131 Comments
User's avatar
Stuart Levine's avatar

I fully understand how the right-wing efforts to kill Medicaid and SNAP hurt the poor, including the working poor. What is troubling is that the general public is not being told that these efforts will also raise medical costs across the board. Especially with respect to nursing home costs and the costs of hospital emergency rooms, the out-of-pocket costs and health insurance costs to non-Medicaid individuals will rise dramatically.

Expand full comment
WinstonSmithLondonOceania's avatar

And that's just for starters.

Expand full comment
Comment removed
May 20Edited
Expand full comment
WinstonSmithLondonOceania's avatar

Begone spam bot.

Expand full comment
Mason Frichette's avatar

The cuts to Medicaid, if enacted, will likely force many, if not all rural hospitals to close. The same fate would be likely for many nursing homes. The casualties will go far beyond the low income and poor people who are being targeted by the Republicans. If rural hospitals are closed, think of the number of doctors, nurses, and support staff that will be out of work.

Emergency departments will be far away from rural residents, some number of whom may die trying to get to the nearest ED.

Mr. Giridharadas raised the question of "electoral stupidity" on the part of Republicans. What that made me wonder immediately was do Trump and his administration toadies (and the GOP) have a plan for the mid-terms that will mean guaranteed Republican success? I know there are still many millions of Americans who are so disengaged that it would never occur to them that Trump might be planning to declare martial law and cancel the midterms. Given what we have seen from Trump is that really unthinkable?

Expand full comment
Edith H Conyers's avatar

Cannot believe it is “unthinkable “! It is very thinkable and is probably already in the PLANS.

Expand full comment
Bodhishanti's avatar

I wouldn’t be surprised if medical professionals displaced by Rump cratering rural hospitals bail out and move to Canada and the EU. That’s what NIH scientists are doing.

Expand full comment
GeorgeM-NY's avatar

Dr. Krugman,

You just mentioned, sadly correctly, to Mr. Anand Giridharadas, that the States would be saddled with the cost of providing Medicaid to their poor residents. Shouldn't then the States reduce by an equal amount what they will contribute to the Federal government in the form of taxes? I do not know whether the States can do so, but if Trump can ignore the Constitution, then it is only fair that the States do the same.

Expand full comment
WinstonSmithLondonOceania's avatar

I was thinking the same thing. Ironically, the states that contribute the most are the big blue states, NY, CA, IL, etc. We'll be in a better position to pick up some of the slack than the smaller red states like LA, KY, MO, etc. Even more ironically, those states have higher Medicaid enrollment.

The MAGAnuts are getting what they voted for, even if they didn't grasp it at the time, they're about to find out. This is what it means to "own the libs".

Expand full comment
Douglas Ptacek, Jr's avatar

My fear is that too many will not “find out”- they’ll just continue to blame their problems on whoever Trump and the Republicans tell them to blame.

Expand full comment
WinstonSmithLondonOceania's avatar

They're finding out already. That's why Republicans in congress are so afraid of having town halls now. Their constituents are really pissed off at them. It's also why there's a big opening for Democrats to hold town halls in GOP districts as they've been doing. The blue tsunami is coming.

Expand full comment
RCThweatt's avatar

A fully understandable fear. At this point, it's actually a default assumption! But there's polling showing cutting Medicaid and taxes for billuonaires is really, really unpopular. See G.Elliot Morris, "Strength in Numbers", here on Substack.

Rs have had so much success for so long conning their voters they probably can't really believe reality will ever bite. But even if they hold them, there's a huge pool of non voters out there.

Expand full comment
GeorgeM-NY's avatar

The states that contribute the most to the Federal Government are known as the "donor" states, and in 2023, these states were:

https://wisevoter.com/state-rankings/donor-states/

Connecticut paid more per capita than any other state $17,193, followed by Massachusetts $16,945, New Jersey $15,012, New York $14,842.

All of them "blue" states. Most of the "taker"/"moocher" states were "red" states.

Expand full comment
Bob's avatar

He'll just exclaim "Biden Biden Biden ". ..and folks will believe him.

Expand full comment
WinstonSmithLondonOceania's avatar

Naturally.

Expand full comment
Tully's avatar

Agree. Many blue states already send in much more revenue to the Feds than they get back. https://apnews.com/article/north-america-business-local-taxes-ap-top-news-politics-2f83c72de1bd440d92cdbc0d3b6bc08c and https://usafacts.org/articles/which-states-contribute-the-most-and-least-to-federal-revenue/

I've read articles where MAGA tries to contort how this is actually done and that it isn't factual, such as saying red states have lower incomes. And whose fault is that??! As if anything is ever factual and honest with MAGAs. Overall, red states get back more than they send in. Let them start to pay for their own corruption. The only sad thing is millions of their very poor would be hurt more than what their elected officials do to them now.

