Republicans Gut Medicaid, Risk 1.75 Million Construction Jobs, Cut Taxes for Rich, and Add Trillions to National Debt

Date:

President Trump walks to a White House event celebrating the passage of the “One Big Beautiful
Bill Act” that will devastate rural American families, kill construction jobs, and add $4 trillion
to the national debt.

Trump and his Republican followers have just passed the “One Big Beautiful Bill Act” (OBBB) which is already being called “the Worst Bill in Modern American History” and the jobs equivalent of “terminating more than 1,000 Keystone XL pipeline projects.”

After weeks of internal disagreements and posturing from Republicans who suggested they would never vote for the bill, on July 1st, 2025 the Senate passed the OBBB 50-50 with Vice President JD Vance breaking the tie. The House of Representatives then passed the identical bill on July 3, 2025 on a 218 to 214 vote. Trump then signed the bill into law on July 4th, 2025.

Every Republican in Congress in Kansas and Missouri voted for the legislation. Every Democrat opposed it. Missouri Senator Josh Hawley, who has made repeated public statements about his opposition to cuts to Medicaid, still voted for the legislation. Kansas Senator Derek Schmidt bragged that this legislation that it would change tax rules to make it cheaper for the wealthy to buy private planes.

The fallout for the legislation has already been enormous. Union leaders across the country are ringing the alarm bill over what North America’s Building Trades Unions president Sean McGarvey is calling “the biggest job-killing bill in the history of this country.”

The AFL-CIO says that the so-called “One Big Beautiful Bill Act” will “raise costs on working people, wipe out million of jobs and rip health care away from 17 million Americans–all to hand billionaires one of the biggest paydays in history.”

Republicans are calling this a win for working people because of tax changes that they are calling “no taxes on overtime or tips.” The reality is that these changes will only apply to tax years 2025 through 2028 and they are actually just deductions. (conveniently going to the year of the next presidential election)

The deduction for “no tax on overtime” is capped at $12,500 in overtime pay in any taxable year, but for union construction workers who may not get much work in the winter but get lots of overtime in the summer, you would quickly exhaust the deduction.

Think of what the Republicans just did this way: Costco lowers the cost of their membership to just $10 a year, but raises their costs by 3% on all items. Your bill might be smaller at first glance, but you are paying more over the year in small ways.

“The value of any policy like a temporary tax break on tips or overtime will be more than wiped out by higher health care and energy costs—or worse, the loss of jobs altogether. There are 17 million Americans who will lose their health care, hospitals and nursing homes will close, millions will lose their jobs, and everyone will be forced to pay higher daily costs— all while driving resources to a nasty mass deportation effort that will disrupt the country’s workforce across industries and lead to more layoffs for everyone,” said AFL-CIO President Liz Shuler.

NABTU President Sean McGarvey, who was in Kansas City just weeks ago, said that, regardless of party, the legislation is a “massive insult to the working men and women of North America’s Building Trades Unions and all construction workers. This is not what they voted for.”

Many economists agree that this legislation is a gift to billionaires, not legislation that will help working people, including the president of the pro-union and pro-working families Economic Policy Institute. (EPI)

“Congress just passed one of the most destructive economic bills in generations. The Republican budget will gut Medicaid, slash food aid for families, and shutter rural hospitals— just to give tax breaks that will go overwhelmingly to the wealthy. It is a staggering upward redistribution of income,” said EPI president Heidi Shierholz. “The tax breaks for the rich are so huge—$100,000+ per year for the richest 0.1%— that even after gutting aid for the most vulnerable, this bill will still increase the national debt by nearly $4 trillion. To cover up how grotesque this is, Republicans have invented a new, completely bogus way to measure the bill’s costs. The bill also turbocharges an authoritarian-style immigration regime—funding internment camps, mass surveillance, and waves of deportations that will kill millions of jobs.”

Shierholz continued: “And, surprise, the GOP structured the bill’s provisions along deeply cynical political timelines. The rich get their tax cuts before the midterms. Some of the most painful (and unpopular) cuts to families? Not until after. It is shameless. And that means that—by design—this bill will cause economic pain that will unfold slowly but steadily over many years. It’s engineered to dodge accountability.

“But make no mistake— the pain will be devastating. Kids will lose food assistance. Families will lose health care. The economic shock will hit hardest in communities least equipped to withstand it. It’s a perfect storm of long-term economic sabotage. This bill will weaken economic growth over the next decade, making this country poorer. All to give huge tax cuts to the richest.”

“The OBBB reconciliation bill that passed the Senate today represents the largest transfer of wealth from the working class to the 1% in our country’s history. This irresponsible bill will balloon our national debt by over three trillion dollars in giveaways to the wealthiest while causing generational harm to our ability to invest in our nation’s most precious resource … its people. It does so at the expense of access to healthcare for millions of Americans, protection of vital federal programs that keep our food, water and workplaces safe, slashing food assistance for nearly 3 million Americans, and the abandonment of federal support for critical energy infrastructure projects that employ hundreds of thousands of construction workers. Congress must act quickly and decisively to address these deficiencies,” said BAC International President Timothy J. Driscoll. “It will kill critical infrastructure jobs – putting construction workers on unemployment while crippling the nation’s energy independence and transportation grid. It will cause the national debt to explode, forcing unsustainable interest payments on to the backs of our children and grandchildren. And as the debt spirals higher, the impact of this bill will cause cuts to vital programs that working Americans count on. This bill is an attack on not only the workers and retirees of today, but on generations to come. Congress must act now to avert these disastrous provisions contained in the OBBB.”

