Dem 47
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GOP 53
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We've Seen This Before, Part IV: On Health Care, GOP Fears Their Goose Is Cooked

Thus far today, we've had the stump speech, the use of the military/sports, and the peacocking. All of them are well-worn items from the Trump toolkit, whenever he and his underlings are trying to change the narrative. But let's not forget that this is a political career that was built, first and foremost, on scapegoating. For Trump v1.0, the preeminent scapegoat was immigrants. They're still a favorite with Trump and his White House staff (especially Stephen Miller), but we think a case can be made that the very favorite scapegoat of Trump v2.0 is trans people. After all, that was the focal point of the final leg of the presidential campaign. Remember? "Kamala is for they/them, President Trump is for you."

In the last 48 hours, Republicans have been back at it when it comes to targeting trans people. First up was Rep. Marjorie Taylor Greene (R-GA). Unlike everyone else we've mentioned in these items, we don't think she's trying to help save Trump. However, we do think that she's viscerally anti-trans, that the next time she leaves D.C. for Georgia will be the last time (her resignation takes effect on Jan. 5), and that if she's going to do something on this front, it's now or never.

Anyhow, for what is likely her last hurrah, Greene wrote a bill that would criminalize providing gender-affirming care to minors. Any doctor who violated the law, say by performing surgery or prescribing puberty blockers, would face up to 10 years in prison. As part of a deal to get her vote on another bill, Speaker Mike Johnson brought it to the floor for a vote yesterday. The bill passed the House 216-211, with three Democrats crossing over to the Republican side of the aisle, and four Republicans crossing in the other direction.

As a practical matter, such a bill has some serious problems. Most obviously, for kids whose gender does not match what's on their birth certificate, lack of treatment is proven to dramatically increase suicide rates. The people who want to stop the medical procedures never seem to have much interest in addressing that part of the issue. There's also the problem of enforcing federal law at the state level, particularly when HIPAA laws are also in play.

As a political and legal matter, Greene's bill is just a show bill, presumably designed to make her feel she fought the good fight before surrendering and going home. It's not going to make it through the Senate (and it might not even come up for a vote). If it somehow does become law, there will be many court challenges, and the matter will be tied up for years and years.

Of course, Donald Trump does not have patience for any of these things. And so he and his good buddy Robert Kennedy Jr. announced (naturally) a new executive order yesterday. It says that hospitals that provide gender-affirming care for minors risk having their Medicare and Medicaid funding yanked.

This new XO, which apparently hasn't actually been written yet, comes with additional problems beyond the ones we list above. To start, surgery on minors is fairly rare, while puberty blockers can be (and are) prescribed from a doctor's office. So, the XO is also kind of for show. On top of that, the judgments of the Trump administration are capricious, and have more to do with politics than with facts on the ground. Why do you think, for example, that National Guard troops have been sent to L.A. and Washington and Chicago, but not El Paso or Dallas? This being the case, it's hard to put all that much effort into falling in line, since falling in line might not help, anyhow. Meanwhile, the XO is a lawsuit waiting to happen. It doesn't even exist on paper yet, and the ACLU is already preparing its filing. And then, wait until such time that someone who has nothing to do with trans medical issues can't get treatment because Medicare or Medicaid funding they are entitled to has been yanked. That's another batch of lawsuits.

In short, none of this looks like serious policy to us. It's a pretty evident attempt (with Greene acting as something of a useful idiot) to shift the narrative from health care subsidies (which Republicans can't agree on) to banning treatment for trans minors (which Republicans largely CAN agree on). We have underestimated the undercurrents of hatred for trans people in America before, so maybe we are not the best people to assess this. But, from where we sit—even though we know that the Republicans' only hope in 2026 is to really fire up the base—we find it hard to accept that someone would say, "Well, I can't get treatment for my diabetes anymore, but at least those trans kids can't get puberty blockers, so that's a net win!" Indeed, we wonder if there's not potential for some very bold Democratic messaging here. Something along the lines of, "Just because President Trump is against they/them does NOT mean he is for you." (Z)



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