Expand full comment
Jim Holley's avatar

George, I get your point, but the left is in the position of having to save the Constitution. If you get into a tit for tat fight of abusing the Constitution to make a point then you're on the fast track to losing it altogether by doing the oligarchy's work for it.

Expand full comment
GeorgeM-NY's avatar

I can see where you’re coming from, however, I want to present you with two counterpoints: 1. The Supreme Court in its current form is as corrupt as can be and we cannot expect it to defend the constitution regardless of the Democrats’ good will and respect for the law. 2. The only way to react to a bully, is by punching back at the bully (I can attest to that first hand). The longer you let the bully get away bullying you , he/she will get emboldened, but if you punch them back and make them feel it, they’ll tuck their tail between their legs like frightened dogs. As I said I am speaking from experience. What good has it done to this point that we, Democrats abide by the law, only to get screwed more!

Expand full comment
David Schmitt's avatar

In this case , what is the "punch back " ?

Expand full comment
Andan Casamajor's avatar

States don't pay; taxpayers do. Federal income taxes don't flow through state governments to the Treasury. They're paid directly by individuals, corporations, and other business entities. The "donor state" argument simply acknowledges that more tax revenue comes from blue-state taxpayers than from red-state taxpayers. This makes it really hard to imagine how "donor states" can functionally hold back federal tax revenue.

Expand full comment
GeorgeM-NY's avatar

The states can change the way the federal taxes are paid to IRS. It will require some infrastructure work but is doable.

Expand full comment
Joe Blow's avatar

Hear hear! And Amen

Expand full comment
Larry's avatar

I guess you are aware the states don't pay taxes to the federal government, rather their citizens do thru federal taxes. I don't think the states could lower what their citizens pay in federal taxes.

Expand full comment
Vicki Mork's avatar

There are many poor states that could not afford to reimburse the Federal govt-

Expand full comment
GeorgeM-NY's avatar

Yet they voted for the felon and against their own best interest. Sorry to disappoint you, but I am tired of paying for them all these years.

Expand full comment
andré's avatar

The states could increase their tax rates, which is deductable for federal taxes.

Expand full comment
GeorgeM-NY's avatar

No, actually not. Remember that with the 2017 tax cut for the 0.1%, this “exquisite” according to Paul Ryan tax cut, limited the SALT (State And Local Tax) deduction was limited to $10,000 thus screwing the blue states, for instance property taxes (Local Taxes) in Long Island are over $20,000, thus the tax payer is taxed twice on the $10,000 that is over the allowed SALT deduction.

Expand full comment
George's avatar

Is there any hope that, somewhere in the bowels of the NYT, some editor is banging his head on the table in despair that they let Krugman go? His body of work in just the 3 (?) months since he left is unmatched by any writer on any subject, much less economics. Timely & relevant, clear, concise and, heck, even mostly understandable to us non-econ types. And doing it daily, which I never expected. I hate to gush like a fanboy but his stuff is pretty darned incredible and a great antidote to the pablum drek his former employer continues to churn out.

I do have a complaint about substack, though. Overall, it's a great model and brings writers -- many, like PK, refugees from the MSM -- with terrific expertise into one loose (very loose...) collective. The major downside is wanting to support them, as they should be. I subscribed to PK at the $70 rate but just can't afford that with any others -- though have dumped both NYT & WaPo quite awhile back so maybe can afford one more... . I keep hoping Substack will start a mix & match subscription rate. I dunno, 3 - 5 authors for $100?? Heck, maybe even put out a print edition and deliver it daily to my mailbox?!

Anyway, main point: there's some really outstanding people here I'd like to support. Would be great if Substack somehow makes that affordable.

Expand full comment
Bob Adolph's avatar

Agree with you re Krugman's extraordinary output - quality and quantity.

And further agree that Substack needs a paid subscription model that can support multiple authors. I want to support multiples, but can't afford that as designed.

Expand full comment
mike harper's avatar

I would like a transcript. I read faster than I listen.

Expand full comment
WinstonSmithLondonOceania's avatar

Below the byline, there's a toolbar with buttons for "like", "comment" and "restack" on the left, and on the right buttons for "share", "transcript" and a "three dots" menu.

Click the transcript button and it'll open up with a complete timeline. At the top right corner is an "X" to close the transcript box when you finish reading.