How the Senate Bill Harms Working People

  • Rips health care away from 17 million people and eliminates 600,000 care jobs, forcing over 300 rural hospitals to close their doors.
  • Spikes health care costs for people with employment-based insurance by nearly $500 per person per year and nearly $2,000 annually for a family of four.
  • Destroys hundreds of thousands of energy jobs in construction, manufacturing and production, and raises energy costs at a moment when working-class households are already struggling.
  • Slashes food assistance for nearly 3 million Americans, and slashes at least 140,000 jobs in food processing facilities, school cafeterias, grocery stores, and farms by cutting billions in SNAP funding.
  • Threatens an estimated 1.75 million construction jobs and over 3 billion work hours, which translates to $148 billion in lost annual wages and benefits.
  • Adds $155 billion in funding for President Trump’s mass deportation agenda to increase raids that target immigrant workers, throw members of our communities and our unions in detention, and rip families apart.

Medicaid Impacts

Congress has just imposed new restrictions and cuts to Medicaid, but many Americans in conservative states may not even know that they or their family members are currently on Medicaid. In Kansas, Medicaid is rebranded to “KanCare.” In Missouri, Medicaid is called “MO HealthNet.”

The Trump bill will require states do even more work to require able-bodied adults, without children, to prove that they are working–or attending school or doing community service–80 hours a month to maintain their a eligibility for Medicaid. Depending on your politics, you may agree or disgagree with that policy, but what this means in reality is that states like Missouri, who have already been in legal trouble for their failure to process Medicaid paperwork in time, will have dramatically more paperwork to process monthly and less resources. Even people who are actually eligible will experience intermittent ineligibility, lose access to healthcare, and put even more strain on emergency rooms as a result of this legislation. That will impact everyone.

Older, disabled, and poor Americans will die because of this legislation and our hospitals will work less efficiently and costs will go up, hurting union members who have their health insurance through their union contract.

It’s important to remember that these cuts don’t stop uninsured people from going to the emergency room, it just means that hospitals won’t be paid.

The Republican cuts are going to hurt rural families the most. In Kansas, 89 rural hospitals are either at risk of immediate closure or teetering. The Kansas Hospital Association says that, even prior to this bill, over half of all Kansas hospitals are now operating at a loss. A 2023 report from the Center for Healthcare Quality and Payment Reform found that one-in-three rural hospitals in Missouri are at risk of closure. That number will increase dramatically.

Key Takeaways from The Budget Lab

Total U.S. Federal Debt in Trillions USD Across Fiscal Scenarios (THE BUDGET LAB AT YALE)

According to the The Budget Lab, a non-partisan policy research center dedicated to providing in-depth analysis of federal policy proposals for the American economy, the “One Big Beautiful Bill” budget bill passed by President Trump and the Republicans “would substantially add to the deficit, particularly if we assume the tax provisions become permanent. If we account for the likelihood that these provisions would become permanent, in 2055 the debt-to-GDP ratio would be approximately 186 percent. For context, the only countries with a higher debt-to- GDP ratio currently are Japan and Sudan. While the impact on the deficit and the debt is not the only important factor to consider in evaluating the impact of this bill, our analysis shows that the impact of this bill on the fiscal picture of the nation would be substantial.”

  1. The budget bill passed by the Senate July 1 would add $3.0 trillion to the debt over the 2025- 2034 window (0.84% of GDP over this time period) and $12.1 trillion from 2025-2055 (0.71% of GDP over this time period).
  2. If the temporary tax provisions became permanent, the cost over the 2025-2034 window is $3.7 trillion and over the 2025-2055 window is $16.1 trillion.
  3. During the 2045-2055 window, the cost in additional interest (even assuming no increase in interest rates due to this bill) is over 88 percent of the direct costs of the bill as written, rising to almost 89 percent if the temporary tax provisions became permanent.
  4. If the tax provisions become permanent, the debt-to-GDP ratio would hit approximately 186 percent in 2055. The only countries that currently have a higher debt-to-GDP ratio are Japan and Sudan.
  5. The Senate version costs more over the 2025-2034 window than the House version ($3.0 and $2.4 trillion, respectively) in part because it has fewer temporary provisions. If made permanent, the Senate version costs $3.7 trillion while the House version costs $4.0 trillion.
  6. Our projection of the deficit depends on our forecast of future interest rates. All else being equal, higher debt and deficit levels will raise interest rates. This analysis does not include any increase in interest rates due to higher debt levels.

 

Editor at The Labor Beacon

Tristin Amezcua-Hogan is the Editor of The Labor Beacon and a member of LIUNA Local 264. Tristin also serves as the Director of Communications for the Greater Kansas City AFL-CIO and the Chair of the Kansas City Regional Transit Alliance.

Tristin grew up as the son of a UA Local 669 member in Tecumseh, KS and the great-nephew of George C. Amis, longtime leader of the United Rubberworkers (now USW Local 307) in Kansas. Growing up in rural Kansas as the child of teen parents, Tristin quickly came to appreciate the life-changing benefit of a union job.

Tristin and his partner, Rebeca Amezcua-Hogan, are residents of the Westside, Kansas City, MO's historic Mexican neighborhood. They are proud members of Kansas City's New Reform Temple.

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