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Former NASA astronauts launch new group to promote U.S. constitutional values

Astronauts for America

More than 100 retired NASA astronauts have banded together to form a new nonpartisan organization dedicated to promoting U.S. constitutional principles. The following is from their web site https://www.astronautsforamerica.org/

“Astronauts For America is a nonpartisan organization of former NASA astronauts who have sworn to defend the Constitution of the United States. We are committed to science, evidence-based decision-making, public service, and the rule of law.

We work to uphold constitutional principles and to support leaders who demonstrate commitment to those principles and the ability to work across differences to solve problems.

We’re focused on protecting American constitutional democracy for the long term—beyond any election cycle.”

Here is their open letter to America:

“To Our Fellow Americans:

Looking at the Earth from space, we see what unites us more than what divides us. As former NASA astronauts, that perspective shapes everything we do.

We view our oath to support and defend the U.S. Constitution as a lifelong commitment. And today, with the launch of Astronauts For America, we take on a new mission: to reinvigorate American democracy. It’s a critical mission that depends upon all of our vigilance and support.

For decades we’ve seen a steady erosion of our founding values and principles that weakens our democratic systems. The result has been political polarization and subversion of key constitutional and institutional norms, including bipartisan cooperation, executive constraint, and judicial independence.

In spaceflight, ignoring evidence costs scientific advancement, mission success, and even lives. In democracy, it costs trust, stability, international respect, and the health and well-being of the governed.

If you’re like us, you might not be used to talking about politics outside of your home. We didn’t spend time discussing who we voted for when we were working in the NASA Astronaut Corps. We know the importance of respecting one another and speaking up when things don’t look right. We’ve seen what Americans can achieve when we work as a team toward a common goal.

Our new mission is patriotic, not partisan. We are Republicans, Democrats, and Independents from many different backgrounds who share a love of this country. We believe deeply in the principles that have propelled our nation for 250 years, such as the rule of law, constructive checks and balances, equal opportunity, and the peaceful transfer of power. A strong democracy makes all else possible: economic growth, national security, and our rights and freedoms.

Astronauts For America will partner with voters and support leaders, regardless of party, who govern in accordance with the Constitution and work out differences to get things done for the good of the nation. We’ll also take officials to task when they ignore the rule of law or distort and disregard the facts.

We’re calling on all our fellow patriots to join us in this mission and put country over party. As we approach America’s 250th anniversary, remember the democratic values that have allowed our nation to excel. We encourage you to sign the pledge and join our crew at AstronautsForAmerica.org.

We are very grateful for the opportunities provided to us by this great country which allowed us to live our version of the American Dream. Together, let’s ensure that America remains a land of opportunity and a beacon of democracy for another 250 years.

Sincerely,
The Members of Astronauts For America”

The Desecration of America

When I first began posting these blogs, there was no shortage of topics. The outrageous behavior of Trump and his minions provided what photographers call a “target rich environment.” The problem was that, as I was spending a day or two writing a blog about one day’s developments, they would commit even more outrageous acts the next day. A number of times, I left one screed unfinished in order to tackle another more-current subject. It was very frustrating. Finally, it just became too exhausting to try and keep up with them.

But Trump’s latest acts that are so egregious as to warrant discussion. I’m talking about his renaming of the John F. Kennedy Memorial Center for the Performing Arts to include his own name. This is doubly disturbing, firstly from the standpoint of the desecration of an iconic American monument and, secondly, being done by a man with absolutely no artistic credentials or even good taste. This is the man, after all, who has redecorated the Oval Office to look like a cheap imitation throne room set from a movie.

He also renamed the United States Institute of Peace to the Donald J. Trump Institute of Peace. This is a gross abomination given that he is waging a fake “war” against fishing boats and is planning to soon invade another country in order to steal their oil.

This comes after his plans to release a U.S. coin with his image on both sides, to construct the Trump Ballroom, and to create “Trump accounts” for children.

