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Of all the actions Musk and President Trump set in motion, nothing will hurt more people around the world than their dismantling of the U.S. Agency for International Development (USAID).
Elon Musk is leaving the White House — and leaving a trail of destruction in his wake. But of all the actions Musk and President Trump set in motion, nothing will hurt more people around the world than their dismantling of the U.S. Agency for International Development (USAID).
By making disease-stemming drugs, clean water, and food available to millions, USAID has probably saved more lives worldwide than any entity in history.
Since 2000, USAID’s programs have prevented the deaths of 58 million people from tuberculosis, 25 million from HIV/AIDS, and over 11 million from malaria. It’s given 70 million people access to safe drinking water and, working in concert with global vaccine initiatives, helped to nearly eradicate polio.
As the main funder of global health interventions, USAID served as a bulwark against diseases that don’t halt at national borders. Its programs identified emerging epidemics and minimized the spread of drug-resistant diseases that threaten Americans as well.
Although it’s commonly assumed to be much higher, foreign aid is just 1 percent of federal spending, so cutting it won’t begin to balance the budget. So instead Trump and Musk attacked USAID by slandering it, calling it a “criminal agency” (Musk) that’s “run by a bunch of radical lunatics” (Trump).
This, of course, was a lie. USAID was known for having rigorous oversight, with 275 investigators and auditors in its watchdog office.
Most USAID funding in low-income countries targets disease prevention, economic growth, and disaster relief. But DOGE and Trump made staggering false claims, like Trump’s that USAID was sending “$50 million to Gaza to buy condoms for Hamas.”
As a result, USAID was the first casualty in the Trump administration’s struggle to make the federal government subservient not to the Constitution but to one man. And Musk — the world’s richest man, whose income last year exceeded USAID’s entire budget — and his fellow billionaire President Trump withdrew medicines and food from millions of the world’s most vulnerable people. Afterward, Musk gleefully announced that they’d fed “USAID into the wood chipper.”
I’ve followed USAID since seeing its economic and agricultural programs in the African Sahel in the 1980s, and I’ve spent 40 years heading nonprofits working to provide clean drinking water internationally.
No organization I’ve led has received USAID funding, but over the years I’ve known scores of USAID staff who were hard working and conscientious about spending U.S. tax dollars. Trump owes an apology to USAID’s employees, now indiscriminately fired or coerced into early retirement.
Every federal agency can stand being streamlined. But what happened to USAID wasn’t reform — it was destruction. “They didn’t know what they were doing or care to find out, but I came to realize that cruelty is their purpose,” one senator told me in April. “Cruelty is how they think they demonstrate power.”
It’s fair to say American voters didn’t ask for this. USAID went unmentioned during the 2024 presidential campaign — and bipartisan majorities continue to say they oppose gutting the agency.
American entities which partnered with USAID — including corporations, faith-based organizations, foundations, universities, and civic groups like Rotary International — will continue to raise their own private funds. But by themselves they can’t replace USAID’s leadership abroad.
Now that Trump and Musk have eviscerated the agency, millions will suffer. The Center for Global Development estimates that U.S. foreign assistance has been saving 3 million lives annually. The journal Nature calculates that the loss of U.S. global health funding alone could result in 25 million additional deaths over the next 15 years.
For Americans — including Trump voters — feeling queasy over what’s been carried out in their name, it’s not too late to convey to Congress your support for life-saving foreign assistance.
Regardless of how they voted, Americans should be proud of how their foreign aid has reduced worldwide poverty, sickness, hunger, and thirst — all for 1 percent of the federal budget. The future cost to the United States, if it abandons its leadership in global health and development, will prove incalculable.
One expert critic said the updated request "confirms once again that the president continues to break his promises to lower families' costs and help people who are struggling to make ends meet."
Progressive critics and Democratic lawmakers responded with predictable fury and contempt after President Donald Trump delivered new details for his 2026 budget request in a Friday night news dump that appeared timed to attract as little attention as possible from the voting public.
"It's telling that President Trump has chosen to release his budget on a Friday night with no fanfare whatsoever," said Sen. Patty Murray (D-Wash.), ranking member of the Senate Budget Committee, following the administration's release of approximately 1,200 pages of budget documents. "That's probably because his budget would raise costs for working people, destroy basic services we all count on, and let our adversaries run circles around us—all while President Trump works to shower billionaires like himself in new tax breaks."
Murray added that, for Trump, "it’s no billionaire left behind—and good luck to everyone else."
