Paul Krugman (Substack)

And their own supporters will be among the biggest victims

I often encounter generally well-informed people who are surprised to learn that Medicaid is a much bigger program, in terms of the number of people covered, than Medicare — 69 million versus 48 million. The perception that Medicare is much more important may reflect the fact that Medicaid still costs taxpayers less than Medicare. This is partly because older people have higher health costs than the young adults and children who make up much of the Medicaid population. But it’s also because Medicaid is quite cost-efficient; more about that shortly.

There’s also, let’s be frank, a perception that Medicaid is politically unimportant, that conservatives can safely target it for cuts, because it’s mainly a program for inner city people of color. But that was never as true as people imagined and is definitely not true now. Again, consider West Virginia. It’s one of America’s most rural states and overwhelmingly — 90 percent — white. Yet as we’ve seen, it’s deeply dependent on Medicaid.