Jonathan P. Baird

As the outlines of President Trump’s budget bill emerged into clearer focus, one fact became apparent. The bill has a shocker price tag. According to the Congressional Budget Office, over ten years, as many as 13.7 million Medicaid recipients will lose their health insurance. It will be the biggest loss of health care coverage ever sustained in American history.

The blow to health care this represents is nothing short of devastating. For poor and working people, this bill strips away what system of health care coverage has existed and replaces it with a far inferior model replete with new impediments. The new impediments are significant. They create barriers to access so that many fewer will qualify for care.

Adding work requirements to Medicaid is a key vehicle for the cuts and projected cost savings. Burdensome and repeated verification requirements are a proven recipe for shrinking rolls. While it may sound good to the uninitiated, there is a body of negative experience with states using such requirements. They create red tape to facilitate churning claimants and recipients off Medicaid.

New Hampshire, along with Arkansas, implemented work requirements in 2019 during Trump 1.0 but suspended the program and the federal court then halted it. There was confusion leading very large numbers to being disenrolled. Yet, those behind the new budget bill entirely ignore the history of how work requirements led to mass disenrollment.

The idea to make employment a precondition to Medicaid is bad public policy. Work requirements actually block access to medically necessary services that might enable work capacity. Medicaid is not a cash assistance welfare program. The purpose of Medicaid has been to furnish medical assistance, rehabilitation and other services that will help individuals attain and retain independence and self-care.

The budget bill plays on the stereotype of able-bodied, lazy people who are choosing not to work to get benefits but the stereotype gets it wrong. Nearly two out of three adult Medicaid enrollees aged 19-64 already work and most of the rest would be exempted for reasons like having a disability, caring for a family member or attending school.

Older adults receiving Medicaid will be particularly hard hit by the cuts. Around 70% of low income adults aged 50-64 live with chronic conditions and experience poor health. Under the budget bill, workers in all states up to age 65 will be subject to the work requirements. Experience has shown that exemptions commonly fail to work and end up excluding many who should remain eligible. It is a safe bet that millions who should be eligible will be locked out of coverage for extended time periods because of red tape..

The harm of the upcoming Medicaid cuts, starting at the end of 2026, is not well-understood. Not having health insurance literally kills. To avoid incurring costs, many will not go to the doctor or they will delay going. If they are suffering from cardiovascular illness, diabetes or cancer, delay could be life-threatening. People will not obtain the medication or treatment they need in a timely fashion.

Putting off care when conditions can be best-treated will lead to worse outcomes and higher costs later as often happens when an uninsured person lands in an emergency room. A new study by investigators at the Keck School of Medicine of USC, Boston University and the University of Amsterdam in the Netherlands, published in the Lancet, found that reduction in Medicaid coverage could lead to thousands of additional deaths among working-age Americans as well as a disastrous financial burden for hundreds of thousands.

The Lancet article found that Medicaid cuts have a ripple effect on patient’s children, their parents and seniors who depended on the patient for care. Families experienced increased stress when primary breadwinners were out of commission. Medical debt can pile up, especially on those who have complex health needs. Those in worse health or those contending with a disability often suffered income loss because of difficulty in maintaining continuous employment.

In the past, Medicaid has generally not required co-pays or any balance billing beyond the Medicaid payment rate. There was an understanding that low income people could not afford such costs. The budget bill would force some Medicaid recipients to pay more for coverage through premiums or other fees. Such payment is entirely ill-advised as people rely on Medicaid because they cannot afford more costs or any private insurance options. They lack the income. This will be creating another impediment to care.

I saw that some Republicans were citing former President Bill Clinton’s use of work requirements with welfare (TANF) to justify Medicaid work requirements. While they have been touted, Clinton’s work requirements ultimately failed and ruined the TANF program, dramatically reducing the number of enrollees. That program is now a shrunken shell of what it once was which is likely the same goal Republicans have for Medicaid. Reducing the size of the program using excessive paperwork and frequent verification requirements is their goal.

All this is done to line the pockets of the obscenely wealthy so they can receive their precious tax cut. It is about a gluttonous transfer of wealth upwards at the expense of the low income. What happened to the goal of universal health care and recognizing health as a human right? The budget bill moves the ball backwards down the field.

Last Tuesday I attended the Campaign for Legal Services Kickoff Breakfast held at the Grappone Center in Concord. It was a wonderful and well-attended event supporting an entirely worthy goal – legal assistance for poor, elderly and disabled people. Many prominent members of the New Hampshire Bar were present as well as Gov. Kelly Ayotte and our two Congresspeople, Chris Pappas and Maggie Goodlander.