Regrettably, this is probably not the end of his desecration of American icons. Trump has a deep narcissistic need to put his name on everything he can. Over the next three years, I think we can expect to see the following:

The Trump-Washington Monument (with his enlarged image in bronze plaques attached at the base to all four sides)

The Trump-Lincoln Memorial (with Lincoln’s immortal words chiseled away and replaced by “President Donald J. Trump – AMERICA’S GREATEST PRESIDENT!”)

The Trump-Arlington National Cemetery

The Trump-Reagan National Airport

The Trump National Mall

The Trump-Smithsonian Museums

Trump Boulevard (formerly Pennsylvania Ave)

The Trump-Pentagon

The Trump National Zoological Park

The Trump Capitol Building

Trump Plaza (formerly Black Lives Matter Plaza)

Trump-Franklin Square

and “The Trump…” on the various other public spaces and the 70 or so government buildings In Washington D.C. (especially The Trump Supreme Court Building).

Not to forget the Trump Triumphal Arch that he’s also planning to build.

In fact, I would not be surprised if he were to rename the whole town to Trump City. And since that is merely a city, he will probably pressure the Republicans in the Texas legislature to rename Texas to The State of Trump. They would, undoubtedly, be happy to do it.

This just goes to prove that there is no bottom for Trump or the GOP. They are willing to sink to whatever the lowest level of fifth-grade behavior they can reach in their efforts to glorify Trump.

The Crumbling Constitution – the First Amendment Goes Down in Flames

One by one, the opposition voices are being silenced – Stephen Colbert, Jerry Greenfield (of Ben and Jerry’s), and now Jimmy Kimmel. NPR and PBS have been defunded. Even the highly respected Voice of America is off the air. Just like the governments in Communist China, North Korea, Hungary, and Russia, the Trump administration is moving to seize control of all the media. Trump and his minions have learned from their dictator-mentors that if the government’s voice is the only one that people hear, then that government can control not only the narrative but the citizens as well.

Unfortunately, this tactic works. Witness Russia where there is still surprisingly strong support for Putin despite the harsh economic sanctions and the failing military campaign in Ukraine. It’s because the Russian people are being told continuously by the government media that they are actually winning the war and that the West will soon bend to their will and cancel the sanctions. Hearing no other voices in opposition, especially since Putin poisoned Navalny, the Russians accept it as the truth.

The day may be coming when no one in our country will be allowed to say anything negative about the administration or its supporters regardless of the First Amendment. Further, if the Trumpists continue to follow the autocratic playbook, the government may soon begin monitoring social media for dissension or force the social media companies, some of whom are already on Trump’s side, to filter and report anything that is not fully consistent with their far-right agenda. All of this raises one question. Are we now seeing the end of freedom of speech?

The First Amendment also protects freedom of the press. But when largely right-leaning multi-billionaires own all the stations on television and radio, will the broadcast media become just mirrors of Fox News? Disney/ABC and Paramount/CBS have already “bent the knee” in order to avoid Trump’s wrath. Honest journalism, which reached its peak with the likes of Walter Cronkite, Edward R. Murrow, Dan Rather, and their contemporaries, seems to be completely dead. I wonder if the next season of “60 Minutes” will be filled with either irrelevant pablum or stories in praise of Trump. Likewise, newspapers and other news outlets, either willingly or under threats of lawsuits, may become simply repeaters of the government approved information, something like Pravda in the old USSR or today’s China Daily.

What about freedom of religion – also a part of the First Amendment? There is currently a strong movement by Christian Nationalists to claim that the United States was founded as a Christian-only country. But the Treaty of Tripoli, which was signed by President John Adams in 1797 (only six years after the ratification of the Bill of Rights), says the opposite. Article 11 of the treaty clearly states, “(T)he government of the United States of America is not in any sense founded on the Christian Religion…” Despite this, there are those who believe that the laws of our nation should be based solely on their particular religion’s interpretation of God’s wishes.

Finally, there are the remaining First Amendment rights – the rights to assemble peacefully and to petition the government for redress. Remember that Trump has been granted broad immunity by SCOTUS. So if peaceful anti-Trump protestors are beaten, arrested, or even shot, I won’t be surprised. Nevertheless, I intend to continue to be one of those protestors.

