§51 —
On the forgotten man
Democrat
$989.7 BILLION
The rest of the paper. The Congressional Research Service, citing the Congressional Budget Office, puts the Medicaid provisions of the July 2025 law at $989.7 billion in reduced federal outlays from 2025 through 2034, with 7.5 million more people uninsured by 2034; the work requirement begins December 31, 2026 1. The same law's SNAP changes extend work requirements to adults 55 to 64 and to parents of teenagers, cut participation by 2.4 million people in an average month, and begin shifting benefit costs to states in fiscal 2028 2.
And the hospitals the promise was about. The Chartis Center counts 417 rural hospitals vulnerable to closure, 206 that have closed or stopped inpatient care since 2010, and 41.2 percent operating at a loss 3. Fifty billion over five years in, nine hundred eighty-nine billion over ten out. The forgotten were remembered at about a dollar for every twenty.
Sources
- The Medicaid provisions "reduce federal outlays by $989.7 billion" over FY2025–2034 and increase the uninsured by 7.5 million in 2034; work requirements begin "beginning December 31, 2026, or sooner at state option" — Congressional Research Service, R48633, 18 August 2025 ↑
- SNAP work requirements extended to ages 55–64 and parents of children 14–17; participation reduced by 2.4 million in an average month; state benefit cost-share beginning in FY2028 — Congressional Research Service, R48552, 15 August 2025 ↑
- 417 rural hospitals vulnerable to closure; 206 closed or converted since 2010; 41.2 percent operating at a loss — The Chartis Group, 10 February 2026 ↑
Republican
FORGOTTEN NO LONGER
The promise was the spine of the first inaugural, and it deserves its full weight: "The forgotten men and women of our country will be forgotten no longer" 1. It named people who had watched the factories and the hospitals leave, and it said the government would look at them first.
There is a receipt for it. In December the Centers for Medicare & Medicaid Services announced $50 billion in Rural Health Transformation awards for 2026 through 2030, reaching all 50 states, with first-year awards averaging $200 million — from about $147 million in New Jersey to about $281 million in Texas 2. The agency's administrator called it "an extraordinary milestone for rural health" 2. Money aimed by name at rural America is the promise, kept, on paper. The other side of the page is the rest of the paper.
Sources
- "The forgotten men and women of our country will be forgotten no longer" — inaugural address, 20 January 2017 — Trump White House archives ↑
- $50 billion in Rural Health Transformation awards for 2026–2030 to all 50 states; first-year awards averaging $200 million, from $147,250,806 (New Jersey) to $281,319,361 (Texas); "an extraordinary milestone for rural health" — CMS, 29 December 2025 ↑
“I kept a copy of the inaugural address — I wasn't there, somebody sent it. "The forgotten men and women of our country will be forgotten no longer." Then I've got this other paper, from the Congressional Research Service. Medicaid: nine hundred eighty-nine point seven billion dollars less over ten years, seven and a half million more people uninsured by 2034. And from the agency, fifty billion for rural health, five years, every state. I did the division in the car at a red light. It comes out about twenty to one. Sorry — I'm going — one more thing. Which of those two numbers is the one doing the remembering?”— Lou
“"Forgotten no longer." Here's how you remember somebody in Washington: fifty billion dollars for rural health over five years, with a press release, and nine hundred eighty-nine point seven billion out of Medicaid over ten, in the fine print. That's about twenty dollars out for every dollar in. Four hundred seventeen rural hospitals are on the vulnerable list. They remember.”
“The fifty billion is a historic investment in rural America, and the nine hundred eighty-nine billion is savings, and savings are also an investment, one you make by not spending — so in a real sense rural America has received over a trillion dollars.”