How Many People Have to Die to Keep a 79-Year-Old Man Suffering from Dementia Happy?
July 3, 2025
Photograph by Nathaniel St. Clair
That’s the question Republicans in Congress will be debating as they struggle to put Donald Trump’s “Big Beautiful Bill (BBB)” in final form to pass and send to his desk. The essence of the bill should be well known at this point. It extends Trump’s 2017 tax cuts past their scheduled expiration date at the end of the year.
This matters little to most of the country, who did not see much benefit from the 2017 tax cut. However, it is big bucks to the rich and very rich who got a large tax cut from the 2017 bill. The bill also includes some extra gravy for the rich and very rich.
For example, it has a provision that allows owners of businesses to have much or all of their income taxed at the lower capital gains rate of 20 percent, instead of the 37 percent rate that they would otherwise pay. Trump is also proposing to cut I.R.S. staffing in half. He has also eliminated the tax enforcement division at the Justice Department. This means Trump and Republicans are effectively putting up a huge neon sign saying “Taxes are Voluntary” for rich people across the country.
Just to be clear, average Joe and Jane types out there should not be confused and think this means they won’t have to pay their taxes. Most of us have our taxes deducted from our paychecks. That will still happen. Maybe some of these people get some small change in interest or dividend income they can hide, but for the vast majority of ordinary people, shutting down enforcement won’t reduce our tax bill even if we wanted to cheat. For the rich and very rich, it is a very big deal.
There are also the “populist” tax cuts in the bills. The most famous is making tips tax free. That’s good news for a small number of relatively highly paid tipped workers in Las Vegas, but pretty much irrelevant for the bulk of people waiting on tables in restaurants. These people generally pay little or no tax already. Depending on the way the final bill is structured, it could actually cost these workers money by reducing the money they get from the earned income tax credit.
The effort to make Social Security benefits tax free turns out to be a nice bonus for higher income retirees but means little or nothing to the bulk of those who could use help. The bill increases the standard deduction for people over age 65 to 6,000. Most seniors either pay no income tax or are in the 10 percent tax bracket, which means it will give them $600 a year. Higher income seniors in the 25 percent bracket would pocket $1,500 a year.
The proposal pushed by Senators Bernie Sanders and Elizabeth Warren, to increase Social Security benefits by $2,400 a year, would do far more to help seniors who are struggling. This could be phased out so as not to benefit those already comfortable.
Making overtime tax free effectively turns the current overtime law on its head. The current law is designed to discourage employers from requiring workers to put in long hours and to instead hire more workers. The 50 percent wage premium is a penalty for employers who insist workers put in long hours. (Overtime in almost all cases is mandatory.)
The BBB will instead subsidize long hours by creating a zero-tax bracket for extra hours. In addition to encouraging tax gaming (remember, no one polices tax fraud anymore), this will mean employers can require workers to put in 50 and 60 hours a week and to shut up and eat their tax break. That’s not exactly family friendly. If we want to help workers putting in long hours the obvious route would be to raise the wage premium for overtime from 50 percent to 75 percent or even 100 percent. This would be money out of the employers’ pockets, not the taxpayers’ pockets.
There also is some additional spending in the BBB. It will increase military spending and provide a huge increase in funding for the Department of Homeland Security. This means Secretary Kristi Noem will have more money to hire plains clothes agents, who grab people off the streets and out of workplaces, to ship off to wherever they feel like. Noem claims she hires snowflakes, who have to remain anonymous, unlike the hundreds of thousands of state and local police officers across the country who wear uniforms and show identification.
This will help keep us safe from gardeners, restaurant workers, roofers, and other people who have been menacing the country by doing hard work at low pay. The funding will also pay for more prisons for Noem to keep these people in while they decide what to do with them.
The best part is how they propose to offset the cost of the tax cuts and increased spending. This is where the dying comes in. They propose large cuts in Medicaid, subsidies in the Affordable Care Act, and food and nutrition programs for low-and moderate-income households. According to the Congressional Budget Office, more than 10 million people will lose health insurance coverage from the BBB.
