The GOP is Courting Disaster with Its Attack on Medicaid

As a young political upstart topples a seasoned pro in New York City’s mayoral race—a stark warning to both parties about the perils of ignoring the electorate—Republican leaders in Washington are making a perilous bet. They are betting that they can push through historic, devastating cuts to Medicaid and that the millions of voters who will be hurt by it will simply, in the now-infamous words of Senator Mitch McConnell, “get over it.”

It is a stunning political miscalculation, a policy war waged by a party leadership that appears dangerously disconnected from the reality of its own base. As President Trump demands that his party “GET THE DEAL DONE” on his “big, beautiful bill,” a civil war is brewing within the GOP. It is a war that pits a Washington establishment, armed with focus-group-tested talking points, against a growing number of their own working-class and rural voters who are terrified of losing the healthcare they depend on to survive.

The view from the Capitol is one of carefully managed messaging and stunning private contempt. In a closed-door meeting, when faced with the political risk of gutting the nation’s healthcare safety net, Senate Minority Leader Mitch McConnell allegedly dismissed the concerns of his own constituents with a curt, “But they’ll get over it.” In a public town hall, when a voter yelled that people could die from these cuts, Iowa Senator Joni Ernst shot back, “Well, we all are going to die,” before doubling down with a mocking video filmed in what appeared to be a graveyard.

This is the “quiet part,” the dismissive shrug from leaders who see their voters’ fears as little more than a temporary political inconvenience.

The public message, of course, is much rosier. House Speaker Mike Johnson doesn’t speak of cuts; he speaks of empowerment. The goal, he insists, is to turn Medicaid from a “safety net” into a “trampoline to success” by forcing “able-bodied men and women” back into the workforce. The White House, meanwhile, has attempted to reframe the entire debate around the culture wars, claiming the bill will “strengthen” the program by removing undocumented immigrants and ending taxpayer funding for gender-affirming care for minors.

But back home, in the small towns and working-class suburbs that form the heart of the modern GOP, a very different conversation is happening—one filled with anxiety, not ideological talking points.

A recent KFF poll reveals the chasm between the party’s leaders and its voters. A full 40 percent of Republicans are worried about the consequences of the proposed cuts. The reason is simple: the Republican base is not who the party’s strategists seem to think it is. A stunning 27 percent of all Medicaid beneficiaries—the very people this bill targets—identify as Republican or lean Republican. Nearly one in five are self-described MAGA supporters.

Among these Republican voters on Medicaid, the fear is palpable. Three-quarters are worried about their family’s ability to get and pay for care. In rural America, where the GOP is dominant, nearly half of all Republicans are worried about the cuts negatively impacting their local hospitals and providers.

This isn’t an abstract fear; it’s a lived reality. The bill’s primary mechanisms for cutting nearly $800 billion are not just numbers on a page. They are strict work requirements that ignore the reality of low-wage, inconsistent jobs and freezes on provider taxes that are the financial lifeblood of rural hospitals. In Missouri, a state that recently expanded Medicaid, residents saw about 10 rural hospitals close in the years before the expansion vote. Since the expansion, there haven’t been any closures. The connection between Medicaid funding and the survival of local healthcare is not a talking point; it’s the difference between a hospital that’s open and one that’s shuttered.

This growing disconnect is producing clear political warning signs that the leadership in Washington seems determined to ignore. The polling data gives crucial context to the vocal dissent from Senator Josh Hawley of Missouri. When he slams the Medicaid cuts, warning that “there’s going to be a lot of rural hospitals in Missouri that close,” he isn’t just a lone dissenter; he is the political manifestation of the fears of the GOP’s own base. He is one of the few who appears to be listening.

The backlash against Senator Ernst’s “we all are going to die” comment provides an even starker warning. Her callous dismissal of her constituents’ fears was so profound that it prompted Iowa Democrat JD Scholten to immediately launch a campaign to unseat her. As one Democratic strategist noted, Ernst simply “said the quiet part out loud.”

This dynamic, of an establishment completely misreading the needs and fears of its own voters, is precisely the kind of political malpractice that led to Tuesday’s stunning upset in the New York City mayoral primary, where a young, energetic upstart, Zohran Mamdani, defeated the powerful and deeply entrenched Andrew Cuomo. It was a clear message that a famous name and a sense of entitlement are no longer enough. Voters are sending warning shots across the political spectrum: listen to us, or we will find someone who will.

Despite President Trump’s pressure, the bill’s passage in the Senate is far from a sure thing. The GOP holds a razor-thin majority. With a populist dissenter like Hawley channeling the fears of the rural base, and other senators hearing the same anxieties from the 40 percent of their own party who are worried, the leadership can ill afford any more defections.

The Republican Party is at a crossroads, facing a civil war of its own making. Its leaders are pushing a bill built on D.C. talking points and a caricature of their electorate, driven by a dismissive “they’ll get over it” mentality. But their voters-the working-class families and rural communities who put them in power—are making it perfectly clear that they will not simply “get over” losing the healthcare that keeps their families afloat and their local hospitals open. The question now is whether the party’s leaders in the Senate will heed the blaring warning signs or if they will press forward, risking a political mutiny they never saw coming.