Having reached the 100 day mark of the fascist regime, major polling outfits have their verdicts on public opinion, and it’s negative. The Washington Post-ABC News-Ipsos poll says Trump has “the lowest 100-day job approval rating of any president in the past 80 years.” The CNN poll conducted by SSRS agrees: “Trump’s 41% approval rating is the lowest for any newly elected president at 100 days dating back at least to Dwight Eisenhower – including Trump’s own first term.” The AP-NORC poll finds “a majority of the public disapproves of Trump overall as president (59% vs 39%),” and that “about half of the public thinks Trump has been a poor or terrible  president so far in his second term.”

It’s no wonder that it was hard to find congressional Republicans in even marginally competitive districts during the recent 17-day recess when they are usually accessible back in their home districts. They weren’t giving town halls and often weren’t even having staff answer phone calls.

But we ain’t seen nothing yet.

On May 7, the House Energy and Commerce Committee will meet to begin marking up their portion of the fascist regime’s “big, beautiful” reconciliation bill, with the task of finding $880 billion in savings over ten years. Let’s talk about that number.

According to the Congressional Budget Office (CBO), the House Energy and Commerce Committee doesn’t have much choice in where they look for cuts in mandatory spending if cuts to Medicare are off the table. Non-Medicare spending under the committee’s jurisdiction is made up almost entirely of Medicaid spending. The 10-year projection is that “Medicaid comprises $8.2 trillion out of the $8.6 trillion in mandatory spending that E&C must use to come up with spending reductions.” Put another way, “over the next 10 years, 93% of non-Medicare spending in the E&C jurisdiction is from the federal share of Medicaid spending.”

Of the little slice of pie available, $200 billion comes from the Children’s Health Insurance Program (CHIP). Here’s how that looks:

Even if E&C eliminated all non-Medicaid and CHIP spending, the committee would need to cut federal spending on Medicaid and CHIP by well over $700 billion, nearly 10% of projected spending; and most agree that E&C is unlikely to eliminate all other sources of non-mandatory spending.

Now, Medicaid provides health coverage to more than 70 million people, including some of the most vulnerable people in the country. It’s an extremely vital and popular program, and for this reason Trump recently told Time magazine that he would veto any bill that made cuts. That’s technically somewhere between an absurdity and an impossibility, as the numbers demonstrate, which is why Trump predictably casts the coming cuts as targeting only waste, fraud and abuse.

Here’s the spin on that from Speaker of the House Mike Johnson:

“When you have people on the program that are draining the resources, it takes it away from the people that are actually needing it the most and are intended to receive it,” Speaker Mike Johnson (R-La.) said on Fox News last week.

“You’re talking about young, single mothers, down on their fortunes at a moment — the people with real disabilities, the elderly,” he continued. “And we’ve got to protect and preserve that program. So we’re going to preserve the integrity of it.”

The truth is, however, that even a successful program of weeding out fraud and abuse would not make save enough money to make a dent. The same is true of other ideas that merely tinker around the edges:

Some of the more politically palatable proposals that have been floated include imposing work requirements and removing noncitizens from Medicaid, but the savings wouldn’t come close to the amount needed to reach the committee’s target.

The real savings must come from rolling back the 90 percent federal match the government offers to states for Medicaid enrollments. This is the Medicaid “expansion” that incentivized states to participate in Obamacare, or the Affordable Care Act. This is a way of kicking people off Medicaid indirectly by forcing state governors to do the dirty work. As Republican congressman Austin Scott of Georgia puts it, “Nobody would be kicked off Medicaid as long as governors decided they wanted to continue to fund the program.”

Here’s how that would look to the governors.

Federal cuts of $880 billion over 10 years (or $88 billion per year) would represent 29% of state-financed Medicaid spending per resident.

States could opt to raise tax revenues to offset federal Medicaid reductions. Proposed federal cuts represent 6% of state taxes per resident.

States could instead make cuts to other states programs such as education, the largest source of expenditures from state funds, to offset federal Medicaid reductions. Proposed federal cuts represent 19% of state education spending per pupil.

To further put the proposed federal cuts in perspective, they are equivalent to all Medicaid spending on 3 million seniors and people with disabilities (18% of enrollees in that group), 14 million other adults (38% in that group), or 22 million children enrolled in Medicaid (76% of that group).

The truth is that the states would work out some mix of tax hikes and massive cuts to education, along with cuts to Medicaid. But at least 12 states would drop their participation in the Affordable Care Act if the federal match falls below a certain threshold.

So, for starters, Trump and Speaker Johnson and individual Republican members of Congress can try to play word games and claim that they haven’t made cuts to Medicaid but only targeted waste, fraud and abuse, but this won’t make the changes any less unpopular or disruptive. The Medicaid expansion covers more than 20 million low-income adults, and in order for this plan to achieve savings, many millions of these people will have to lose their health coverage, along with many seniors and people with disabilities. This will also have a major negative impact on sectors of the economy that depend on those Medicaid payments.

There appears to be no other way for the Energy and Commerce Committee to proceed, but there’s another problem.

Conservatives are agitating for steep cuts to Medicaid, while moderates have said they would oppose any bill that rolls back coverage and benefits for their constituents.

“We won’t vote for something that takes away benefits from seniors, disabled and vulnerable people that we represent who rely on Medicaid,” Rep. Nicole Malliotakis (R-N.Y.) told reporters earlier this month, after the House adopted the GOP budget plan.

Malliotakis was among a group of 12 vulnerable and moderate Republicans who earlier this month wrote a letter to House leaders warning that they would not back the reconciliation plan over concerns about cuts to Medicaid.

Speaker Johnson has reportedly assured at least some of these 12 members that the 90 percent reimbursement rate won’t be lowered.  He can break that promise. In fact, I can’t see any way around breaking that promise. But that’s going to make it difficult to corral those votes, and he’s going to need almost all of them to support the bill in order for him to secure passage.

In any case, all the rhetoric and spin will be put aside when the committee meets on May 7 and has to actually make decisions. It looks like a buzzsaw awaits them. They have pressure from conservatives to cut Medicaid and pressure from moderates to protect seniors, the disabled and vulnerable people. They have pressure from states and governors and health-providing industries not to screw them over. They have tens of millions of constituents facing the loss of health insurance. And they have a president who says he’ll veto a bill that makes cuts beyond waste, fraud and abuse. Finally, they have a hard number of $880 billion.

One possibility is that they won’t find a way out of this conundrum and will be unable to produce a bill at all. Another possibility is that they’ll produce a bill but not one that they can pass through the full house. Another possibility is that they muscle through a bill by intimidating the moderates into falling in line, but then pay an astronomical political price in the 2026 midterms.

I don’t see any happy outcomes for the GOP, but there are still several scenarios that will be happy outcomes for the American people and the Democrats.

These are the things that happen under a fascist regime.