People without insurance coverage don’t stop getting sick or having accidents, they just get less medical care. This means many conditions, like cancer, will go untreated until they reach a point where they can no longer be treated.
The Republicans know this sounds awful, so they just lie and say no one will lose their Medicaid. This is absurd. The Congressional Budget Office is projecting close to $800 billion in savings (roughly 10 percent of Medicaid spending and 1 percent of the total budget), which the Republicans are assuming in their analysis of the bill, based on the assumption that close to 10 million people will lose benefits.
To be clear, the Republicans are making their cuts in the sleaziest possible way, they are increasing the paperwork required to get benefits. The most important item in this category is a work requirement. As it stands, the vast majority of people getting Medicaid already work. Past experience shows that work requirements don’t increase work, but they do cause people who don’t handle the paperwork properly to lose coverage.
To appreciate the true sleaziness of this route for cutting benefits remember that Republicans have placed a high priority on reducing regulatory paperwork for businesses, saying that it creates an unnecessary burden. When it comes to businesses that have lawyers, Republicans are very sensitive to the difficulties imposed by complying with regulations. However, when it comes to lower income people, many of whom have limited education, the Republicans are very happy to impose more paperwork.
And experience shows many will fail to complete the necessary forms correctly. This is the basis for the CBO analysis showing over 10 million people losing coverage and the government saving $800 billion over the decade on Medicaid.
Throwing people off health insurance to pay for tax breaks to the rich sounds pretty awful, which is why Republicans lie about what they are doing, but those of us not in on the joke need to deal with the truth, not Trump’s reality TV show version. The truth about the BBB is pretty awful, but at least passing the bill will make Donald Trump happy.
This first appeared on Dean Baker’s Beat the Press blog.
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US May Consumption Data Looks Pretty Bad
Photograph by Nathaniel St. Clair
Sorry, I’ve been on the road, so not much time for writing. I did want to quickly mention a couple of points about the data on consumption for May which were released on Friday.
First, real consumption actually fell in the month. That is not good news, but as the law of economic data says, do not pay much attention to a single month’s data.
Income also fell, but making a big deal of this is in the ungodly stupid category. Income for March and April was inflated by Social Security checks sent to recipients as retroactive payments for 2024 provided by the Social Security Fairness Act. Those checks stopped coming in May, hence the fall in income.
But stepping beyond the one-month issue, if we compare May consumption to October, the last month before people knew Trump would be in the White House, the picture is not very good. The logic of going this far back is that durable goods consumption jumped, beginning in November, as people wanted to beat price increases from the Trump tariffs.
Anyhow, overall consumption has grown at 1.4 percent annual rate since October. That is not a great story for the economy. If consumption is growing at a 1.4 percent rate, it is hard to see the economy growing much faster.
Remember, consumption is 70 percent of GDP. Government spending is more than half of the remainder, mostly state and local. With Trump and the Republicans trying to shut down much of the government, does anyone anticipate rapid growth there?
Housing accounts for 4 percent of the total. With mortgage rates staying high and people uncertain about the future with Trump’s constantly changing policies, don’t anticipate any big upswings here.
Investment is also hit with uncertainty. The Biden boom in factory construction is unwinding. Investment in intellectual products is likely going nowhere, with Trump nixing all sorts of funding and projects. Equipment investment is also likely to be hit by uncertainty.
We will see an improvement in the trade balance in the second quarter, but that’s after a surge in the first quarter. Hard to make any bets with Trump’s erratic policies and chasing away foreign visitors.
Long and short, May is just one month, but the picture was not very good.
This first appeared on Dean Baker’s Beat the Press blog.
