I like to pronounce it "COUP DE GRAHHHHHH" (emphasizing the AHHHHH) because by the annoyance on their faces I can find the people around me who are secretly French but pretending to be normal.
You know who’s made a strong case against Republicans messing with Medicaid? A Republican, specifically Sen. Josh Hawley, the otherwise very conservative Senior Senator from the State of Missouri.
As for Missouri, it is one of 40 Medicaid expansion states — because our voters wanted it that way. In 2020, the same year Mr. Trump carried the Missouri popular vote by a decisive margin, voters mandated that the state expand Medicaid coverage to working-class individuals unable to afford health care elsewhere. Voters went so far as to inscribe that expansion in our state Constitution. Now some 21 percent of Missourians benefit from Medicaid or CHIP, the companion insurance program for lower-income children. And many of our rural hospitals and health providers depend on the funding from these programs to keep their doors open.
All of which means this: If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It’s that simple. And that pattern will be replicated in states across the country.
One of my constituents, a married mother of five, contacted me to explain why Medicaid is vital to her 8-year-old daughter, who depends on a feeding tube to survive. Formula, pump rentals, feeding extensions and other treatments cost $1,500 a month; prescriptions nearly double that cost. These expenses aren’t covered by private insurance. The mother wrote to me, “Without Medicaid, we would lose everything — our home, our vehicles and, eventually, our daughter.”
Can you coauthor a guest post with Curt where he dolls out some dating advice? If he's got a rotating cast of girlfriends there's a lot of fellas out here on six figures+ who would learn a thing or two from him
Balancing the budget by no longer paying four times the going rental rate to "illegal immigrants" in the middle of nowhere... and not putting them up in the Roosevelt Hotel in NYC. And maybe we could stop needing National Guard on the NY Subway if we stopped letting all the terrorists in...
Yep, AI could take all your jobs. Dance for the AI, and pray it is merciful.
I applaud you for including a sankey diagram without making a fluffer joke. That joke has been nailed enough. That joke's been ridden like the town bicycle. Making a joke so obvious would be disappointing, like having a warm apple pie, but before getting the chance to eat it you cum in a fluffer.
One clarification on the topic of only being able to dodge the uninsured folks’ hefty hospital bills if you’re a let them die in the streets libertarian. If you ran a hospital, you actually could not dodge these bills even if you were a libertarian. In order to let folks die on the streets, the US would have to get rid of EMTALA (1980s law mandating that hospitals with emergency rooms treat everyone until they are stable regardless of their ability to pay). I bring that up because so many folks want to wax poetic about their philosophical opinion on whether healthcare is or is not a right — but in the US currently today, this is not a question up for debate. Emergency medical care is a legal right of everyone. Unless we were to repeal EMTALA, the only question we really have reason to debate is whether non-emergency services such as check-ups with a primary care doctor should or should not be a right. And as you sort of alluded to in the article, primary care services are FAR cheaper than emergency services (which, again, we legally have to provide under EMTALA). If we funded primary care as a right of every American, the most likely scenario is that we would incur more costs for the first 2-5 years and then would see a serious drop-off in costs as progressively fewer expensive emergency visits would be needed. This is extremely obvious to almost everyone I’ve ever met in healthcare, yet the average citizen has no idea. This frustrates me to no end. Anyway…….Thank you for coming to my ted talk.
Young delinquent men basically consume no health care resources.
I think there's a good argument that we want these deadbeats to get jobs and even if it costs Medicaid money, the point is to make them get jobs.
I also don't buy the "they skip preventative things and go drive up health care costs." It sounds nice, like free money, but nearly all attempts at saving money through prevention fail. The deadbeat guy who doesn't bother filling out the Medicaid form probably doesn't bother going to see the doctor for that annoying rash until it's covered half their body, either, even if he's got coverage.
But. I've known people who struggled to get on Medicaid and when finally got on it the first thing they did was have cataract operations so they weren't literally driving blind. Medicaid is pretty shitty coverage, but it will pay for the few thousands of dollars needed to stop being blind, so I'd rather everyone just defaulted to be on it automatically, and you have to do work to not be on it.
