For journalists covering domestic policy, this past week poses some hard choices. Should we focus on the Trump budget’s fraudulence — not only does it invoke $2 trillion in phony savings, it counts them twice — or on its cruelty? Or should we talk instead about the Congressional Budget Office assessment of Trumpcare, which would be devastating for older, poorer and sicker Americans?
For journalists covering domestic policy, this past week poses some hard choices. Should we focus on the Trump budget’s fraudulence — not only does it invoke $2 trillion in phony savings, it counts them twice — or on its cruelty? Or should we talk instead about the Congressional Budget Office assessment of Trumpcare, which would be devastating for older, poorer and sicker Americans?
There is, however, a unifying theme to all these developments. And that theme is contempt — Donald Trump’s contempt for the voters who put him in office.
You might recall Trump’s remark during the campaign that “I could stand in the middle of Fifth Avenue and shoot somebody and I wouldn’t lose any voters.” Well, he hasn’t done that, at least so far. He is, however, betting that he can break every promise he made to the working-class voters who put him over the top, and still keep their support. Can he win that bet?
When it comes to phony budget math — remember his claims that he would pay off the national debt? — he probably can. We’re not talking about anything subtle here; we’re talking about a budget that promises to “abolish the death tax,” then counts $330 billion in estate tax receipts in its rosy forecast. But even I don’t expect to see this kind of fraud get much political traction.
The bigger question is whether someone who ran as a populist, who promised not to cut Social Security or Medicaid, who assured voters that everyone would have health insurance, can keep his working-class support while pursuing an agenda so anti-populist it takes your breath away.
To make this concrete, let’s talk about West Virginia, which went Trump by more than 40 percentage points, topped only by Wyoming. What did West Virginians think they were voting for?
They are, after all, residents of a poor state that benefits immensely from federal programs: 29 percent of the population is on Medicaid, almost 19 percent on food stamps. The expansion of Medicaid under Obamacare is the main reason the percentage of West Virginians without health insurance has halved since 2013.
Beyond that, more than 4 percent of the population, the highest share in the nation, receives Social Security disability payments, partly because of the legacy of unhealthy working conditions, partly because a high fraction of the population consists of people who suffer from chronic diseases, like diabetics — whom Mick Mulvaney, Trump’s budget director, thinks we shouldn’t take care of because it’s their own fault for eating poorly.
And just to be clear, we’re talking about white people here: At 93 percent white, West Virginia is one of the most minority- and immigrant-free states in America.
So what did the state’s residents think they were voting for? Partly, presumably, they supported Trump because he promised — falsely, of course — that he could bring back the well-paying coal-mining jobs of yore.
But they also believed that he was a different kind of Republican. Maybe he would take benefits away from Those People, but he would protect the programs white working-class voters, in West Virginia and elsewhere, depend on. What they got instead was the mother of all sucker punches.
Trumpcare, the budget office tells us, would cause 23 million people to lose health insurance, largely through cuts to Medicaid — remember, the program that benefits almost a third of West Virginians. It would also lead to soaring premiums — we’re talking increases on the order of 800 percent — for older Americans whose incomes are low but not low enough to qualify for Medicaid. That describes a lot of Trump voters. Then we need to add in the Trump budget, which calls for further drastic cuts in Medicaid, plus large cuts in food stamps and in disability payments.
What would happen to West Virginia if all these Trump policies went into effect? Basically, it would be apocalyptic: Hundreds of thousands would lose health insurance; medical debt and untreated conditions would surge; and there would be an explosion in extreme poverty, including a lot of outright hunger.
Oh, and it’s not just about crucial benefits, it’s also about jobs. Coal isn’t coming back; these days, West Virginia’s biggest source of employment is health care and social assistance. How many of those jobs would survive savage cuts in Medicaid and disability benefits?
To be fair, the Trump budget would protect West Virginians from the ravages of the estate tax, which affects around 20 — that’s right, 20 — of the state’s residents each year.
So, many of the people who voted for Trump were the victims of an epic scam by a man who built his life around scamming. In the case of West Virginians, this scam could end up pretty much destroying their state.
Will they ever realize this, and admit it to themselves? More important, will they be prepared to punish him the only way they can — by voting for Democrats?
Paul Krugman is a syndicated columnist who writes for the New York Times News Service.