Republicans wanted the 2026 midterms to be a victory lap for Donald Trump’s tax cuts. Instead, the GOP’s signature legislation from the president’s second term — 2025’s One Big Beautiful Bill Act — is shaping up to be a sleeper vulnerability for the party.
When Republicans first passed Trump’s signature bill in party-line votes in both the House and Senate in 2025, its tax cuts took effect immediately, while the deepest cuts to Medicaid were scheduled for after the midterms, when the voters who would feel them could no longer hold anyone accountable. But even then, one of their own issued a warning that now hangs over the midterms. North Carolina Sen. Thom Tillis, who announced his retirement after indicating he would oppose the legislation, told CNN’s Jake Tapper that the bill would result in losses of the kind Democrats suffered in 2010 after passing Obamacare.
Republicans passed the One Big Beautiful Bill Act anyway. Now, across social media, Americans are sharing stories of children cut off from cancer treatment and families struggling to afford prescriptions.
On Tuesday, Children’s Mercy Hospital announced that families in the Kansas City metropolitan area who buy coverage on the Affordable Care Act marketplace will find the region’s only dedicated children’s hospital out of network on Jan. 1 — a devastating development for parents whose children depend on specialized care. It is also the kind of story that can demolish incumbent Kansas Sen. Roger Marshall’s carefully constructed distinction between cutting government spending and hurting actual people.
The story went viral fast. Influencer Jen Hamilton’s video walking viewers through what the Children’s Mercy Hospital news means for families drew 3.2 million views across three social media platforms and was shared on Facebook at 73 times her average rate. Kasey Jackson, a Kansas City mother whose son is being treated for cancer, posted a series of videos explaining that her family’s marketplace plan would stop treating his hospital as in-network when the new year arrived. Jackson explained that she previously sold her small business to pay for her son’s leukemia treatments, but had few options left with no health plans to choose from. “As entrepreneurs, we don’t really have access to a group plan, so we have to go through the [Affordable Care Act] because there’s nobody that will provide private insurance for a kid with a pre-existing condition,” she explained. One clip passed half a million views.
The Children’s Mercy news arrives at an especially dangerous moment for Marshall, who has found himself in the middle of a re-election bid that was never supposed to be competitive.
The Children’s Mercy news arrives at an especially dangerous moment for Marshall, who has found himself in the middle of a re-election bid that was never supposed to be competitive. Kansas has not elected a Democrat to the Senate since 1932, and Trump carried it by 16 points in 2024. Yet the Cook Political Report moved the race to a toss-up this month, and an Emerson College poll gives his challenger, Adam Hamilton, a Kansas City-area megachurch pastor running on the cost of living, a two-point lead.
Republicans have quadrupled their ad spending in the state since late September, a move that must be particularly galling for the party because as a physician, Marshall should have been inoculated against a healthcare attack. Instead, the OB-GYN specialist’s career choices have come under heavy scrutiny.
In September, The New York Times reported that Marshall’s former practice had sued more than 700 of its own patients over unpaid bills, some as small as $101, and that 81 people were arrested as a result. Hamilton’s campaign built an ad around Meischa Zimmerman, who says she was arrested while eight months pregnant after missing a $50 payment, and found herself pleading not to be handcuffed in front of her two-year-old. “Roger Marshall preyed on the low-income families of Kansas,” she says. The ad has been viewed more than a million times on X. Marshall’s lawyers have called it defamatory, demanding it come down, saying the debt was larger and the arrest was for missing court dates. Marshall himself told cameras there were “no Medicaid cuts” in the law he voted for, dismissing the Times’ reporting as a “hit job.” A doctor-senator insisting the largest Medicaid cut in American history does not exist, while his own brutal record of collecting fees runs in heavy rotation, is the Big Beautiful Bill’s national problem in miniature.
But the social media outrage is not confined to one hospital or one state. The issue is also the number one subject in Senate advertising and the number two issue in House advertising, according to the nonpartisan Cook Political Report’s Battleground Issue Tracker, which found that Democrats are airing tens of thousands more ads and spending tens of millions more on the issue than Republicans, who have all but declined to defend their own law. GOP candidates in competitive races have run a total of four television ads about the Big Beautiful Bill since its passage, according to AdImpact.
Still, a POLITICO poll released last week found an overwhelming majority of voters know the law and oppose its contents, with their views slightly worse than when the bill was passed and signed into law. At the time, a KFF survey found opponents outnumbering supporters two to one. Since then, the White House’s attempt to rebrand the package as the “Working Families Tax Cuts” has moved almost no one, per the same POLITICO poll.