We should be applying pressure to make deadbeats work. Just not in the Medicaid system.
Everyone on Medicaid managed to jump through whatever hoop was needed to sign-up. So, they went to some minimal effort and therefore thought there was a benefit large enough to justify this minimal effort. I seriously doubt that proving you are working is any harder to do. Actually working is much, much harder than proving you work and that’s the real stumbling block.
We ended "polio" (what FDR got, not actual polio) through prevention. Prevention is generally done on a LARGE scale, and eliminates Causes, not "here have some pills" to a perfectly healthy person.
Prevention is outlawing people living in Picher (former lead mining zone, causes retardation).
A bit further south than where I live, you have the highest rate of childhood cancer in the country. Sounds like we could learn something, and clean it up.
That would be interesting to see and I suspect it would make the R position look even worse. Children/elderly/disabled people generally use quite a bit more health care than working age adults.
I thought the graphic was still interesting as-is. Even with being very skeptical of R messaging, if I'd guessed at the percentage of Curts on Medicaid before seeing it I probably would have been off by an order of magnitude.
The one thing I know is that solid advice, that makes me go "yeah, this is the minimum Democrats needs to do" will be ignored. Plus, Democrats have no alternative plan, so their objections would go no where. I would just put a five year sunset on the proposal and let Republicans pass it. Then in 2030, a new President and Congress can fight about it.
"cost of that [non-insured] person’s care always gets borne by someone, usually the hospital or the hospital’s customers." Well, it's not really borne by the hospital since the hospital has no money except from customers (generally known as patients) and the government (which took the money from the "customers" to start with--or just printed it out of thin air which is paying by money taken by "customers" via inflation).
Private hospitals have investors, so in theory it could come out of their profits. I'm not sure this behaviour has ever been observed in the wild, though.
Hospital worker here. "Cost of non-insured person's care" is generally put at 10 times the amount an insured person pays. Then we boast about how much health care we give away for free (so as not to lose our nonprofit status).
This is a Feature.
What is not a feature is homeless, using the Emergency Room when "3 hots and a cot" would serve them perfectly well, and is all they really need. If we had some decent, safe place for them, we could save a TON of nurse time and money -- and expense.
I made a comment last week about an improper double negative in a column, which I think was ignored (i really don't know how to navigate the substack app), but Jeff! This is not proper:
the government should definitely not not be subsidizing people to sit around and play Grand Theft Auto VI.
I would be curious to dig into the "worked" this year or next year. What is the work? How much do you need to work to meet that category? Are most of these people focused on bettering their lot or just drifting between low level dead end work?
I would suspect many in that category are dirtbags. I don't know how to figure that out, but if it's true, it means a much larger amount of people are in the crosshairs.
This is the first time I, Curt "Ross" Andrews-Maurer, have ever read one of Jeff's pieces, and wow this was a tough blow. The good news is I think this might finally be the motivation I need to turn my life around.
"Some progressives interpret 'protect the vulnerable' to mean 'become a lobbyist for the most antisocial people on Earth, even when they’re shitting on the social contract and/or your driveway.'"
It's "coup de grâce" ('mercy blow') that finishes you off. "Coup de gras" would mean "hit with/by fat". Sincerely, an obnoxious French reader.
Nice article! =)
I'm trying to think if there's some way that I can spin this as "no no no, I DID mean "hit by fat", but...nope.
Corrected -- thanks! Or, as they say in your country: gracias.
You could argue that a significant portion of deaths due to obesity are, in fact, a coup de gras.
Maybe he meant a coup de fois gras.
I like to pronounce it "COUP DE GRAHHHHHH" (emphasizing the AHHHHH) because by the annoyance on their faces I can find the people around me who are secretly French but pretending to be normal.
I feel like there's a dirty joke and/or fairy-tale-made-awesomer-by-mistranslation somewhere in there
I think you'll find that the English translation of coup de grâce is "lawnmower".