Is the United States of America doomed? I don’t know. But in all my 78 years, I have never seen such an effort to openly turn our country into a dictatorship. Even Nixon was eventually forced to face the consequences of his illegal activities. But when every day brings fresh assaults on our democracy, I fear for tomorrow.

Public Urged to Comment on Significant USDA Cuts by Sept. 30, 2025

Individuals interested in potentially losing government-provided financial aid amounting to $157.11 billion in 2025 for food, nutrition, and safety, as well as agriculture in general, should join in opposition to the reorganization attempts by Agriculture Secretary (USDA) Brooke Rollins.

Rollins, a Trump appointee and daughter of Helen Kerwin, a member of the Texas House of Representatives, announced plans to send 2,600 of her 4,000 (65%) of her Washington, DC staff to five regional hubs: Raleigh, NC; Kansas City, MO; Indianapolis, IN; Fort Collins, CO; and Salt Lake City, UT.

This relocation move follows the loss of at least 15,000 employees who have accepted Rollins’ “voluntary” resignation offers as she seeks to eliminate 30,000 (30%) of its workforce.[i]

In addition, last month, Rollins announced the elimination of a $360 million program, established during the Biden era, through the American Rescue Plan Act to bolster rural development and build stronger food supply networks in the wake of the COVID-19 pandemic. 

Rollins’ move to cut her Washington, DC staff by 65% masks the actual importance of those people.

Federal agencies place political appointees and hire civil service individuals in their Washington, DC staff for both political and professional reasons.

USDA Washington, DC personnel, both political and civil service, deal with several congressional committees when budgeting, planning, and programming, including House Agriculture, Supplemental Nutrition (SNAP), Livestock and Foreign Agriculture, Nutrition, Oversight and Department Operations, Forestry and Horticulture, Farm Bill Committee, General Farm Committee, and Risk Management and Conservation programs. Additionally, statistical information on farm and agricultural activities comes from the DC office.

Furthermore, political appointees, as expected, serve the whims of the party in power, whereas civil service individuals provide the long-term knowledge, skills, and abilities necessary to run an organization and, sometimes surreptitiously, provide Congress with organizational information that often corrects distorted or misinterpreted political presentations.

Through these collaborative efforts, in 2025, Congress obligated $192.71 billion to the USDA. Of that amount, Congress directed USDA to spend $157.11 billion (81.5% of the total) on private sector contractors (4.6%) and financial assistance (95.4%).

In simple terms, it’s civil service employees who determine the cost-effectiveness of obligation spending. At the same time, political appointees attempt to do the opposite, either by ending funding or diverting those dollars to special interest groups, without oversight.

In Nevada, USDA funds cover aerial photography, conservation programs, daily market prices, disaster assistance, farm loans, outreach and education, and price support for food banks, as well as SNAP.

Unfortualy, under Rollins, as of March 2025, USDA funding for programs supporting Nevada’s food banks, schools, and local businesses, such as the Home Feeds Nevada program and regional food business centers, has been significantly reduced or eliminated.

While some rural development grants continue, Rollins terminated significant funding for locally sourced food purchases, which impacts the state’s agricultural sector and food security efforts. 

According to Jeniffer Solis of Nevada Current, the USDA terminations amount to $3 million, and local small and mid-sized food and farm businesses ended three years ahead of schedule. 

For her part, Rollings, while serving as president and CEO of the Texas Public Policy Foundation, an Austin-based conservative think tank, advocated for the end of agriculture subsidies for farmers and opposed ethanol requirements for fuels.

Meanwhile, as agriculture trade groups sound alarms about price slumps for crops and worsening credit conditions, during Trump’s chaotic trade war, Rollins, in addressing the Northern AG Network in July, congratulated Trump on his trade policies, saying that “I believe with every fiber of my being that prosperity is around the corner because of Trump’s trade negotiations.“

As a reminder, it was Rollins who told reporters on July 8, 2025,  that Medicaid recipients could replace farm laborers.

