The recently passed Republican budget plan is touted as a reduction in government spending and in taxes, and indeed it succeeds. It drastically reduces spending on social programs like Medicaid, Medicare, and Education and sets the stage for major cuts in Social Security. The tax reductions significantly benefit wealthy individuals and corporations. The bill is said to be the largest transfer of wealth from the poor to the wealthy in American history.

So how exactly are we paying to increase the wealth of the American kakistocracy? The bill has hundreds of provisions, stretching over approximately 900 pages, but this article will focus on the most malevolent aspects that will have the greatest impact on healthcare, the environment, and the economy.

Healthcare takes a big hit. Sixteen million people will lose their health insurance through the Affordable Care Act or Medicaid, according to the Congressional Budget Office. There will be an increase of 51,000 preventable deaths due to loss of insurance and other aspects of the legislation.

Those with the lowest incomes and the greatest needs will suffer the most. Medicaid spending will be reduced by $793 billion over 10 years, and there will be 10.3 million fewer enrollees. A total of 2.3 million Medicaid enrollees, including 1.3 million dual-eligible individuals (those with limited resources who qualify for both Medicaid and Medicare), will lose benefits due to delayed implementation of two Biden-era rules designed to reduce administrative barriers. The loss of coverage cascades into the loss of access to the Medical Savings Program and the Low Income Subsidy, which help pay for copays and drugs. Preventable deaths occur when healthcare and medication are inaccessible. Five and a half million people will suffer increased food insecurity by losing SNAP benefits due to reduction in spending for food aid by $300 billion, more stringent rules regarding work requirements, citizenship, and shifting program costs to states. Medicaid cuts of $465 million in 2026 will result in average yearly losses of 56 percent of hospitals’ net income which, in addition to the loss of Medicaid coverage by rural residents, will put 300-500 rural hospitals at risk of closure. The American Hospital Association (AHA) and state-level hospital groups have warned that the act could destabilize access to care in dozens of states, especially in regions already struggling with physician shortages.

Medicare does not escape the Republican wrath. Legislative rules mandate that if a bill increases the budget deficit, it must be made up through automatic “sequestration” cuts. The budget increases the deficit by over $3.3 trillion. There is a limitation on Medicare cuts of four percent, amounting to $45 billion in 2026. The CBO estimates the total 10-year cuts would equal $490 billion, which will shorten the viability of the Trust Fund.

Our health, of course, is interconnected with the environment, and this bill is dedicated to making it unhealthy. It repeals or phases out most clean energy tax credits introduced under the Inflation Reduction Act, including those for electric vehicles (EVs), solar panels, wind farms, and battery storage. It also introduces new taxes on renewable energy infrastructure, while expanding fossil fuel incentives, including credits for domestic coal and oil production.

This undermines grid reliability and will increase electricity prices by 19% by 2030 and more than 60% by 2035. This disproportionately affects lower- income Americans. The Billionaire Bill will also result in more forest fires by eliminating $50 million for the management and protection of old-growth forests on National Forest System land. The intent is to cut the funding protecting the forests, open the areas for logging and development, and eliminate the environmental reviews. It is well-established that uncontrolled logging increases fire risk. This bill will reverse recent environmental progress, increase US carbon emissions by up to 574 million metric tons by 2035, potentially lead to the extensive destruction of carbon-sequestering forests, increase pollution from smoke and gas-powered vehicles, and contribute to atmospheric warming, all of which are devastating to health.

The Billionaire Bill will also bring us an unhealthy economy. These provisions deliver substantial tax savings for high-income earners and corporations. Analyses show that 70% of the tax benefits flow to the top 20% of earners, with the top 1% alone receiving nearly 20% of the overall relief. Meanwhile, middle-class families see modest gains, and many lower-income households actually lose net benefits due to cuts to programs like Medicaid and SNAP. Increasing medical expenses due to loss of insurance or access to medicalcare will further decrease the economic resilience of the majority of Americans. The financial inequity in the country will expand.

Because Trump’s budget will add between $3.3 trillion and $4.5 trillion to the national debt over the next decade, debt-to-GDP is now projected to reach 126% by 2034, raising concerns among fiscal conservatives and global investors. Job losses are expected in both the healthcare and clean energy sectors, with estimates suggesting up to one million jobs lost by 2030 due to program cuts and reduced investment. Only the greediest of the top 20% of earners (and the Trump cultists) will consider this bill “Beautiful.” Keep in mind that the crumbs tossed to the rest of us, like eliminating tax on tips or overtime pay, car loan interest deduction, “Trump accounts for kids,” the “bonus deduction” of $6,000 for those over 65 years, are all restricted and phase out in 2028.

In conclusion, the Big Billionaire Bill increases the wealth of the richest Americans, takes away healthcare and other essential services from the rest of us, destroys the environment, increases pollution and global warming, and raises the national debt, thereby putting the national economy at risk of inflation and/or recession.