sarah-kliff
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TRANSCRIPT

Jane Coaston: It’s Tuesday, February 25th. I’m Jane Coaston, and this is What a Day. The show that says if you buy tickets to Fyre Festival two, it would have probably been for the best if you had just sent that money to me. [music break] On today’s show, federal workers continue to get jerked around by President Elon Musk, and a judge blocks Trump administration immigration enforcement in some houses of worship. But let’s start with health care. Millions of Americans, just around 80 million people or one in five, rely on a program called Medicaid for health care. From grandparents in nursing homes to pregnant moms to kids with disabilities, they all rely on Medicaid for support. In fact, in 2019, Medicaid paid for half, yes, half of all births in the United States. And the GOP has been trying to gut Medicaid for decades, especially since Medicaid expansion added millions of low income adults, including those without kids, to the program after the passage of the Affordable Care Act in 2010. They claim that Medicaid encourages dependency and that the people who use Medicaid are becoming, quote, “slaves” to a government entitlement program. But Republicans have a big problem. Here’s Steve Bannon on his War Room podcast to explain why. 

[clip of Steve Bannon] Medicaid, you got to be careful because a lot of MAGA’s on Medicaid. I’m telling you, if you don’t think so, you are dead wrong. Medicaid is going to be a complicated one. You just can’t take a meat ax to it. Although I would love to. 

Jane Coaston: Yeah, see, lots of people are on Medicaid, including lots of working class and low income voters, which includes lots and lots of folks who voted for President Donald Trump. And Republicans in Congress, especially those who are facing tough reelection battles ahead, know it. Take Republican Representative Robert Bresnahan, who represents northeastern Pennsylvania, including Scranton. About 27% of his constituents are on Medicaid. Republican Senator Josh Hawley of Missouri has spoken out against cuts to the program. About 21% of his constituents are enrolled in Medicaid. You know who else knows just how much President Donald Trump’s voters need Medicaid? President Donald Trump. He told Fox News host Sean Hannity last week. 

[clip of President Donald Trump] Medicare, Medicaid. None of that stuff is going to be touched.

Jane Coaston: But while a bunch of Republicans and Trump have voiced concerns about cutting Medicaid, the House GOP and Trump have put forward a budget proposal that asks for nearly a a one trillion dollar cut to Medicaid. Yes, Donald Trump has sworn to never cut Medicaid and endorsed a budget that cuts Medicaid. The full Donald Trump experience. Republicans are debating the budget resolution today, and already two members of Congress, Representative Thomas Massie of Kentucky and Representative Victoria Spartz of Indiana, have said they are no on the current version. With a razor thin margin in the chamber, house speaker Mike Johnson can only afford to lose one Republican if he wants to get the proposal adopted. And while my math isn’t great, two is bigger than one. So to get a better idea of what these proposed cuts to Medicaid would mean for actual people, I had to talk to Sarah Kliff. She’s an investigative healthcare reporter for The New York Times, and she’s covered health care policy for a long time. Sarah, welcome to What a Day. 

Sarah Kliff: Thank you for having me. 

Jane Coaston: So 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? 

Sarah Kliff: 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. 

Jane Coaston: 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. 

Sarah Kliff: 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. 

Jane Coaston: And Medicaid has also been a political target of Republicans for decades. Why? 

Sarah Kliff: 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.

Jane Coaston: Yes. Those babies got to get them in the mines. 

Sarah Kliff: Yeah. I mean, one thing I would even add about the adults on Medicaid, the vast majority of them are working already. 

Jane Coaston: Right. 

Sarah Kliff: 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. 

Jane Coaston: 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? 

Sarah Kliff: 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. 

Jane Coaston: Yeah. Let’s let’s get into the budget. How are they looking to get those major savings from Medicaid? 

Sarah Kliff: 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. 

Jane Coaston: 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. 

Sarah Kliff: 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. 

Jane Coaston: 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? 

Sarah Kliff: 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. 

Jane Coaston: Do you think that Medicaid is a harder political target than Obamacare is or was? 

Sarah Kliff: 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. 

Jane Coaston: 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? 

Sarah Kliff: 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. 

Jane Coaston: Sarah, thank you so much for joining me today. 

Sarah Kliff: Thank you. 

Jane Coaston: That was my conversation with Sarah Kliff, investigative health care reporter for The New York Times. We’ll get to more of the news in a moment, but if you like the show. Make sure to subscribe. Leave a five star review on Apple Podcasts. Watch us on YouTube and share with your friends. More to come after some ads. 

[AD BREAK]

Jane Coaston: Here’s what else we’re following today. 

[sung] Headlines. 

[clip of President Donald Trump] We’ve had some very good talks with Russia. We’ve had some very good talks with others, and we’re trying to get the war ended with Russia and Ukraine. And I think we’ve come a long way in a short period of weeks. 

