What “Medicaid Reforms” Actually Mean

Why say “Medicaid reforms” when trying to kick people off of Medicaid?

Why did GOP lawmakers insist they couldn’t negotiate over health care if the government was shut down?

Why lie about federal spending on undocumented people’s health care?

To understand, @bychrisvazquez turned to an unlikely source: his high school English notes on ‘Language in Thought and Action’ by S.I. Hayakawa. The book can help answer: Why do politicians sound like that?

Take House Speaker Mike Johnson. After the government shut down, he discussed “Medicaid reforms, not cuts.” Then he clarified what reforms he had in mind: “Kick those people off,” he said of groups that he believed to be improperly enrolled. The difference is a matter of semantics, or more specifically, what Hayakawa calls “affective connotation.” That’s our personal feelings attached to language. After all, if 74 percent of surveyed Republicans approved of Medicaid (per a June KFF poll), wouldn’t you—a GOP politician—avoid admitting to cutting it?

Next, take JD Vance lying about Democrats demanding “billions of dollars” for undocumented people's health care. Even if we put aside the cruel implication that undocumented people don’t deserve affordable health care, the claim isn’t true. But pitting undocumented people against other Americans reinforces what Hayakawa calls the two-valued orientation—an "us vs. them" mentality that politicians use to mobilize their base.

Lastly, take Senate Majority Leader John Thune’s vague statements about needing to reopen the government. What does that mean, actually, and how did he want to get there? This is another rhetorical device Hayakawa calls “abstraction.” We all do it to streamline conversation. But we can also use it to point fingers or absolve ourselves of blame, like talking about reopening the government without specifying how one might—or might not—do that. So next time you're listening to politicians use maddeningly euphemistic terms to describe real people's future pain, don’t be outwitted by tactics basic enough to be taught in high school.

And I hope you can keep checking out my special health care series with Mother Jones. Just look for, well, my face.