OPINION: The "Big, Beautiful Bill's" Winners and Losers
By Jay Brock
CONTRIBUTOR
Some people in America will be celebrating Christmas early this year, now that the Republican budget bill known as the “Big, Beautiful Bill” has been passed by Republicans in Congress and signed into law. This bill will extend the huge tax cuts started in the first Trump Administration, which benefit mostly the very wealthiest Americans and the most powerful corporations in the country. In America, we call these people and business interests “winners.” (There will also likely be a surprise winner—more on that shortly.)
In our American system, a bill like this also produces “losers:” the many people who not only don’t benefit from such legislation, but end up paying for it.
There are two main points of contention for most observers.
One is the National Debt—basically how much we’ve put on the national credit card—which is currently almost $36 trillion, and increasing by more than $6 billion/day. The Big, Beautiful Bill is expected to increase the debt by $3.3 trillion over the next ten years. How, or even whether, we pay off the debt, is controversial, anybody’s guess, and largely ignored by this bill. Most observers point out that if anyone is going to pay for it, it will be our children and grandchildren.
The second point of contention has a more immediate impact for tens of millions of Americans: these are the folks who will also end up paying for this bill. How? In order to keep the debt from going even higher, and also to help pay for these huge tax breaks for the wealthy, this Republican budget plans to cut healthcare funding, mostly by slashing funding for Medicaid—health insurance for the poor and disabled—as well as funding for the Affordable Care Act and Medicare.
How much is being cut from healthcare spending? Upwards of $1 trillion. 14 million or more Americans could lose their health insurance, and experts are already predicting that as a result, 51,000 Americans could die prematurely each year when they are unable to get timely medical care. (This is in addition to the 70,000 who already die each year because, in our dysfunctional health insurance system, so many people already cannot afford, and thus defer, timely medical care.)
While some Senate Republicans worry that decimating healthcare spending will harm many of their constituents, other sentiments have dominated the outcome: Iowa Republican Senator Joni Ernst has disparaged people who fear losing their life-saving health insurance with a dismissive, “Well, we are all going to die!”; and soon-to-retire Kentucky Republican Senator Mitch McConnell is telling voters to just “get over it.”
Sound advice, I’m sure, to those for whom it arrives too late.
Biggest losers here? Probably Red states, especially those with smaller and more rural populations, when hospitals, dependent for their survival on Medicaid funds, start going out of business after these funds are slashed. Local economies will be big losers, since these hospitals tend to be major employers, and when they disappear, financial impacts can be significant. And it’s not just poor patients who suffer. Everyone in these communities ends up as “the loser” when the hospital closes.
But while the mainstream media lavishly covers all this, one issue that it does not seem to pay much attention to is how we got here in the first place: alone among the world’s most advanced nations, we have a broken health insurance system that fails to do the two main things any good system should do—cover everyone, and do it affordably.
Instead our system is based mostly on the profit requirements of the American for-profit health insurance industry, which is simply an extraneous, politically powerful and extremely costly middleman standing between patients and their healthcare needs. (They are so powerful because of the tens of millions of dollars from our healthcare contributions they spend on lobbying politicians to protect their interests, not the interests of voters.)
Though Republicans are worse, it’s the not-so-benign neglect of both parties that got us here.
The solution the mainstream media doesn’t like to talk about? A single payer, government-funded health insurance system that would cover everyone and be truly affordable for everyone.
Oh…almost forgot. The other winner.
Democrats.
Turns out the concept of separating tens of millions of people from their healthcare to enable huge tax cuts for the wealthiest Americans, especially when unaffordable healthcare is already a huge kitchen table issue, is deeply unpopular with most Americans—some polls run almost 2 to 1 against this bill.
Now that this Big, Beautiful Bill is law, Democrats will surely be honing their political messaging to markedly increase their odds of a big win at the midterms. Who knows, they may even pull it off.
References:
https://apnews.com/article/cbo-trump-tax-bill-republicans-senate-5f591bea21bd95eec45ba90c93c50687
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33019-3/abstract
https://www.cnbc.com/2025/07/01/how-trump-bill-medicaid-cuts-will-impact-us-health-care.html
Support the Advance with an Annual Subscription or Make a One-time Donation
The Advance has developed a reputation for fearless journalism. Our team delivers well-researched local stories, detailed analysis of the events that are shaping our region, and a forum for robust, informed discussion about current issues.
We need your help to do this work, and there are two ways you can support this work.
Sign up for annual, renewable subscription.
Make a one-time donation of any amount.
Local Obituaries
To view local obituaries or to send a note to family and loved ones, please visit the link that follows.
This article is published under Creative Commons license CC BY-NC-ND. It can be distributed for noncommercial purposes and must include the following: “Published with permission by FXBG Advance.”