Jane Coaston: President Donald Trump met with French President Emmanuel Macron at the White House Monday. Their conversation largely focused on the war in Ukraine. Macron’s visit coincided with the third anniversary of Russia’s invasion of the sovereign country. He and Trump spoke with reporters in the Oval Office before their meeting, and the two struck very different tones when it came to Russia. Macron seemed to push back on the Trump administration’s current plan to get Ukraine to give the US access to its rare earth minerals in exchange for continued American aid. The French president said it’s Russia who should be helping pay for the costs of the war. 

[clip of French President Emmanuel Macron] I support the idea to have Ukraine first being compensated, because they are the ones who have losed a lot of their fellow citizens and being destroyed by these attacks again all of those who have been paid for could be compensated, but not by Ukraine, by Russia, because they were the ones to aggress. 

Jane Coaston: This led to a very awkward exchange where Trump falsely claims that Ukraine is going to pay European countries back for their support. 

[clip of President Donald Trump] Europe is loaning the money to Ukraine. They get their money back. 

[clip of French President Emmanuel Macron] No, in fact to be to be frank, we paid. We paid 60% of the total default and it was [?] out like the US, loans, guarantee, grants. And we we provided the [?]money to be clear. 

Jane Coaston: I would prefer to never be corrected by a French person. Trump also once again refused to condemn Russian President Vladimir Putin at all really. Instead, he doubled down on his choice to call Ukrainian President Volodymyr Zelensky a dictator last week. 

[clip of unknown person] When you called Zelenskyy a dictator, would use the same words regarding Putin?

[clip of President Donald Trump] Uh. I don’t use those words lightly. 

Jane Coaston: You don’t? Interesting. Also Monday at the United Nations, the U.S. joined our historic BFFs, Russia, Iran, North Korea. Wait, what? In voting against a resolution to condemn the Kremlin’s invasion of Ukraine. It passed anyway. Trump was asked to explain the vote on Monday during Macron’s visit, to which he said. 

[clip of President Donald Trump] I would rather not explain it now, but it’s sort of self-evident, I think. 

Jane Coaston: That’s not the word I would use. The U.N. also passed a watered down US resolution that calls for an end to the war in Ukraine. The U.S. abstained from voting on that resolution after European leaders inserted some anti-Russian language. It also passed. Two days after asking federal workers to justify their jobs. The Trump administration continued to sow chaos. We’re recording this Monday night and the story is still changing a lot. But the drama all started Saturday with an email from the Office of Personnel Management to more than two million federal workers. It asked them to list five things they did at work last week and demanded a response by Monday night. Before the email went out though DOGE leader, non leader Elon Musk said on Twitter, quote, “failure to respond will be taken as a resignation.” But some government agencies balked and told employees not to respond. That included agencies led by staunch Trump loyalists like the Justice Department and the Pentagon. By Monday afternoon, multiple news outlets reported that OPM had backed off, telling top agency officials responses were now voluntary. The personnel department also made clear that failing to respond would not be considered a resignation, but President Trump voiced support for Musk’s demand during his Oval Office meeting with the French president. 

[clip of President Donald Trump] I thought it was great because we have people that don’t show up to work, and nobody even knows if they work for the government. So by asking the question, tell us what you did this week, what he’s doing is saying, are you actually working? And then if you don’t answer like you’re sort of semi fired or you’re fired because a lot of people are not answering because they don’t even exist. 

Jane Coaston: They don’t even exist. Also, what is semi fired mean? Okay. And as if all of that wasn’t confusing enough, Musk weighed in on the whole thing on Twitter Monday night. He said that the email request was, quote, “trivial” and so many failed what he called “an inane test.” He wrote, quote, “have you ever witnessed such incompetence and contempt for how your taxes were being spent?” Well, Elon Musk seems to have a prominent role in this administration. So yeah, I have. Also Monday, NBC news reported emailed responses from federal workers were likely to be fed into an artificial intelligence system to figure out whose jobs were worth keeping. NBC news cited anonymous sources in its report. A federal judge Monday blocked immigration agents from making arrests at some churches, mosques and other places of worship. Former President Biden initially barred agents with Immigration and Customs Enforcement, or Ice, from raiding, quote unquote, “sensitive locations.” Like churches, schools and hospitals. But Trump’s Department of Homeland Security, led by Secretary Kristi Noem, tossed out those restrictions late last month. A group of congregations from multiple states sued Noem and DHS over the order a few days later. The plaintiffs include some Quaker congregations and Baptist churches, as well as a Sikh temple. At a hearing earlier this month, the religious groups argue that the threat of ICE entering their places of worship has discouraged migrants from attending service. Lawyers for the Trump administration downplayed those claims. In a court filing, they insisted the faith groups have no proof their congregations are being targeted for immigration raids. But a federal judge sided with the congregations, saying that the new DHS policy could violate migrants right to religious freedom. He put the policy on hold while the lawsuit makes its way through the courts. It’s important to note, though, Monday’s ruling only applies to the faith groups that joined the lawsuit. Not all places of worship. It states that any immigration agents who make arrests at their facilities will face penalties. 

