Not-my-favorite-guy-in-the-world Matt Yglesias talking about what Republicans actually mean when they talk about cutting Medicaid:

I think you could see there’s a mismatch in the way Mike Johnson characterizes this. He talks about: We’ve got all these able-bodied young men who are sitting on the couch all day playing video games, collecting Medicaid benefits.

But you don’t collect Medicaid benefits. Able-bodied young men are not racking up incredible medical bills, almost by definition. So for the bill to save money, it has to be cutting off care to people who are in fact sick and in need of medical care. That’s how the savings work.

It’s also easy to neglect how hard it is to fulfill certain kinds of requirements. But people who are poor, who are dealing with medical problems, who have a lot of stuff going on in their lives, aren’t always able to get all this check-box stuff done, which is why millions of people are going to lose coverage — and why it’s going to save a meaningful amount of money.

The only way to offset the cost of tax cuts is to deny medical care to people who need treatments.

The bill, which was just signed into law, adds massively to the federal deficit, increases spending, reduces revenue by lowering taxes, so they had to at least pretend to be doing something to offset those new deficits, so they are spinning things by saying they're going to save money on Medicaid. As Yglesias points out, you don't "collect" Medicaid, it helps you pay your medical bills, and indeed the vast majority of healthy young people don't rack up medical bills, so there's not much savings to be had there. The way this saves money is by taking people who were getting medical care and either having them stop receiving that care or make them pay out of pocket, something they literally can not do without going into debilitating debt.

Also, no one thinks that the amount of savings that Republicans suggest this bill will save in Medicaid spending will come from healthy people no longer receiving care, which means it needs to have people who actually need care to no longer get it. How will they do this? By introducing red tape and paperwork that needs to be regularly filed in complicated systems, which will get 100% eligible people to make mistakes and lose coverage. The party that loves to complain about government inefficiencies is literally using that as a weapon to save money by taking away healthcare from poor people.

I think this data from the non-partisan C.B.O. (visualization by NY Times) is telling:

The more money you make, the more you benefit from the bill. All of this talk of reducing taxes on things like tips and overtime, and that amounts to a measly 0.3% increase in household income for the bottom 20%, and 1.5% for the 20-40% earners. Those measly gains are completely undone by the cuts to Medicaid and SNAP alone, not to mention the fact student loan payments are going up, often by a couple hundred dollars per month.

They don't believe in deficits unless they make them, in which case they can shatter all spending records. They don't believe the government can be efficient, but they introduce intentional inefficiencies to make it so fewer poor people receive medical care. They pretend to represent the poor and working class, but their policies routinely benefit the wealthiest among us. It's an absolute farce.