MEDICAID: Winning The Messaging Battle
The Medicaid fight will have potentially devastating human consequences.
But the political impact will be profound as well -- either strengthening or weakening our ability to constrain Trump on many other fronts. And the coming Medicaid struggle will also define the context for the vital 2026 elections.
As the debate begins in earnest, let’s examine the lay of the land and lay out seven guidelines for persuasive Democratic and progressive messaging on this pivotal issue.
So Much On The Line
There are multiple reasons why the Medicaid debate is fraught with danger for Republicans and absolutely essential for Democrats.
It’s not only how many people will be personally hit by severe Medicaid cuts. It’s the makeup of that at-risk audience. Republicans looking to find $880 billion in cuts seem to be leaning towards reversing the Affordable Care Act Medicaid expansion. As the Atlantic’s Ron Brownstein recently pointed out, that “could raise the number of uninsured by 11 million and destabilize budgets in all 40 states that expanded.” He went on to point out that 6.8 million people in Republican districts have their Medicaid coverage on the line.
Going after the health care of your own base is a dangerous move. Here’s how Steve Bannon put it. “A lot of MAGAs on Medicaid. If you don’t think so you are dead wrong. You can’t just take a meat axe to it.”
Throwing people off Medicaid is an affront that’s easy for voters to understand and hard for Republicans to obscure. Kitchen table issues directly affecting people’s daily lives always have more political punch. With the major exception of tariffs, many of the first 100 days moves by Trump and Musk haven’t fit that definition, making them easier for people to ignore or explain away. But, taking away someone’s health care is about as direct as you can get and it won’t be hard for people to see whose fingerprints are all over the move.
Trump is already in hot water on the economy. Taking peoples’ health care away challenges their health and their family budget. And, thanks largely to his chaotic tariff escapades, Donald Trump is already underwater on the economy. In a recent NYT Sienna poll, 50% say Trump has made the economy worse since taking office. And 36% say his policies have hurt them personally more than twice the 17% who say his policies have helped them. It’s hardly a position of strength from which to take on slashing Medicaid.
The Medicaid battle gives congressional Democrats an opportunity to repair their standing with working class voters and with the Democratic base. It’s encouraging to see recent polls with headlines like “Rising distaste for president and his agenda” and “Are things falling apart for Trump?” But it’s not all good news for Democrats. For example, despite peoples’ deep misgivings about the president, last week’s Washington Post poll showed Americans still trust Trump (37%) over congressional Democrats (30%) when it comes to dealing with the country’s
major problems.
That’s why it’s crucial Democrats embrace the Medicaid debate as a chance to show working class voters the party is both committed to and capable of fighting for them when it counts. Doing that effectively will also help Democrats repair their standing with their progressive base frustrated by a too often weak and tepid response to the Trump assault.
Medicaid Messaging Guidelines
Here are seven ways progressives can help Democrats deliver a winning message in the battle to protect Medicaid.
#1: Defend peoples’ access to health care, not a government program. It’s not about “protecting Medicaid.” It’s about making sure we defeat a cruel plot to take away millions of families access to health care.
#2: Focus on wide impact, not just the most vulnerable. Too many working class voters believe Democrats cater to the rich and to the most disadvantaged, leaving them to fend for themselves. We can’t feed into that perception. We want “Democrats” to be a credible answer when people ask themselves “Who is fighting for me?”
#3: Make it about emotions not statistics. Facts don’t move people. Emotions do. So it’s fine to share a few numbers about what’s happening. But the core of our campaign has to be emotional, gut-level messaging making clear what Republicans are trying to do is both devastating and totally unnecessary.
#4: Tell stories – and make them local. The cuts the GOP is trying to make will hit hard in the districts of almost every member of Congress. We have to tell powerful stories that hit home like warnings about the hospitals that will be forced to close in rural districts. This language from a Save Our Care ad running in the district of a vulnerable GOP member is a great example: “Over 293,000 of us in our community could have our health care ripped away. We’re talking veterans, seniors, kids with disabilities, and everyday working people all losing their health care while Congress passes another tax cut for billionaires.”
#5: Tell people Republicans are hurting them to help billionaires. The Achilles’ heel of the GOP plan is that their purpose in taking away peoples’ Medicaid coverage is to free up billions of dollars for more billionaire tax cuts.
We need to say that over and over.
#6: Democrats have to fight like hell. Democrats in Congress can’t just “put up a good fight” and then throw up their hands. People will see the difference between going through the motions and putting everything on the line. If we’re going to be what AOC calls “brawlers for the working class,” this has to be a battle we refuse to lose.
Democratic leader Hakeem Jeffries has the right rhetoric. He calls the GOP budget “unacceptable, it’s unconscionable, it’s un-American, and we’re going to do everything we can to bury it in the ground, never to rise again.” Now he and his colleagues in Congress need to back up the tough talk.
#7: Don’t make it all about Trump. Donald Trump will have a big role in this battle. We don’t have to ignore that. But we shouldn’t obsess about it either. This is about whether Republican members of Congress will sell out the people they represent to do the bidding of billionaires. In that contest, we need people to see us fighting for them, not just against Trump.
Conclusion
Fasten your seat belts. This is going to be a real, high-stakes donnybrook with the day-to-day reality of millions of peoples’ lives on the line. And if we’re smart, strategic and steadfast, I know we can win it.