Collateral damage, a term usually applied to a military action, refers to “an injury inflicted on something other than an intended target.” The concept can be reasonably applied to Trump’s “One Big, Beautiful Bill Act,” passed by the Republican-controlled House.

The intended targets of the act are legion, but include proposed legislation diminishing the legislative and judiciary checks and balances on executive power set out in the Constitution, a step toward dictatorship. To offset current and proposed tax cuts for the wealthy, $800 billion in Medicaid cuts (approximately 10%) over 10 years are also proposed. The act further nibbles away at the Affordable Care Act, which enabled 19 million people to obtain health coverage.

According to the nonpartisan Congressional Budget Office, the House bill will increase the deficit by $2.4 trillion and cause 10.9 million people to lose health insurance.

Is being uninsured associated with injury? Working-age people without insurance present for medical care late and with more advanced diseases. They have a 25% increase in mortality compared to insured peers, amounting to an estimated 18,000 excess deaths per year.

Adding 10.9 million to the ranks of the uninsured should be expected to add thousands of surplus deaths. Giving Republicans the benefit of the doubt, I’ll assume this is an unintended consequence, collateral damage. But when the military evaluates a planned attack, it weighs the importance of the target against the costs, including unintended injuries.

Thousands of deaths against tax breaks for the already wealthy?

Steven Zimmerman
Topsham