The Price of Hunger in the
United States
Photo by Steven Cordes
“There is no question or doubt that nobody will starve or go hungry in the United States.” Herbert Hoover spoke those words in 1931, days after thousands of poor Americans converged for a Hunger March on Washington DC, demanding government aid. The Great Depression had thrown millions out of work and into poverty, but President Hoover refused to consider how he and Congress could help them. He opposed any form of welfare or “government dole.” Media reports of hunger and destitution were “over-exaggerated,” he said.
Almost a hundred years later, the Trump administration is repeating that same playbook. Researchers in The Lancet wrote that Congress’s proposed cuts to Medicaid could cause 14,660 American deaths each year, which otherwise would not have happened. Unprecedented cuts to food benefits (SNAP) will make millions of people hungry and malnourished, increasing the risk of suffering and premature death. Russell Vought, Trump’s director of the Office of Management and Budget, went on CNN and called these reports “totally ridiculous” and “astroturf.”
The Boston University School of Public Health’s Impact Counter estimates that almost 60,000 children worldwide have already died of severe acute malnutrition as a result of Trump and DOGE throwing USAID’s humanitarian aid into the woodchipper. Scientists in Nature calculated that 369,000 more children will die of malnutrition every year, children who would have been saved if aid had not been cut. Secretary of State Marco Rubio called these numbers “false” and “fake:” “There’s just no evidence of the fact… that 100,000 children have starved to death because of cuts to USAID.” Rubio told the Senate that poor countries are to blame for having their aid cut, because they don’t make business and mineral deals with the US.
This has happened before. The United States has a long history of using hunger as a weapon and a policy, and denying responsibility for its impacts.
The hunger marchers of the Great Depression recognized that food was power. Government authorities, charities and employers colluded to keep poor people hungry so that they would work and do what they were told. Plantation owners withheld access to food from the croppers on their land, to keep them obedient and disciplined. Mine owners paid their workers with little brass tokens called scrip, which could only be used at the company store, where prices were high. When miners or textile mill workers went on strike, or when their labor was no longer needed, owners tried to starve them out. Local charity offices made sure that only obedient workers had access to relief. Striking workers’ self-help kitchens were bombed and destroyed. Their children went hungry.
Hunger forced poor people to work. As one Union army commander put it after Emancipation, “the liberty given [freedpeople] is the liberty to work, work or starve.” US Indian Agents used hunger to discipline Native people who had been removed from their homelands to reservations. Agents withheld food rations to force Native people to sell their land, work for wages and send their children to Indian schools. US agents then blamed Native people and freedpeople for their own hunger, accusing them of backwardness and indolence.
Welfare agencies also used hunger as a tool for discipline and exclusion. Local welfare officials sometimes made poor people labor for public works to access food benefits. In the 1960s, county welfare offices in the South set up barriers to accessing food aid by making poor people pay an impossibly high deposit for food stamps, or by requiring a letter from a landowner to sign up for benefits. When thousands of people suffered from hunger and malnutrition, public officials blamed them for making bad food choices or for being lazy.
Early in Ronald Reagan’s presidency, drastic welfare cuts led to long lines at food pantries across the country. White House Counselor Edwin Meese dismissed reports of rising hunger in America. Like Rubio, Meese called statistics on hungry children “purely political.” He claimed that there was no evidence: “we do not know how many people there may be who are hungry.” And he suggested that poor people were faking hunger. “People go to soup kitchens because the food is free and that that’s easier than paying for it.”
Poor people are not fooled by this kind of duplicitous rhetoric. Eleven year-old Grace Chiaramadi, daughter of two unemployed textile workers, joined the Children’s Hunger March in 1932. A skeptical reporter told her, “you don’t look hungry.” “Oh, don’t I though!” she retorted. “Sometimes we go for days without eating anything.” Chiaramadi told the reporter that she had a two-month old brother, who she feared would die of starvation. “I want to tell you I know what it means to be hungry.” Children across the US and worldwide know what it means to be hungry. If Trump and Congress ignore them, the price will be suffering and death.
This first appeared on the UC Press blog and is reprinted with permission.
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