By Daniel Béland

July 16, 2025

One of the most striking characteristics of the second Trump presidency is the hyperactivity of a President who makes announcement after announcement at a dizzying pace, in both domestic and international affairs.

This situation makes it harder to distinguish important and potentially durable policy shifts from ephemeral outbursts leading to flip flops, which are so common in areas like trade policy, where a TACO (“Trump Always Chickens Out”) effect might be at hand.

In tactical terms, this flooding of the information ecosystem is perhaps best understood as a combination of the propaganda techniques of “information overload” and “firehose of falsehood”, both designed to misrepresent, misdirect, and neutralize critical processing and effective response.

In strategic terms, its use within the corrupt weaponization of US democracy’s own institutions, features and mechanisms — from Congress to the Supreme Court to the media and social media — as instruments of democratic backsliding echoes and replicates a global trend that has pushed democracies from Hungary to India in an “illiberal” and autocratic direction.

In Trump’s case, the recent passage of the so-called One Big Beautiful Bill Act (OBBBA) — from its ludicrous Orwellian title to its coercive vote-securing methods — provides an excellent case study.

One of the many dangers of the ongoing flurry of executive orders and dramatic presidential statements about trade and domestic issues is that they obscure the adoption of lasting policies that have transformative impact. The OBBBA is especially worth sustained attention, as it will have deep and durable effects on the United States. Beyond the political theatre surrounding its enactment, we can look at some key provisions of the Act to get a better idea of how Trump’s second presidency might be transforming America.

The OBBBA is a complex and sprawling piece of legislation that, among many other things, cuts taxes, increases military and boarder control spending, and reduces health care and social policy expenditures as well as support for green energy. Although each provision would have specific effects, the data point to the overall negative fiscal effect of the legislation. According to the Congressional Budget Office (CBO), for instance, the legislation could increase federal deficits by more than three trillion dollars over the next decade. This is why fiscal conservatives, including Republican Rand Paul, publicly criticize the OBBBA, to the point of calling it the “Big Bankruptcy Bill”.

Yet, the OBBBA is also incredibly regressive and some of its provisions will have a massive detrimental impact on the US safety net and the country’s already deeply flawed health care system. Particularly dramatic are the cuts to Medicaid and the Children’s Health Insurance Program (CHIP), which will reduce federal funding for these programs by more than one billion dollars in total, resulting in the exclusion of more than 10 million people from their coverage. The OBBA will also make it harder for states to fund home- and community-based services and create more paperwork for Medicaid beneficiaries that may lead to their exclusion from the program in the name of “work requirements.” Simultaneously, despite the creation of a special fund to support rural health care, Medicaid cuts embedded in OBBBA could seriously hurt rural hospitals.

This last point might seem paradoxical considering the fact that Rural America overwhelmingly voted for President Trump. Clearly, Republicans in Congress are more afraid of Trump than they are afraid of their constituents. This situation is related to the U.S. primary system, in which long-time incumbents in safe districts or states can be defeated by challengers from their own party, a threat that the White House used to coerce some Republican members of Congress reluctant to support the OBBBA.

The OBBBA is worth sustained attention, as it will have deep and durable effects on the United States. Beyond the political theatre surrounding its enactment, we can look at key provisions of the Act to get a better idea of how Trump’s second presidency might be transforming America.

This is what President Trump did when Republican North Carolina Senator Thom Tillis expressed strong reservations about the OBBBA, including and especially regarding health care funding for his state. In the end, Senator Tillis voted against the bill but, a day later, he announced that he would not seek reelection in 2026, a decision that would avoid him facing a potential primary defeat at the hand of a Trump-backed challenger. In his statement, he pointed to “the greatest form of hypocrisy in American politics. When people see independent thinking on the other side, they cheer. But when those very same people see independent thinking coming from their side, they scorn, ostracize, and even censure them.”

Although there is no formal party discipline in the US Senate, in the era of Trump 2.0, obedience to the Republican president must be absolute, which helps explain why such a terrible piece of legislation as the OBBBA, which is both fiscally and socially reckless, was enacted in the first place.

Fortunately, some of the most negative components of the OBBBA will not be implemented right away. This means there is still time for interest groups opposing them to mobilize. For example, Congress delayed implementation of the most devastating cuts to Medicaid until 2028, giving time to hospitals and the lobbyists working for them to persuade lawmakers to rescind them.

Yet, it is not certain that these policy reversals will take place soon enough to limit the strong damage that the OBBBA is likely to inflict on the US health care system, whose long-embedded design flaws and built-in injustices Barack Obama’s 2010 Affordable Care Act was passed to mitigate despite formidable opposition from special interests and their assorted political proxies. The OBBBA is expected to imperil the Obamacare coverage of roughly four million people.

Importantly, if some of the Medicaid cuts featured in the OBBBA are rescinded and nothing else is done to increase revenue, the impact of this legislation on the federal budget will be even more negative than expected. This is because the OBBBA is largely about adopting tax cuts at the expense of both sound public finance and the existence of a basic safety net.

President Trump does not seem to care about the safety net or about people who voted for him and who rely on it. Instead, he prefers to bully members of his own party into enacting such a politically self-sabotaging legislation. Only a crushing Republican defeat at the 2026 midterms might save the United States from more OBBBA-style policy awfulness during what The Guardian‘s Steve Greenhouse calls “the worst presidential term ever.”

Whether Democrats, whose approval ratings remain extremely low, will be up to the task and find a way to crush Republicans at the next midterms remain to be seen, however. The awfulness of the OBBBA might help them win this battle if they can find a way to convince voters that they can fix the economic and social problems they care about, in contrast with the President’s appalling legislation, which symbolizes how corrupted US democracy and public policy have become in the illiberal era of Trump.

Daniel Béland is professor of political science and director (on leave) of the McGill Institute for the Study of Canada at McGill University. He has published several books on U.S. social policy, including Obamacare Wars(with Philip Rocco and Alex Waddan).