Individuals can provide comments by emailing [email protected] and are also encouraged to contact their senators and representatives. The comment period is open through September 30, 2025.

[i] See: USDA workforce according to Politico.

“A Republic, if you can keep it.” B. Franklin

Well, that didn’t take long. Trump has been in office now for less than a year, but he has just boldly revealed his ultimate goal. On Monday (8/25/25), Trump told reporters at the Oval Office, “A lot of people are saying, ‘Maybe we like a dictator.’” On Tuesday, he added, “Most people are saying, ‘If you call him a dictator, if he stops crime, he can be whatever he wants’ — I am not a dictator, by the way.” But he also claimed to have “the right to do anything I want to do,” which is actually the very essence of dictatorship.

Despite his claim of not being a dictator, his use of the phrase “people are saying” is classic Trump. It’s one of his ways of laying the groundwork to justify his later actions. He likes to imagine in his fantasy world that many, if not most, Americans agree with him. So now he is trying to imply that a majority of Americans actually want a dictator as a leader. And, despite his protestations, it goes without saying that he thinks it should be him. He won’t call it a dictatorship though. It will be something like President for Life.

Naturally he fully expects the Republicans in Congress to go along with this plan since they all suffer from TTS (Trump Toady Syndrome). And the Supreme right-wing Court will merely say that it is a political matter outside of their jurisdiction. They have already granted him immunity from any consequences for illegal actions while in office. It seems that there is not a single Republican in any branch of our government who is willing to fulfill his or her oath to “preserve and protect” the Constitution, least of all, Trump.

In the meantime, Trump continues to subject Americans, including citizens, to unconstitutional dictatorial actions daily. He shows disdain for the laws and ignores the courts. He is building his own paramilitary force and assuming control of cities he doesn’t like. He is attacking his “enemies” with “lawfare,” coercion, and outright extortion. He is trying to assume control of the entire economy (don’t forget that he has a history of bankruptcy). He, along with his Republican toadies, are working hard to restrict voting rights (mostly of minorities but recently some voices on the Right have said that women should not be allowed to vote either). And so on and so on.

His deployment of ICE and the military into blue cities is specifically intended to provoke a reaction against the troops. No matter how minor, he will then use that reaction as an excuse to invoke the Insurrection Act. This will give him the authority to flood cities and states with military units. The mass arrests of Democrats will likely follow including Senators, Representatives, Governors, past Presidents, and other Democratic leaders. The concentration camps have already been built ostensibly just for the deportable immigrants, but they can hold Trump’s enemies as well. I believe that the mid-term election results will either be rigged or cancelled altogether to eliminate the possibility of any reductions in the Republicans’ powers.

So, dear Mr. Franklin, I regret to inform you that we were not able to keep the Republic you gave us. We managed for nearly 250 years to have a mostly honorable government run by mostly honorable people. There were exceptions of course, but our Founding Fathers never anticipated the level of dishonor, incompetence, and corruption that we are seeing now. The Constitution was written under the assumption that the “best of the best” would be chosen to govern, but it tells us nothing about what to do when the “worst of the worst” seize and hold the levers of power. I fear that it may already be too late to recover our democracy. Any advice from you, even posthumously, would be very much appreciated.

Trumps Tarrif War reduces income

Donald Trump’s tariff rates, ranging from 10 to 41 percent on goods from more than 90 countries, took effect after midnight on Thursday.

His move to reignite his trade war, particularly against Canada, Mexico, and China, will result in a 2.7% reduction in income for the bottom 20% of earners, while the top 1% will lose 0.6%.

The Yale Budget Lab estimates that the overall price level resulting from all tariffs enacted in 2025 will lead to an average household income loss of $2,400 in 2025 dollars. Other analyses project even higher costs, with some estimating a $3,800 annual loss per household from consumer price increases tied to all 2025 tariffs.

