“There’s a big difference between the old Republican Party that focused on Wall Street,” said Republican senator Jim Banks of Indiana in a video clip titled “The new GOP is the party of the working class” a couple weeks ago, “and the new Republican Party that focuses more on Main Street and working-class families.”

That party, Banks said, “has to recognize that those mechanics, factory workers like my dad and members of my family, teachers, police officers, people who go to work and make an hourly wage and a working-class living, that has to be the emphasis of the tax cuts this season.” Senator Josh Hawley of Missouri and many others have made similar statements in their attempt to portray the GOP as a “pro-worker” party and win over more working-class voters.

It’s easy to get jaded about fraud and humbuggery in politics. But the notion of the contemporary Republican Party as champion of the working class is a particularly brazen scam. There’s no better example of why than House Republicans’ gleefully approving the most devastating cuts to Medicaid in the program’s history, alongside a budget gifting the rich with enormous tax cuts.

The House voted 215-214 for the “One Big Beautiful Bill Act.” (You thought that name was just Trump being Trump — actually, it’s the official title.) The legislation is big, but only a misanthropic billionaire could find it beautiful. This budget cuts Medicare spending by nearly $800 billion over the next ten years, and the Congressional Budget Office estimates that some 7.6. million people will lose coverage.

They also added draconian work requirements to the program, although most Medicaid recipients are already working, and those who are not are mostly too disabled or sick to work, are in school, or have caregiving responsibilities. They eliminated gender-affirming care, and in a tour de force of gratuitous cruelty, offered to pay states not to expand their Medicaid programs.

People will die because of these cuts, several studies have found. One National Bureau of Economic Research paper found that people who got Medicaid through the Affordable Care Act were 21 percent less likely to die, once enrolled, than those who went uncovered, and states that chose to expand Medicaid saved 27,400 lives between 2010 and 2022. Other studies have found that access to Medicaid improves people’s health and reduces deaths from diabetes and cancer. It even saves lives among the young and physically healthy by giving them access to mental health care and substance abuse treatment.

As brutal as these proposed cuts are, they don’t even provide enough savings to pay for the tax cuts, which are expected to reduce federal revenue by $3.8 trillion over the next decade. (Note that this is a lot more than the $800 billion in Medicare cuts.) But what the whole package does do is lock in a thoroughly oligarchic agenda: immiserate and kill the working class and help the rich get richer.

Sixty percent of the tax cuts will go to the top 20 percent, according to the Tax Policy Center, and more than a third will go to those making over $460,000. The budget is set to increase the wealth of the top 10 percent of Americans by 2 percent; the resources of the bottom 10 percent are expected to shrink by 4 percent, because of the cuts to health care and food assistance.

Some House Republicans warned against cutting Medicaid. Rep. David Valadao of California said less than a month ago that he wouldn’t support the bill if it included any Medicaid reductions for vulnerable populations. Rep. Nicole Malliotakis of New York attracted fawning media attention for “breaking with her party and taking a stand against Medicaid cuts.” Last month, these representatives and ten others wrote a strongly worded letter saying they wouldn’t support Medicaid cuts and warning that such cuts would lead to hospital closures, especially in rural and underserved areas.

But that was April. In the end, all the signatories sold out their working-class constituents. All but two Republican House members, Thomas Massie of Kentucky and Warren Davidson of Ohio, voted for the bill.

Now this brutal excrescence of a bill goes to the Senate. Both Hawley — and more surprisingly, President Trump — are still claiming to oppose the Medicaid cuts. Trump reportedly told Republicans, “Don’t fuck with Medicaid.” (He also threatened to primary Massie for opposing the bill, so his position is confusing and erratic at best.)

Hawley wrote an op-ed in the New York Times arguing that Medicaid cuts would be “morally wrong and politically suicidal.” Hawley blamed the cuts in the bill on “corporatist Republicans” and said following their lead would “represent the end of any chance of us becoming a working-class party.” He described the stakes of the conflict this way: “Will Republicans be a majority party of the working people or a permanent minority speaking only for the C-suite?”

He’s right to worry. As Hawley pointed out in his op-ed, more than 80 percent of Americans oppose cuts to Medicaid, and over half either use the program or have a family member who does. Nearly two-thirds of Republican voters have a favorable view of Medicaid.

No one can predict the future, and sure, it’s possible that Hawley and Trump will remove some of the worst cuts in the Senate version of the bill. Maybe Trump will save Medicaid! We live in strange times. But the fact that the House passed this version should be a moment of truth for all working-class Americans: even if you hate the Democrats, most of the Republican Party elected officials hate you even more.