One thing that bothered me about the event was what was not said. You would not have known that the rule of law in America is under serious attack. I heard a few vague references to the importance of due process and the difficulties of being a judge but mostly I heard platitudes about how great the justice system is. There was an unremitting effort to be bipartisan and to pretend normalcy.

Ignoring the 800 pound gorilla in the room doesn’t serve the rule of law. Times are anything but normal. An authoritarian regime is actively attempting to dismantle constitutional rule and it is not hidden. Neither on a state or national level has the Bar responded. This is too reminiscent of other historical circumstances where lawyers did not speak up and collaborated with fascism.

In the last week, President Trump’s senior advisor Stephen Miller explained that the Trump administration was considering suspending habeas corpus. He did not know or care that the authority to suspend habeas is vested in Congress, not the Executive branch. Miller, not a lawyer, said:

“That’s an option we’re actively looking at. A lot of it depends on whether the courts do the right thing or not.”

The Latin translation for habeas corpus is “deliver the body”. It goes back to the Magna Carta and the idea that people may not be detained without being brought before a judge. It is hard to overstate the importance of habeas corpus. I think it is fair to say it is a bedrock principle in American jurisprudence. No one is above the law, at least theoretically. The principle is embedded in our Fifth and Fourteenth Amendments that hold that “no person should be deprived of life, liberty or property without due process of law”. I am reminded of John Adams’ famous quote:

“We are to look upon it as more beneficial, that many guilty persons should escape unpunished, than one innocent person should suffer. The reason is, because it’s of more importance to community that innocence should be protected, than it is, that guilt should be punished; for guilt and crimes are so frequent in the world, that all of them cannot be punished; and many times they happen in such a manner, that it is not of much consequence to the public, whether they are punished or not. But when innocence itself, is brought to the bar and condemned, especially to die, the subject will exclaim, it is immaterial to me, whether I behave well or ill; for virtue itself, is no security. And if such a sentiment as this, should take place in the mind of the subject, there would be an end to all security what so ever.”

The Trump administration is the opposite of John Adams. Their priority is to punish the innocent and to use the law to intimidate. The Kilmar Abrego Garcia case is a prototype for the lawlessness we are seeing. First removal without due process and then stonewalling in bad faith as the Administration ignores a Supreme Court order. No one talks about the over 200 Venezuelan men who were removed from the U.S. without due process. They are all rotting away in a foreign prison. 60 Minutes showed that 75% of these men had no criminal record yet they have been wrongly renditioned.

ICE has been playing the role of Trump’s gestapo. The stories of its outrageous misconduct have been multiplying. Masked and unidentified ICE agents have been disappearing people in the manner of 1970’s-1980’s Latin American fascists. On May 4, ICE agents took away a man filling up gas in his truck at a gas station in Oxnard, California. They disappeared him, drove away and left his children in the truck.

On April 24, ICE agents terrorized a family of U.S. citizens when they broke into a house in Oklahoma City in the middle of the night but the search warrant was meant for someone else. ICE ordered the family out into the rain in their underwear and confiscated the family’s phones, laptops and cash savings as “evidence”. In the last two months, there are cases of U.S. born children having been wrongfully deported without due process. Trump is now seeking a six-fold increase in ICE funding.

Some of the immigrants ICE has picked up have been taken into custody for the crime of writing an op-ed and advocating for Palestinian rights. Now you get arrested and deported for having an opinion. What happened to the First Amendment? Tyrants don’t tolerate dissent.

Then there are the attacks on judges. Trump has displayed a troubling pattern of badmouthing judges who issue rulings he disagrees with. He calls the judges “radical left lunatics” and wants them impeached. Next the MAGA mob descends threatening the judge and his or her family. The Administration orchestrated the arrest of Wisconsin judge Hannah Dugan with the FBI Director Kash Patel posting a photo on X of the handcuffed judge doing a perp walk. This is all about intimidating and threatening the judiciary.

I also must mention the Administration’s perversion of pro bono work. Pro bono work was supposed to be about helping the needy but nine heavy hitter law firms have signed agreements to provide Trump a collective $940 million in free legal work. This is akin to a mob boss shaking down a business. What a terrible example these Big Law firms set!

While being critical of lawyers who bend the knee or stay silent, I also acknowledge and appreciate the heroic actions of many judges who are upholding the rule of law. These judges have shown courage and integrity. Their actions have been critical in holding back the authoritarian tide.

Any student of history knows things could get far worse in the U.S. but that does not negate the darkness and backwardness into which we have fallen as a nation. Trump is about hoarding power for himself. Lawyers and judges have a key role to play in preventing the onset of an American version of fascism.