[clip of Dan Bongino] I’m going to accept the role proudly as a deputy director of the number two spot at the Federal Bureau of Investigation. 

Jane Coaston: Dan Bongino, the former Secret Service agent turned right wing podcaster, announced on his show Monday that he plans to accept the role as FBI deputy director. He said he needed to turn in his man card to get a little emotional about the whole thing, because I guess men aren’t allowed to feel feelings. 

[clip of Dan Bongino] President, attorney general Bondi, and now director. Gosh, that sounds good to say FBI Director Kash Patel, offered this role. A role I expressed an interest in. And ladies and gentlemen. I told you, you see, it’s hard for me. 

Jane Coaston: President Trump announced Bongino’s appointment Sunday. Trump posted on Truth Social that FBI Director Kash Patel, a Trump loyalist, chose Bongino for the role. The president called Bongino quote, “a man of incredible love and passion for our country.” Like Patel, Bongino has never served in the FBI, but the deputy director role does not require Senate confirmation. Bongino served on the presidential details for then presidents George W. Bush and Barack Obama. He was a commentator on Fox News before leaving the network in 2023. In 2018, Bongino said, quote, “owning the libs is a lifestyle. You must own the libs repeatedly.” And his online persona includes spreading misinformation like lies about the 2020 election being stolen. And that’s the news. [music break] One more thing. This administration is trying to make me and you insane. It’s difficult to keep up with the rage bait, sort out what matters from what doesn’t, and not just scream on street corners or on social media. But sometimes it’s worth saying, what in the entire hell are you doing? Case in point. Ed Martin is the interim U.S. attorney for the District of Columbia. Before his posting, he was probably best known for his work on behalf of the Stop the Steal campaign that aimed to overturn the 2020 election results. And on Monday, he posted a tweet from the official account for the U.S. Attorney’s Office, as one does. The tweet was in reference to The Associated Press’s lawsuit against three Trump administration officials for their efforts to bar the AP from press briefings and Air Force One over the outlet’s refusal to use the new Gulf of America moniker. The tweet reads as follows, quote, “as President Trump’s lawyers, we are proud to fight to protect his leadership as our president, and we are vigilant in standing against entities like the AP that refuse to put America first.” Now, a few things. First, I know you probably can’t see this, but mercifully, there is only one Donald Trump, so the location of the apostrophe in Trump’s is wrong. I’m a punctuation [?], but also that’s not what a U.S. attorney is. See, if you go to the official website of the U.S. attorneys, it will tell you what a U.S. attorney is. It reads, quote, “charged with ensuring that the laws be faithfully executed. The 93 United States attorneys work to enforce federal laws throughout the country.” Did you get that? Did you get that’s the job of a U.S. attorney is to enforce federal law and not to be Donald Trump’s personal attorney? If you’re a U.S. attorney, your job is to act on behalf of the American people. Legal briefs won’t say your name at the top. It’ll say United States versus whomever. And this might be tough for Ed Martin to understand, but the United States is not Donald Trump. And the United States was not Joe Biden or Barack Obama or president James Buchanan, for God’s sake. The job of a U.S. attorney is not actually to run cover for the American president in a stupid battle over the name of the Gulf of America/Mexico. You’re not standing against fascism. You’re standing against a journalistic outfit that the president of the United States is mad at. There’s a lot I could ask for from the attorney general from my former home city. I could ask that you show at least some small amount of interest in doing his actual job, which is not, contrary to Martin’s opinion, pursuing people who have, quote, “acted unethically in their criticisms of Elon Musk and the Department of Government Efficiency,” quote, “to the end of the Earth,” or acting as Donald Trump’s personal lawyer. But I will ask this instead. Be less embarrassing, say less online, do less of whatever this is because you can be the most enthusiastic supporter of Donald Trump to ever exist, but man, just be less embarrassing. [music break]

[AD BREAK]

Jane Coaston: That’s all for today. If you like the show, make sure you subscribe. Leave a review. Don’t tell fired federal workers that it’s all good because quote, “God has a plan.” And tell your friends to listen. And if you’re into reading, and not just about how Missouri Republican Representative Mark Alford told a town hall full of recently fired workers in Belton, Missouri, there are jobs available. God has a plan and purpose for your life, and everyone in the crowd got very understandably mad, like me. What a Day is also a nightly newsletter. Check it out and subscribe at Crooked.com/subscribe. I’m Jane Coaston and maybe don’t bring God into this whole DOGE thing. [music break] What a Day is a production of Crooked Media. It’s recorded and mixed by Desmond Taylor. Our associate producers are Raven Yamamoto and Emily Fohr. Our producer is Michell Eloy. We had production help today from Johanna Case, Joseph Dutra, Greg Walters, and Julia Claire. Our senior producer is Erica Morrison. And our executive producer is Adriene Hill. Our theme music is by Colin Gilliard and Kashaka. Our production staff is proudly unionized with the Writers Guild of America East. [music break]