The problem for the GOP is that voters do not have to agree with every Democratic argument about healthcare to dislike paying more for their own insurance. In a KFF health opinion poll conducted in June, 37% of Republican voters said healthcare costs were extremely important. More than half of Republican and Republican-leaning independents who identify with the MAGA movement said Congress had done the wrong thing by allowing enhanced Affordable Care Act subsidies to expire, according to KFF polling released in March. Among marketplace enrollees, 62% blamed Republicans or Trump for the expiration.
Meanwhile, Vice President JD Vance recently announced that the Centers for Medicare and Medicaid Services had canceled ACA enrollments covering 760,000 people, citing claims of widespread fraud. The Trump administration views its focus on fraud in federal health programs as a message that will resonate with voters. A KFF poll in mid-September found that 44% of voters and 54% of Republican voters call fraud in government programs extremely important for candidates to address, and a separate KFF and Associated Press survey found it was the top topic rural Republicans want to hear about. The administration withheld about $2 billion in Medicaid funding from California, and announced plans to defer more than $500 million in federal funds from Minnesota, claiming the state had failed to protect its Medicaid program from abuse.
Republicans are betting on energizing their base — and hoping to pull along persuadable voters. Polling, however, points the other way. A fraud crackdown may be the top concern for Republican-leaning voters, but only 44% of voters overall call it extremely important, according to KFF, which found healthcare to be the top issue for the electorate at large.
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Some of the largest disruptions from the Big Beautiful Bill Act that Republicans scheduled for later are being moved forward by state budgets. Because the law shifts enormous new costs onto states in the coming years, some state lawmakers are cutting now to brace for the shortfall. Colorado, facing a $1.5 billion hole, has cut what it pays doctors who treat Medicaid patients. In Maine, a hospital has eliminated its labor and delivery unit. The $50 billion rural health fund that Republicans added to the bill at the last minute amounts to a fraction of what rural communities stand to lose from the same law.
Democrats who have made the bill’s Medicaid cuts a leading message are tied or leading in many battleground races, including in states Trump previously won. In Georgia, ACA enrollment dropped by more than half a million, hitting Trump strongholds like the district in northwestern Georgia formerly represented by Marjorie Taylor Greene, where the number of uninsured is higher than the national average. Incumbent Sen. Jon Ossoff, D-Ga., has been laser-focused on hitting GOP cuts on the campaign trail all year. In Maine, incumbent Republican Sen. Susan Collins is being attacked by Troy Jackson, her Democratic challenger, for casting a procedural vote to advance Trump’s cuts to Medicare and Medicaid to a Senate floor debate.,Although Collins voted against final passage of the One Big Beautiful Bill, Jackson argues her vote helped pave the way for its enactment. In the House, California Rep. David Valadao’s Central Valley toss-up district, where roughly six in 10 constituents are enrolled in Medicaid, could help give Democrats control of Congress. Valadao, a Republican, voted for the Big Beautiful Bill. During a televised Oct. 6 debate, he said there are no actual cuts to Medicaid. His Democratic challenger has supported Medicare-for-All.
The GOP’s scramble explains why, weeks before the election, the Trump administration began mailing one-time payments of $500, along with a letter from the president touting his health record, to more than 950,000 people in the 30 states that use HealthCare.gov. The money comes from accumulated marketplace user fees, but only enrollees who bought coverage without premium subsidies qualified, which means roughly one in 20 marketplace customers received a check while the rest got the higher bills. Trump has also promised every American adult $5,000 if Republicans keep Congress, and Medicare beneficiaries have been told to expect $90.
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But it is not just drastic healthcare cuts driving voters’ alienation from the GOP. An analysis published Thursday showed that millions of Americans have lost critical food assistance since Trump signed last year’s massive Republican tax giveaway for the superrich, with soaring grocery prices and cuts to school meals exacerbating the crisis. According to a report from the Center on Budget and Policy Priorities, approximately 5.5 million people, including roughly two million children, have lost Supplemental Nutrition Assistance Program assistance since July 2025. SNAP participation and spending have been falling, and the decline is much deeper than the Congressional Budget Office initially projected. These are by far the deepest SNAP cuts in history, and each month, new data reveals the damage is worse than previously anticipated. Republicans have responded that a slight reduction from an explosive increase is hardly a cut, and they have cheered SNAP participation returning to pre-pandemic levels, ignoring the mounting human toll.
As Election Day approaches, the reality of these policy choices has turned the GOP’s signature legislative victory into a major political liability. The strategic miscalculation of the One Big Beautiful Bill Act is getting harder for conservatives to contain. By forcing millions of Americans to choose between basic medical care and daily necessities, Republicans transformed tax cuts for the rich into a personal crisis unfolding on screens and in living rooms nationwide.
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from Sophia Tesfaye
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