In the many years I worked as a staff attorney at New Hampshire Legal Assistance, I learned the importance of public benefits for low-income people. Two of the most important benefits were Medicaid and SNAP (also known as Food Stamps). Part of the importance is just the number of people these programs reach. 72 million Americans depend on Medicaid. Over 42 million rely on Food Stamps. Both of these programs are essential whether it is for access to health care or addressing hunger.

So it is shocking to see these programs in the Trump Administration’s crosshairs so they can fund an enormous tax cut to benefit billionaires. The budget bill that President Trump calls “the big beautiful bill” should properly be called the “Marie Antoinette Let Them Eat Cake” bill. It is taking from the poorest and neediest and giving to the wealthiest. You don’t hear Trump talk about cutting the bloated trillion dollar Pentagon budget.

Trump loves naming things but as is all too often the case his naming is opposite the reality. He ran for president, in part, on the idea that he would help the little guy. His concern now is how he can disguise his Robin Hood-in-reverse actions. Many of the Republican right are squeamish about the budget bill because they know it will shaft their voters who need medical care or food assistance. They want to figure out how to impose the cuts so no one knows what actually happened.

To allow for the tax benefits to the billionaires, the anticipated cuts from Medicaid and Food Stamps must be mind-bogglingly large. The Trump administration wants to cut $880 billion from Medicaid over 10 years and $230 billion from Food Stamps.

There are many possible ways these cuts could be imposed and it remains unclear how the Republican architects will get to the cut numbers they seek. They are scrambling to finalize the cuts with two goals in mind. First, they must maintain their threadbare majority in the House while getting across the finish line. Second, they must maintain the illusion that they are not hurting millions which they absolutely are.

One possible avenue that could be used is to tinker with the share of money states must pay for their matching contribution in what are joint federal/state programs. In both Medicaid and Food Stamps, the federal government has paid the lion’s share of cost. If the federal contribution is slashed it will be on the states to pony up. The likelihood of that is not a great bet.

A second avenue is the imposition of stricter work requirements. This would be a design to kick millions off both these programs . Since the goal is steep cuts, reducing the number of beneficiaries works toward the goal. There are other ways to impose cuts but all methods are about shrinking the programs and the numbers getting benefits.

What is crazy is that this is being done at a time when the risk of recession is rising. Food Stamps has always been a counter-cyclical program. It was set up to kick in and help more when economic need becomes greater. Cutting safety net programs before a recession is asking for trouble. It will sabotage response when need increases in the low-income community.

The sheer sinister absurdity of cutting Medicaid and Food Stamps to pay for a billionaire tax cut needs to be pondered. Trump has appointed at least 14 billionaires to serve in his administration. We all saw the coterie of billionaires standing behind him at his inauguration. That’s his team and the billionaires, especially Musk, bought him.

The combined wealth of the super-rich oligarchs at the inauguration topped $1.2 trillion. Elon Musk alone has a net worth between $335 billion and $396 billion. In the past five years, the five richest men in the world including Musk, Jeff Bezos and Mark Zuckerberg have increased their wealth by $464 billion or 114%. Meanwhile, over half of Americans say they lack the cash to cover a $1000 unexpected emergency expense.

Wanting ever more, these billionaires could care less about pummeling Medicaid and Food Stamp recipients. Their greed is bottomless. How to explain the level of selfishness their behavior reflects? When you have so much why do you care about a tax cut? Warren Buffett once told the New York Times:

“There’s class warfare, all right, but it’s my class, the rich class, that’s making war, and we’re winning.”

That quote is more true now than when he said it in 2006. For the last few months, the ransacking of federal agencies has been unprecedented. It is not surprising that Republicans have gone along with MAGA and the Trump cult. That Party leadership has become a sorry collection of bootlickers, opportunists, religious fanatics, racist xenophobes and bigoted conspiracy theorists.

What has been disappointing has been the Democratic response to the class war. With a few notable exceptions like Bernie, AOC, Jasmine Crockett and Chris Murphy, the Democrats seem incapable of throwing a punch. There is a reason the Democrats’ favorability rating is underwater. Their leadership is aged and moribund. They just got their asses kicked in an election but they seem determined to repeat the past.

The Bernie-AOC “Fight Oligarchy” message expresses the feelings of many among the frustrated Democratic rank-and-file voters. Democrats need to defend working people on all fronts. Democrats want to see passion and fight from our leaders, not pitiful silence. It is the 1% versus the 99% and the 99% need fighters who will challenge and oppose the billionaires at every turn. We have been taking a lot of punches. It is time to show we can throw and land some punches.

The budget is a moral document, expressing societal priorities. Funding a garrison state while depleting Medicaid and Food Stamps is an expression of nihilism. It means many more Americans will die unnecessarily or will become uninsured or hungry.