While US tariff revenues have risen significantly, they still constitute a small portion of the federal budget deficit. The projected fiscal year 2025 federal budget deficit is $1.9 trillion. The increased tariff revenue, even with recent increases, amounts to roughly 7% of that figure. 

Such a minor increase in revenue puts to rest Trump‘s idea of entirely replacing the federal income tax with new tariffs.

To replace the roughly $2 trillion of revenue raised by the individual income tax with tariffs would require astronomically high tariff rates.

 Raising tariff rates to astronomically high levels would significantly depress imports, making it impossible to generate enough revenue to offset the costs of Trump’s tariff rates fully.

Watch Out! The GOP Is Coming After Your Money!

Like thieves in the night, the Republicans have been hiding their intentions in the shadows lest anyone find out what they are actually up to. And just like those thieves, they won’t break into your house through the front. Instead, they’ll go around to the back door. It’s not so obvious that way.

This week, a prominent member of the administration, Treasury Secretary Scott Bessent, proudly revealed their subtle plot. On Wednesday, he stated that the so-called “Trump accounts” Republicans created for children in their tax and spending bill are “a back door for privatizing Social Security.”(1) Like the thieves, the Republicans can’t be up front about their plans, they have to sneak through a “back door.”

The Republicans ultimate goal, the destruction of Social Security (along with Medicare and Medicaid), has always been somewhat out in the open. We’ve all known it, but until Bessent’s statement, it was something that most Republicans would vigorously deny.

In fact, Republicans have stated over and over again that they were not planning to touch Social Security. Unfortunately, they said the same things about Medicare and Medicaid, and we have all seen what happened to those programs when they took power.

The GOP would object and say, “We’re not planning to destroy Social Security; we just want to ‘privatize’ it.” But what would that mean? It means that your money will be taken from the safe and secure government accounts and distributed to private investment firms and banks — you know those kinds of businesses in which the C-suite executives are paid tens if not hundreds of millions of dollars. Where do you think that money comes from?

And, while they’re at it, the Republicans also plan to eliminate all fiscal regulations on these firms such as fiduciary requirements. That will allow all manner of investor fraud to occur, not to mention abuse and waste.

The argument they make is that private firms can earn higher returns on investment than the government. This may be true in some cases, but it is also true that investment firms and banks have, at times, lost money through overly risky opportunities and sheer incompetence. Some of these firms have even gone bankrupt losing all of their clients’ capital (after paying out inordinate sums to their executives in salary and bonus packages). Remember the financial crisis of 2008? It included the collapses of Lehmann Brothers and Bear Stearns as well as the government bailouts (using taxpayer dollars) of JPMorgan Chase, Goldman Sachs, Bank of America, and Morgan Stanley because they were “too big to fail.” Again, your money became their money without them having to go through the trouble of breaking the law.

Of course, once your funds are in the hands of these greedy people, you can expect to be charged all manner of “fees” in order to help pay for the exorbitant salaries and bonuses. There will be “maintenance fees,” “investment fees,” “administrative fees,” and so on. I anticipate that, under this scenario, the “fees” will steadily grow no matter what your return on investment is. Rather than receiving an annual letter from the Social Security Administration telling you about next year’s increase in your payments, you’re likely to get a bill from your investment banker for next year’s inflated fees.

But Social Security is going broke the Republicans argue. Yet they won’t take common-sense steps to save it like removing the arbitrary cap on Social Security taxes. It’s only there to keep the wealthy from having to pay more. Rather than save the program, the GOP would prefer to let it self-destruct even if it means that millions of Americans, some of whom are Republicans, will lose their only source of income.

Why are Republicans so adamant about privatizing Social Security? Because they see this HUGE pot of money in the government’s coffers that they and their billionaire backers can’t get their hands on. They lust after that money to the point of obsession. They aren’t really concerned about whose money it is, as long as they can get it somehow: like thieves in the night.

(1) https://www.nytimes.com/2025/07/30/business/bessent-trump-social-security.html

At-risk Rural Hospitals in Nevada

In June, several Democratic U.S. Senators sent a letter (1) to President Trump, Speaker Johnson, and Majority Leader Thune outlining the consequences of the soon-to-be-passed reconciliation bill (the Big Ugly Bill). The letter warns that “these cuts will have devastating consequences for health outcomes and costs, jobs, and the economic success of rural communities.”