Expand full comment
Connie weeks's avatar

You can set the playback time. I listen at 1.2 times normal speed.

Expand full comment
George's avatar

Yeah. I teach online courses using mostly self-produced YouTube videos. I speak annoyingly slowly with lots of 'ums', 'ah', and pauses. I tell my students they can, mostly, increase to even 1.4X and still follow what I'm saying and without sounding like a chipmunk... .

I just upgraded my video app to the latest version of Adobe Premiere Elements. It's now got a function that takes out filler words and will also delete pauses at a length you can set. I did that on one video of mine and it reduced the time from 20 minutes to a little over 17. A bit embarrassing but a really nice feature!

Expand full comment
George's avatar

The videos that PK produces have all had fairly good transcripts -- identifying the speaker and seem, even, to be edited. When he's being interviewed, the transcripts seem to be just verbatim voice recognition and hard, though not impossible, to follow.

Expand full comment
Kaija Reiss's avatar

SSAis already very fragmented. It takes hours to get a phone call back, the workers are very clearly exhausted, #mymedicare” online does not accept passwords or ID, one telno refers to another and they refer you back to original, misleading info is given while the needed info is not provided and IF your benefits were discontinued it can take up to 60 days to have them re-insisted etc. ( My case ).

Total cluster fuck.

While my medical debt grows, so does the content of my ”cuss jar”!

Expand full comment
George Kappus's avatar

I was remiss to not include a shout out to the SSA employees who helped me and who are manning their posts during most difficult times during the most difficult circumstances.

Expand full comment
George Kappus's avatar

Sorry to hear. I got through to the office responsible for my account within 5 minutes and got the delayed payment within a week.

Expand full comment
Bill Lloyd's avatar

It seems that a large percentage of people on Medicare are eligible to vote. Time for them to register to vote and choose a candidate that will reverse these new budget policies.

Expand full comment
Jonathan R. Lautman's avatar

That's part of the point. They are not only less likely to vote, they are more easily purged from the registration rolls (as they move more frequently) are more likely to have ID for a previous address, etc. etc. So as always they are the least potent political threat, and therefore the easiest target to shake down.

Expand full comment
Science Curmudgeon's avatar

Who are they?

1. The Tories never left.

2. The Confederates never disappeared.

3. The KKK and right wing militants are still here.

4. The Religious fanatics are still active and looking for power.

Trump united them and gave them a voice. They will not give up power easily.

The sleeping giant needs to wake. Ring the alarms! Great works are needed again.

Expand full comment
Courtnxy's avatar

Heather Cox Richardson wrote How The South Won The Civil War:

https://www.amazon.com/How-South-Won-Civil-War/dp/0190900903

Expand full comment
Serge L.'s avatar

I'm sure I'm not alone in feeling a connection to Paul Krugman's verdict that Newt Gingrich's takeover of Congress was the first hint of the demise of American democracy. That certainly was the moment for me when America started turning away from its ideals, its allies, and from reality itself. As a Canadian living in the US at the time, that event was horrifying, even traumatic, and Trump's presidency seems like just a fulfillment of Newt Gingrich and Dick Armey's nihilistic impulses. They showed that you could go to war against America and get away with it, if you were Republican and wrapped yourself in the flag.

Expand full comment
Lee Peters's avatar

Nixon’s declaration that anything the President does is legal was the first hint, followed by the election of Reagan who ran on an anti-government, blame the poor platform. Gingrich brought the playbook used for those two executive branch officials to the legislative branch. Roberts and company brought the playbook to the judiciary.

Expand full comment
Serge L.'s avatar

Sure. You could also trace a huge part of the problem back to the Civil War and how the South was never denazified and was allowed to whitewash its sins and reinstate a form of authoritarianism. HOWEVER, Southern "fascism" had been steadily dismantled from the 1950s through the 1970s and beyond. Similarly, Nixon had to resign and live the rest of his life in infamy. In contrast, I think that the 1994 midterm GOP takeover was the start of a slow but irresistible reversal of democratic progress (though not yet of social progress), perhaps because Republican extremists were finally no longer constrained by the Cold War.

As for Reagan, yes, he was surely another turning point in democratic backslide, as he brought the mask of entertainment and fake optimism over the forces of darkness, but he was constrained by the Cold War, where the concept of democracy was very much a tool in fighting Communism, however hypocritically. The biggest fear about Reagan was not the end of US democracy, but a nuclear war brought on by his saber rattling.

