Donald Trump’s long State of the Union reached new levels of horror and mendacity. Some House Democrats protested by dressing all in pink or waving signs that said simply “False” when the president said something untrue. But eleven-term congressman Al Green, age seventy-seven, handled the situation more forcefully. When Trump bragged about his “mandate,” Green stood and interrupted the address, waving his cane and shouting, “You have no mandate to cut Medicaid!”

It’s hard to imagine how any Democrat could have made a more relevant, morally urgent, and politically savvy intervention during that speech. Nearly one in four Americans depend on Medicaid, including many Trump voters. As unpopular as much of the Trump/Elon Musk agenda is, the move to cut Medicaid and Social Security is by far the most widely hated. Republican elected officials are hearing about it from panicked constituents across the country. Gutting the program would cause chaos and mayhem in our health care system. People would suffer horribly. Many would die.

It would also be politically stupid of the Republicans to do this, as Michael Kinnucan has argued. According to a 2024 Kaiser Family Foundation poll, 71 percent of people think the program should continue and two-thirds support expanding it. But that doesn’t mean the GOP won’t cut it. It’s not clear the extent to which elections or popular feelings matter to this administration, and cutting Medicaid is a long-standing goal of theirs.