Attached to the letter is “information provided by the Cecil G. Sheps Center for Health Services Research at the University of North Carolina (that) illustrates what your party’s reconciliation bill will mean for the health of Americans living in rural communities.”

The attached study identified the at-risk rural hospitals by state. The study looked at how “(s)ubstantial cuts to Medicaid or Medicare payments could increase the number of unprofitable rural hospitals and elevate their risk of financial distress. In response, hospitals may be forced to reduce service lines, convert to a different type of health care facility, or close altogether.”

The study named hospitals that meet one or both of two financial criteria: (1) the hospital is in the top 10% (ten percent) Medicaid payer mix of rural hospitals across the country, (2) the hospital has experienced three consecutive years of negative total margin. This means these rural hospitals face greater risk of being forced to stop providing some services, converting, or closing.

In Nevada, two hospitals were specifically identified as “at-risk” under these criteria. These were

1. Battle Mountain General Hospital in Battle Mountain and

2. Humboldt General Hospital in Winnemucca.

While neither of these is in our area (they are both in Congressional District 2), the study does illustrate the situation that rural hospitals face. Should one or both of these institutions be forced to close, the population using their services would then have to find (and travel to) other hospitals that will provide care to them. This will, in turn, increase the economic pressures on the other hospitals and possibly putting them at risk as well. There could be a snowball effect throughout the state.

Recently, the Mesa Valleys Progress published a story (2) about Mesa View Hospital titled “Hospital launches fundraising for critical expansion.”

The article begins “Hospitals can benefit all of us in our most vulnerable time of need. They must focus on providing quality health care, irrespective of costs and patients’ ability to pay; they serve all. However, the reality is hospitals must manage organizational costs, pay their bills and provide levels of service that match their financial position. Oftentimes, the hospital’s range of services fall short of what all local residents need, so patients are forced to travel elsewhere for care. This is the story of Mesa View, a critical access hospital and one of the 14 (fourteen) rural hospitals in Nevada.”

It goes on to describe how Mesa View is planning to expand in the future to meet the growing needs of our communities. The article explains that “(i)n order to fund the expansion, Mesa View Hospital has established a Friends of Mesa View Fund. The fund is a registered 501(c)(3) and is held at the Wyoming Community Foundation. Donations to the fund are tax deductible and directly support expanding specialized health care services, beginning with cardiology. Too many residents are traveling to St. George or Las Vegas for health care services currently unavailable at Mesa View, a trend the hospital is committed to reversing.”

It seems that, even in these uncertain times, Mesa View Hospital is committing to ensuring good health care in northeast Clark County. Having been a patient myself at Mesa View, both in the ER and the regular hospital, I can agree with the article’s assertion that “the real anchor level of services is Mesa View’s emergency room, the gold standard in the community.” Let us hope that the at-risk rural hospitals situation doesn’t negatively affect this fine facility.

(1) https://www.markey.senate.gov/imo/media/doc/letter_on_rural_hospitals.pdf

(2) https://mvprogress.com/2025/07/15/hospital-launches-fundraising-for-critical-expansion/

Impacts of the Big Ugly Bill on Medicaid

Many analyses have been published to parse the effects of the Big Ugly Bill on Medicaid. A number of them differ due to the fact that they are all projections and are based on various assumptions. Also because they were prepared at different times and the text in HR1 kept changing to the very end. In this blog, we have attempted to assemble the most recent and authoritative sources.