You know who’s made a strong case against Republicans messing with Medicaid? A Republican, specifically Sen. Josh Hawley, the otherwise very conservative Senior Senator from the State of Missouri.
https://www.nytimes.com/2025/05/12/opinion/josh-hawley-dont-cut-medicaid.html?smid=nytcore-ios-share&referringSource=articleShare
As for Missouri, it is one of 40 Medicaid expansion states — because our voters wanted it that way. In 2020, the same year Mr. Trump carried the Missouri popular vote by a decisive margin, voters mandated that the state expand Medicaid coverage to working-class individuals unable to afford health care elsewhere. Voters went so far as to inscribe that expansion in our state Constitution. Now some 21 percent of Missourians benefit from Medicaid or CHIP, the companion insurance program for lower-income children. And many of our rural hospitals and health providers depend on the funding from these programs to keep their doors open.
All of which means this: If Congress cuts funding for Medicaid benefits, Missouri workers and their children will lose their health care. And hospitals will close. It’s that simple. And that pattern will be replicated in states across the country.
One of my constituents, a married mother of five, contacted me to explain why Medicaid is vital to her 8-year-old daughter, who depends on a feeding tube to survive. Formula, pump rentals, feeding extensions and other treatments cost $1,500 a month; prescriptions nearly double that cost. These expenses aren’t covered by private insurance. The mother wrote to me, “Without Medicaid, we would lose everything — our home, our vehicles and, eventually, our daughter.”
Evolution’s Deadbeats is going to be the name of my band.
Can you coauthor a guest post with Curt where he dolls out some dating advice? If he's got a rotating cast of girlfriends there's a lot of fellas out here on six figures+ who would learn a thing or two from him
I assume the key is that he has lower standards than you for who he’ll sleep with.
I second this. We need to know how he's doing this.
If he can do this while unemployable imagine what the average Maurer reader could do with his game!
It's weird to me that Elon Musk can think simultaneously that
A: AI is coming for our jobs, and the only way to prevent complete societal breakdown is Universal Basic Income, and
B: the government can balance the budget by cutting services to poor people.
Balancing the budget by no longer paying four times the going rental rate to "illegal immigrants" in the middle of nowhere... and not putting them up in the Roosevelt Hotel in NYC. And maybe we could stop needing National Guard on the NY Subway if we stopped letting all the terrorists in...
Yep, AI could take all your jobs. Dance for the AI, and pray it is merciful.
I applaud you for including a sankey diagram without making a fluffer joke. That joke has been nailed enough. That joke's been ridden like the town bicycle. Making a joke so obvious would be disappointing, like having a warm apple pie, but before getting the chance to eat it you cum in a fluffer.
It was in a draft; didn't make the final.
One clarification on the topic of only being able to dodge the uninsured folks’ hefty hospital bills if you’re a let them die in the streets libertarian. If you ran a hospital, you actually could not dodge these bills even if you were a libertarian. In order to let folks die on the streets, the US would have to get rid of EMTALA (1980s law mandating that hospitals with emergency rooms treat everyone until they are stable regardless of their ability to pay). I bring that up because so many folks want to wax poetic about their philosophical opinion on whether healthcare is or is not a right — but in the US currently today, this is not a question up for debate. Emergency medical care is a legal right of everyone. Unless we were to repeal EMTALA, the only question we really have reason to debate is whether non-emergency services such as check-ups with a primary care doctor should or should not be a right. And as you sort of alluded to in the article, primary care services are FAR cheaper than emergency services (which, again, we legally have to provide under EMTALA). If we funded primary care as a right of every American, the most likely scenario is that we would incur more costs for the first 2-5 years and then would see a serious drop-off in costs as progressively fewer expensive emergency visits would be needed. This is extremely obvious to almost everyone I’ve ever met in healthcare, yet the average citizen has no idea. This frustrates me to no end. Anyway…….Thank you for coming to my ted talk.
The NYT graphic is interesting, but the real question it doesn't answer is how much money is spent in each of those categories.
Young delinquent men basically consume no health care resources.
I think there's a good argument that we want these deadbeats to get jobs and even if it costs Medicaid money, the point is to make them get jobs.
I also don't buy the "they skip preventative things and go drive up health care costs." It sounds nice, like free money, but nearly all attempts at saving money through prevention fail. The deadbeat guy who doesn't bother filling out the Medicaid form probably doesn't bother going to see the doctor for that annoying rash until it's covered half their body, either, even if he's got coverage.
