Heidi M Przybyla

USA TODAY

WASHINGTON — Sen. Al Franken, the former comedian from Minnesota, had a not-so-funny response to President Trump’s first budget that relies on deep cuts to the nation's health care and safety-net programs: “This piece of legislation is cruel,” said Franken, who co-chairs the Senate rural health caucus.

It could be particularly punishing for the rural, working-class voters who overwhelmingly supported Trump, according to a USA TODAY review.

The White House budget unveiled Tuesday would slash Medicaid by more than $800 billion over the next decade. It also takes aim at programs used disproportionately by people without college degrees, who voted for Trump by six points, including food assistance, crop subsidies and education and job training.

During his 2016 campaign, Trump promised to prioritize the “forgotten men and women” of America. Many of them are manual laborers who eventually rely on Social Security disability insurance, which Trump slashes despite a campaign promise not to touch the program. It could also force the closure of a number of rural hospitals, which overwhelmingly rely on Medicaid and serve many of the oldest and sickest working-class Americans. Hospitals in such rural areas, which supported Trump by 28 points, are already under duress from an opioid epidemic. Other cuts include to retiree benefits and tax credits for the working poor and families with children.

“The irony of the Trump budget is that it hurts many of the people who supported him most,” said Sen. Chuck Schumer of New York, the top Senate Democrat, calling it “a comic book-villain-bad budget.”

In the rural and small-town counties that Trump won, one-third of families live paycheck to paycheck, a rate that is 24% higher than in urban counties, according to left-leaning Center for American Progress. “You’re getting it from both sides,” said Jacob Leibenluft, a senior adviser at the Democrat-aligned Center on Budget and Policy Priorities. “You’ve lost a set of tools that help you get back to work and, at the same time, you are losing access to safety-net programs,” he said.

White House Budget Director Mick Mulvaney said it is a taxpayer-focused budget that seeks to help those who really need government assistance while nudging others who need to “get off of those programs” and “get back in charge of their own lives again.” The budget would also make room for tax cuts estimated to cost $6.2 trillion over 10 years, with more than three-quarters going to the top 20% of taxpayers.

The blueprint is unlikely to become law, given stiff opposition in the Senate, including from some Republicans who’ve called the cuts unrealistic and even harmful. It is reminiscent of former President Ronald Reagan’s first budget, which his then budget director referred to as “starving the beast” of big government.

Senate Majority Leader Mitch McConnell, R-Ky., seemed to distance himself from the White House outline in remarks to reporters Tuesday, saying, “The present budget, as we all know, is a recommendation. We'll take these things into consideration and move forward.”

Even so, Democrats worry the White House, inspired by a House Republican blueprint that Speaker Paul Ryan has championed for several years, could eventually achieve a legislative version that cuts less deeply but is nevertheless devastating to already struggling working-class communities across the nation.

Indeed, lawmakers including Rep. Mark Meadows, R-N.C., who chairs the conservative House Freedom Caucus, say the budget represents a starting point for negotiations in Congress. Despite the deep cuts, the blueprint doesn't fundamentally restructure Medicare and Social Security, which should come next, according to the Heritage Foundation, a conservative policy group that advocated for many of the cuts.

"If enacted, the president’s budget would be a major down payment on federal entitlement reform," said Robert Moffit, a Heritage senior fellow.

“This is a step down the same road to ruin advanced by years of Republican budgets,” said Rep. Nancy Pelosi of California, the top House Democrat.

Reaching out to rural America

Following Democratic presidential candidate Hillary Clinton’s November loss to Trump, Democrats were accused of ignoring rural areas in heartland states including Wisconsin and Michigan. The attempt to reach out to those communities was evident on Tuesday, as Democrats on in both chambers of the U.S. Capitol highlighted the budget’s implications for rural Americans.

Even amid new revelations about Trump’s attempts to stanch an investigation into his Russia ties, House Democrats leading the party’s 2018 election effort stayed focused on the budget and the Republican health care program to replace Obamacare during a Tuesday news conference. Medicaid, nutrition assistance and Social Security disability insurance are all disproportionately used by people who don’t have a college degree and who live in rural areas.The budget follows a House Republican health care replacement plan which disproportionately takes away taxpayer dollars from parts of the country that supported Trump.

Other examples of program cuts likely to hurt Trump’s rural voters include:

• Job-training programs, including those seen in rural strip mall storefronts where displaced workers can get new skills training. These include a 43% cut from fiscal 2015 to Workforce Innovation and Opportunity Act programs.

• Student aid: It proposes eliminating subsidized loans for new undergraduate borrowers. It would also freeze the maximum Pell Grant at its current level of $5,920 per year for the next 10 years. Some of the states that stand to lose the most, percentage wise, include deep red states like Alabama, Alaska and Kentucky as well as Midwestern states like Iowa and Missouri, according to a CAP analysis.

• Heating costs. Eliminating the LIHEAP program that subsidizes winter home heating costs for low-income Americans (many served are in Great Lakes states like Michigan and Wisconsin that voted Republican for the first time in a generation). About 9 in 10 households that receive LIHEAP include a child or someone who is elderly or disabled; and community grant programs that support services like “Meals on Wheels,” which delivers hot meals to seniors who are poor or alone.

• Appalachia. It would eliminate the Appalachian Regional Commission, created under President Lyndon Johnson to support the economically depressed region of the country Trump made so central to his campaign. The program provides small business loans, invests in local infrastructure and provides job training. It would also eliminate the Rural Economic Development program that promotes the agriculture industry.

Even if the budget faces strong opposition, lawmakers will have to reach a resolution of some sort on government spending after the current funding bill expires at the end of September. In the meantime, Democrats are taking the case to Trump’s voters.

“He said he would be a different type of Republican,” said Sen. Bernie Sanders, I-Vt., “who would stand up for working class people, that he understood their pain,” he said.

Read more:

White House backs off proposed cuts to anti-drug programs

Health care advocates say the Trump budget plan would gut Medicaid

President Trump's budget reveals his major priorities: Here are the highlights