BACKGROUND OF MEDICAID

What is Medicaid and who are the recipients? (1)

State & Federal taxpayer-funded health insurance

Covers a core set of benefits for recipients at no cost

Covers about 1 in 4 Nevadans; nearly half are children

Payer of last resort, making up about a quarter of Nevada’s insurance market

Largest source of federal funds for health care in the State (60/40)

800,000 Average number of people in Nevada covered

22% growth pre-COVID

54% Percentage of births covered by Nevada Medicaid; 1 in 2 births

75% Recipients served by Medicaid Managed Care Plans

40% Recipients who are children or youth (0-18)

11% Dually eligible for Medicare & Medicaid (85,897 individuals)

78% Recipients who live in Clark County

66% Percentage of adults enrolled in Medicaid who are employed

71% Nevadans enrolled in Medicaid who are people of color

57% Number of nursing facility residents covered by Medicaid

(1) Sources – State Legislature

https://www.leg.state.nv.us/Session/83rd2025/Exhibits/Assembly/HHS/AHHS70C.pdf

https://dhcfp.nv.gov/uploadedFiles/dhcfpnvgov/content/LegislativeSessions/2026-2027%20Budget%20Overview%20DHCFP_02272025.pdf

HR1 EFFECTS ON INDIVIDUALS

How many people will lose Medicaid coverage nationally? In Nevada? In Congressional District 4? (2) and (3)

Nationally

8,689,000

That translates into one in 10 people currently enrolled in the Medicaid program nationwide losing their coverage.

Nevada

116,000

Out of 787,384 statewide which is approximately15.6%

Clark County alone currently has 623,739 Medicaid recipients

Congressional District 4

30,000

Also about 15.6% (of approximately 192,000 recipients, calculated)

(2) Source – Nevada Office of Analytics

https://app.powerbigov.us/view?r=eyJrIjoiZThjMWU5Y2YtZDE4NC00MDM2LWJkMDctZTgzYjliZGIyMjE3IiwidCI6ImU0YTM0MGU2LWI4OWUtNGU2OC04ZWFhLTE1NDRkMjcwMzk4MCJ9

(3) Source – Manatt Health


https://shvs.org/resource/senate-passed-h-r-1-updated-estimates-on-impact-to-state-medicaid-coverage-and-expenditures-hospital-expenditures-including-impacts-by-congressional-district/


However, there are other estimates that differ such as this one cited in the Washington Post on July 10 although the CBO letter dates from a month before the signing of the bill:

“Trump displays magical thinking. How can he enact the biggest spending cut in history and no one feel it? And, contrary to his claim that ‘Medicaid is left alone,’ the nonpartisan Congressional Budget Office estimated that new work requirements and other changes in the health care program for the poor will cause 7.8 million people to lose their coverage. CBO added that changes in the Affordable Care Act and a cutoff of aid to undocumented immigrants will mean a total of 11.8 million people will lose their health coverage under the law.” (4)

(4) Sources

https://www.washingtonpost.com/politics/2025/07/10/trump-democrats-tax-spending-bill-fact-checker

https://www.cbo.gov/system/files/2025-06/Wyden-Pallone-Neal_Letter_6-4-25.pdf

HR1 EFFECTS ON FINANCING

How much money is being taken away from Medicaid nationally? In Nevada? In CD4? (3)

Nationally

-$1,248,773,000,000 ($1.2 trillion)

Nevada

-$12,328,000 ($12.3 million)

CD4

The cited analysis does not include the specific amounts of the overall financing effects by Congressional District. However a prorated calculation based the changes in the number of recipients implies a reduction of about $3 million.

HR1 IMPACTS ON HOSPITALS

What are the impacts on hospitals’ Medicaid funding nationally? In Nevada? In CD4? (3)

These impacts will affect many of the rural hospitals like Mesa View.

Nationally

-$664,954,000 ($665 million)

Nevada

-$6,881,000 ($6.9 million)

CD4

-$2,874,000 ($2.9 million)

FURTHER INFORMATION

There is also a very detailed breakdown of the Medicaid cuts in this article from the NY Times:

https://www.nytimes.com/interactive/2025/06/30/upshot/senate-republican-megabill.html

SCOTUS Strips Executive Oversight Power from the Judiciary

On Friday, the Supreme Court issued a ruling that severely hobbled the Judicial branch’s checks and balances over the Executive branch. The ruling bars district court judges from blocking government actions across the nation even when they are patently illegal or unconstitutional. Judges below the Supreme Court level no longer have the authority to grant a universal injunction against Executive branch actions regardless of how unconstitutional they are.