But. I've known people who struggled to get on Medicaid and when finally got on it the first thing they did was have cataract operations so they weren't literally driving blind. Medicaid is pretty shitty coverage, but it will pay for the few thousands of dollars needed to stop being blind, so I'd rather everyone just defaulted to be on it automatically, and you have to do work to not be on it.
We should be applying pressure to make deadbeats work. Just not in the Medicaid system.
*EDIT* said Medicare everywhere I meant Medicaid
Everyone on Medicaid managed to jump through whatever hoop was needed to sign-up. So, they went to some minimal effort and therefore thought there was a benefit large enough to justify this minimal effort. I seriously doubt that proving you are working is any harder to do. Actually working is much, much harder than proving you work and that’s the real stumbling block.
We ended "polio" (what FDR got, not actual polio) through prevention. Prevention is generally done on a LARGE scale, and eliminates Causes, not "here have some pills" to a perfectly healthy person.
Prevention is outlawing people living in Picher (former lead mining zone, causes retardation).
A bit further south than where I live, you have the highest rate of childhood cancer in the country. Sounds like we could learn something, and clean it up.
That would be interesting to see and I suspect it would make the R position look even worse. Children/elderly/disabled people generally use quite a bit more health care than working age adults.
I thought the graphic was still interesting as-is. Even with being very skeptical of R messaging, if I'd guessed at the percentage of Curts on Medicaid before seeing it I probably would have been off by an order of magnitude.
Children are cheap and always have been. Unless you think that giving children meth (Ritalin) is actually expensive?
Whenever I saw Curt, my brain saw a different word that seemed to fit better. Some people can't understand normal thinking.
It was the lower-case "curt", meaning "blunt and rude", right?
The one thing I know is that solid advice, that makes me go "yeah, this is the minimum Democrats needs to do" will be ignored. Plus, Democrats have no alternative plan, so their objections would go no where. I would just put a five year sunset on the proposal and let Republicans pass it. Then in 2030, a new President and Congress can fight about it.
"cost of that [non-insured] person’s care always gets borne by someone, usually the hospital or the hospital’s customers." Well, it's not really borne by the hospital since the hospital has no money except from customers (generally known as patients) and the government (which took the money from the "customers" to start with--or just printed it out of thin air which is paying by money taken by "customers" via inflation).
They bear the expense in terms of consumables and staff time that they have to write off.
Private hospitals have investors, so in theory it could come out of their profits. I'm not sure this behaviour has ever been observed in the wild, though.
Hospital worker here. "Cost of non-insured person's care" is generally put at 10 times the amount an insured person pays. Then we boast about how much health care we give away for free (so as not to lose our nonprofit status).
This is a Feature.
What is not a feature is homeless, using the Emergency Room when "3 hots and a cot" would serve them perfectly well, and is all they really need. If we had some decent, safe place for them, we could save a TON of nurse time and money -- and expense.
I made a comment last week about an improper double negative in a column, which I think was ignored (i really don't know how to navigate the substack app), but Jeff! This is not proper:
the government should definitely not not be subsidizing people to sit around and play Grand Theft Auto VI.
It's proper if it's a typo.
Fixed!
So you don’t not hate double negatives?
You're breaking my brain.
Or you haven't not unbroken it. Or something
I can't not like that.
I would be curious to dig into the "worked" this year or next year. What is the work? How much do you need to work to meet that category? Are most of these people focused on bettering their lot or just drifting between low level dead end work?
I would suspect many in that category are dirtbags. I don't know how to figure that out, but if it's true, it means a much larger amount of people are in the crosshairs.
This is the first time I, Curt "Ross" Andrews-Maurer, have ever read one of Jeff's pieces, and wow this was a tough blow. The good news is I think this might finally be the motivation I need to turn my life around.
It's true. There is a credibility issue and it helps to countersignal a bit.
"Some progressives interpret 'protect the vulnerable' to mean 'become a lobbyist for the most antisocial people on Earth, even when they’re shitting on the social contract and/or your driveway.'"
Far, FAR too many Progressives.