The Newt Gingrich crew was very different. For me at the time, the nomination of famously and openly racist Jesse Helms as Chairman of the Senate Foreign Relations Committee was the clearest sign that the US was no longer a serious country and that the clock was ticking on all American alliances. But this was also more broadly a political revenge of the Confederacy and the normalization of democratic backsliding in American political discourse.

Expand full comment
Diana Haering's avatar

They continue to commit crimes against humanity with the not-so-supreme court’s rulings!

Expand full comment
Courtnxy's avatar

It’s purposeful, the traditional way autocrats work to demoralize.

Expand full comment
Steven L Whysel's avatar

Dr Krugman, why hasn’t anyone asked this question, why didn’t anyone propose free continuing education for workers who have lost their jobs due to CEOs seeing more profit by sending their their businesses to China and Vietnam?

Expand full comment
Tully's avatar

Not even just CEO's, but people like the WalMart family who live off the billions in profits and pay very little in tax percentages as compared to the rest of us. Why so much going to so few instead of more support for those who do the work?!

Then's there's the CEO's, such as the one United Technologies CEO, kicked out with $195 million in benefits in 2015. Think he had to pay taxes on any of that?

Expand full comment
Lee Peters's avatar

There were retraining programs provided by community colleges with deindustrialization in the early-mid 1980s (the first Rust Belt era). They weren’t necessarily effective, perhaps because automation and technological advances kept roiling the job market on shorter and shorter timelines. For example, by the time someone learned to be a bookkeeper or accountant back then, Lotus 123 and the Microsoft Office Suite became available, which reduced the need for kinds of skills the retraining programs provided. By the 1990s, the mantra was for everyone to get a four year college degree (preferably in computing or business), but that didn’t work either. By the time anyone graduated with a degree in programming, the language they learned was obsolete. Now AI is doing the same thing to programmers in Silicon Valley and to recent graduates with degrees in IT.

Expand full comment
Steven L Whysel's avatar

What you say is true but the cities and states that lost those factories and resultant job losses did not make the effort with tax incentives to bring in service related businesses and no cost trade school training for those willing to work with their hands.

Expand full comment
Elliot Hoffman's avatar

Yes - billionaires in the Citizens United era is a very dangerous scam. Get rid of Citizens United, no dark $ (big jail time is you cheat).

Citizens "United" is a si9ck term for what it does.

Expand full comment
rpasea's avatar

One cynical aspect of the budget, amongst many, is the tax cuts happen now while the Medicaid cuts happen in 2029. The GOP may be covering their bets on the 2028 election as they would rejoice at the Medicaid cut protests all over the red states while a Democrat sits in the White House. Plus the orange felon can say he didn't cut Medicaid.

Expand full comment
Andy's avatar

why does everyone assume that there will BE elections? Or at least elections where the list of "eligible" voters hasn't been drastically purged? If you add up all the voter suppression that has ALREADY happened, you'll see how trump got elected. And there is a definite risk of trump declaring a state of emergency (due to a martian invasion or whatever) and cancelling the election altogether. Don't the republicans in Congress appear to be acting as if they are not actually afraid of real elections? Yes, they're afraid of being primaried, but the people voting in republican primaries are not the voters who are going to get culled.

Expand full comment
Lee Peters's avatar

Speaking of purging voter lists, the SAVE Act passed by the House has not received the attention it should since it could result in preventing 79 million women from voting. The Act could jeopardize the voting rights of married women who took their husband’s name since it requires an original birth certificate as identification. If the Act passes and becomes law, there are going to be a lot of surprised women, but no surprised Republican elected officials.

Expand full comment
David Schmitt's avatar

The GOP has no intention of letting any Democrat , Lefty , or Progressive wield the power they are now crafting .

Expand full comment
WinstonSmithLondonOceania's avatar

Apparently they're not counting on the blue tsunami in 2026.

Expand full comment
rpasea's avatar

The House should flip but unlikely in the Senate. We can hope!

Expand full comment
David's avatar

Dr. Krugman,

More than half the time that you are speaking you're looking away from the camera.

Please look into the camera more.

Expand full comment
Ralph T.'s avatar

Rush and Gingrich were creations of the end of the Fairness Doctrine.

Then Citizens United came along and sealed the deal.

Clear as ice.

Expand full comment
Dave Huegel's avatar

I don’t have much to add other than this has been one of the best discussions coming out of the Krugman line of thinking. As Noam Chomsky said, “ optimism is better than despair “.

Expand full comment
Ron's avatar

An excellent discussion. It aided my understanding of a number of important issues. Thank you!

Expand full comment