Going forward, the justices said, lower courts may only grant injunctive relief to the specific plaintiffs who have filed lawsuits. So the Trump administration may start enforcing its birthright citizenship order in the 28 states that have not challenged it, unless individual parents have the wherewithal and gumption to bring their own lawsuits.

This ruling effectively limits any judicial restraints on Trump’s actions. As expected, he will continue to enforce his efforts to undo birthright citizenship in violation of the 14th Amendment. He undoubtedly will also continue with the extralegal capture and deportation of undocumented aliens, knowing that his administration won’t be held accountable in any reasonable length of time.

News analyst Charlie Savage, writing in the New York Times said, “Mr. Trump, rejecting norms of self-restraint, has pushed to eliminate checks on his authority and stamp out pockets of independence within the government while only rarely encountering resistance from a Supreme Court he reshaped and a Congress controlled by a party in his thrall.”

He added, “The administration has steamrolled internal executive branch checks, including firing inspectors general and sidelining the Justice Department’s Office of Legal Counsel, which traditionally set guardrails for proposed policies and executive orders.

“And Congress, under the control of Mr. Trump’s fellow Republicans, has done little to defend its constitutional role against his encroachments. This includes unilaterally dismantling agencies Congress had said shall exist as a matter of law, firing civil servants in defiance of statutory limits and refusing to spend funds that lawmakers had authorized and appropriated.”

On the other side of the issue however, Justice Brett Kavanaugh argued in his concurrence that the fundamental role of the courts has not really changed. He wrote that he wished “simply to underscore that this case focuses on only one discrete aspect of the preliminary litigation relating to major new federal statutes and executive actions—namely, what district courts may do with respect to those new statutes and executive actions in what might be called ‘the interim before the interim.’ Although district courts have received much of the attention (and criticism) in debates over the universal-injunction issue, those courts generally do not have the last word when they grant or deny preliminary injunctions. The courts of appeals and this Court can (and regularly do) expeditiously review district court decisions awarding or denying preliminary injunctive relief. The losing party in the district court—the defendant against whom an injunction is granted, or the plaintiff who is denied an injunction—will often go to the court of appeals to seek a temporary stay or injunction. And then the losing party in the court of appeals may promptly come to this Court with an application for a stay or injunction. This Court has therefore often acted as the ultimate decider of the interim legal status of major new federal statutes and executive actions.

“After today’s decision, that order of operations will not change. In justiciable cases, this Court, not the district courts or courts of appeals, will often still be the ultimate decision maker as to the interim legal status of major new federal statutes and executive actions—that is, the interim legal status for the several-year period before a final decision on the merits.”

Note that even Justice Kavanaugh recognizes that the period before a final decision on the merits is made can be several years long. In the interim though, if SCOTUS does not issue an immediate universal injunction, the Trump administration is free to enforce its will in districts where it has not been sued. And even if the Supreme Courts ultimately rules against executive actions, it can be very difficult, if not impossible, to unwind the effects.

Justice Sonia Sotomayor in her dissent strongly disagreed with the opinion, which she called a “travesty of law” and warned it would “cause chaos for the families of all affected children.” The high court’s conservative majority, she said, had ignored the unlawfulness of Trump’s citizenship ban and instead declared the president “generally free to enforce unquestionably unconstitutional policies against everyone except those who file suit.”

The justices kept Trump’s ban on hold for at least 30 days and sent a set of cases back to the lower courts to determine the practical implications of their ruling. So it remains to be seen what the overall effect of this ruling will be. But given the conservative justices’ deference in the past to Trump’s goal of an imperial executive, I don’t hold out much hope.

Sources:

https://www.nytimes.com/2025/06/28/us/supreme-court-trump-executive-branch-power.html

https://www.supremecourt.gov/opinions/24pdf/24a884diff_8nka.pdf