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There has been a ferocious debate playing out in the American Jewish community about the actions of the Israeli government. On one side stand the uncritical supporters of Israel. On the other side are Jews who have been horrified by Israel’s actions in Gaza and the West Bank.

Whatever position has been taken, far less attention has been paid to why Israel has transformed into an illiberal country. When I was a younger person growing up in the 1970’s, Israel had a stronger humanistic left rooted in the kibbutz movement, the Labor Party and socialist values. That tradition was far from flawless but liberal and secular values were prominent and many did believe in a genuine two state solution.

Over time, that liberal tradition atrophied and it has been replaced by a combination of far right forces who have formed the most extreme government in Israel’s history. The tenets of this extremism include belief in Jewish supremacy and a commitment to ethnic cleansing and annexation of Palestinian territory.

The story of this evolution can be told through the stories of two men, Itamar Ben-Gvir and Bezalel Smotrich. Both are leaders in the present Netanyahu government. Ben-Gvir is Minister of National Security and he oversees the police in Israel and the West Bank. Smotrich is the Finance Minister and he has broad authority over the Israeli governing body in the West Bank.

Ben-Gvir used to be a pariah. He is an ultranationalist settler leader who was previously on the fringe of Israeli politics. He was a follower of the racist rabbi, Meir Kahane, and Kahane’s fascist political party, Kach. Kahane was convicted of multiple acts of terrorism both in the U.S. and in Israel. Kahane advocated for a theocracy and complete segregation between Jews and Arabs. He wanted to criminalize sexual and romantic relationships between Jews and Palestinians.

Kach was originally outlawed in Israel for inciting racism and the party was banned but the party’s members remained active in new contexts. Ben-Gvir defended settler terrorists on the West Bank. For years he kept a picture in his living room of Baruch Goldstein, an American Israeli settler who massacred 29 Palestinians in Hebron in the 1990’s.

Ben-Gvir has called for the deportation of all Arab citizens from Israel. He has no interest in creating a multi-party democracy and he opposes the concept of equality before the law. He is an unabashed supporter of the idea of Jewish supremacy and he is now the leader of the Jewish Power Party.

He wants to annex large parts of the West Bank, arm more Israeli Jewish settlers and expand Jewish settlements on the West Bank.

As for Bezalel Smotrich, he is a religious fundamentalist. He once described himself as a “fascist homophobe”. He is a leader of the National-Religious-Religious Zionist Party. He had previously been detained in 2005 for terrorist offenses connected to that Gaza disengagement. He has sought to prevent the development of Palestinian construction in the West Bank. He is also a West Bank settler.

As an ultra-Orthodox nationalist, Smotrich follows a narrow doctrinaire conception of Jewish law and he rejects values like feminism, anti-racism, liberalism and LGBTQ rights. He has his own Jewish version of A Handmaid’s Tale. Like the hardcore religious right, he has no use for liberal or secular Jews.

Among the internal divisions in Israel is a huge divide between religious fundamentalist Jews and secular Jews who comprise a large part of Israel’s population. They don’t want to be told how to live their lives by religious extremists. The fight last year over the Israeli Supreme Court was, in large part, about stopping the imposition of a theocratic tyranny on secular Jews.

Both Ben-Gvir and Smotrich reflect the ascendant far right in Israel. The far right in Israel has been calling for ethnic cleansing and the expulsion of Palestinians from Gaza. When Donald Trump talks about creating a Gaza Riviera, it sounds unhinged from reality but it is consistent with the perspective of extremists in Israel. Since October 7, these forces have actually gained momentum.

There remains a desire in the American Jewish community to see Israel as a liberal country but those days are long gone. It is wishful thinking on the part of American Jews to see Israel as its 1970’s incarnation. 73% of Israeli youth identify as right-wing.

Netanyahu and Ben-Gvir have effectively used Tik Tok to build support for Jewish supremacy and extreme settler ideology. They have supported armed gang violence and aggression against Palestinian civilians living in the West Bank. There is no accountability for the Jewish perpetrators of this violence.

Because Netanyahu has needed Ben-Gvir and Smotrich to forge and maintain a government, they have leverage. First and foremost, Netanyahu has been committed to maintaining his own power, indefinitely. I think he has lengthened the Gaza War and failed to make a final hostage deal because it would not serve his goal of remaining in power.

Thousands of Palestinian children living in the Gaza Strip continue to face an increased threat of starvation but in absolutely unconscionable fashion Israel has blocked all humanitarian assistance since March 2.

AIPAC, ADL and mainstream Jewish organizations in America seem trapped in the past, seeing Israel not as it is but as they want it to be. Nothing has been more cynical than their use of the allegation of antisemitism to shut up opposition to Israel’s extremist slide. For anyone who cares about Israel, this is a truly tragic state of affairs.