As his Republican allies in Congress continued work on a major reconciliation bill that would offer sweeping tax cuts to the nation's corporate giants and wealthiest Americans while gutting Medicaid and food assistance programs for the poor, the more detailed budget request from Trump offers a deeper look into the far-right president's desired slash-and-burn approach to the nation's social safety net, valued programs, and key institutions relied upon by tens of millions.
While the topline target of the Trump proposal aims to cut $163 billion from the 2026 fiscal budget, a lack of critical details withheld by the White House appears to be part of a concerted effort to limit public outrage over the impact it would have—on people and communities as well as the overall economy. As the Washington Post's Jeff Stein explains:
With little fanfare, the budget office released 1,224 pages that spell out its spending plans in detail, expanding on the abbreviated "skinny budget" it unveiled this month. So far, though, the administration has addressed only the portion of federal outlays known as discretionary spending, which doesn't cover programs such as Social Security, Medicare and Medicaid that make up the bulk of the federal budget.
Typically, the White House releases a comprehensive budget proposal each year that provides 10-year estimates of federal spending, revenue and deficits, as well as projections of economic growth, interest rates and other important indexes. These numbers are hotly contested and typically initiate a debate over the White House's priorities. But the Trump administration appears to be trying to avoid that debate, at least for now, by ignoring the traditional process for releasing a budget.
However, slashed funding for key programs is clear throughout the documents released by the administration, with cuts to healthcare initiatives, public education, student loan support, environmental and labor protections, food aid, and housing assistance for low-income Americans among the most prominent.
According to the New York Times:
The updated budget reiterated the president's pursuit of deep reductions for nearly every major federal agency, reserving its steepest cuts for foreign aid, medical research, tax enforcement and a slew of anti-poverty programs, including rental assistance. The White House restated its plan to seek a $33 billion cut at the Department of Housing and Urban Development, for example, and another $33 billion reduction at the Department of Health and Human Services.
Targeting the Education Department, the president again put forward a roughly $12 billion cut, seeking to eliminate dozens of programs while unveiling new changes to Pell grants, which help low-income students pay for college.
Sharon Parrott, president of the left-leaning Center on Budget and Policy Priorities (CBPP), said the updated request "confirms once again that the president continues to break his promises to lower families' costs and help people who are struggling to make ends meet."
Parrott emphasized that the updated Trump budget request cannot be separated from what the GOP are trying to push through Congress in their spending package.
"To get the full picture of the administration's harmful agenda requires including the Trump-backed bill under consideration in Congress, which gives massive tax cuts to the wealthy, partly paid for by raising costs and taking away health coverage and food assistance from millions," explained Parrott. "Policymakers of both parties in Congress need to see this budget, and this entire agenda, for what it is—an irresponsible tax giveaway at the expense of everyday families and investments in our future—and plan a better course for the country."
An estimate by the nonpartisan Congressional Budget Office, which examined an earlier version of Trump's budget, forecasted that the plan would add over $2 trillion to the federal debt over the next decade.
Rep. Brendan F. Boyle (D-Pa.), ranking member of the House Budget Committee, decried the budget request update as a "half-baked proposal" which only serves to prove Trump's determination "to make life harder for struggling families" nationwide.
"Republicans are already pushing a bill that would inflict the largest losses of health care coverage and food assistance in our nation's history," added Boyle. "This funding request goes even further, decimating critical public- and mental-health programs and slashing housing aid, home-energy support, and job-training grants. Republicans will claim these cuts are about fiscal responsibility, yet they're happy to add trillions to the deficit to shower billionaires with tax breaks."
For his part, Senate Minority Leader Chuck Schumer (D-N.Y.), vowed committed opposition from his party in the upper chamber.
"Trump's radical 2026 budget would be a gut punch to working families and a windfall for billionaires—raising prices for American families while hollowing out the programs critical to families across the country," Schumer said on Saturday. "Senate Democrats will never let it become law."
Republicans are spouting lies about a work requirement for Medicaid because they’re really trying to push eligible people off it—to help finance their big tax cut mainly for the rich.
One of my purposes in sending you this daily letter is to give you the truth about an important issue that U.S. President Donald Trump and his lapdogs in Congress are demagoguing—so you can spread the truth.
Right now, the Senate is taking up Trump’s “Big Beautiful budget bill” (really a Big Bad Ugly Bill) that just emerged from the House.
If enacted, it would be the largest redistribution of income in the nation’s history—from the poor and working class to the rich and super-rich.
The entire work requirement would affect 7% at most. In reality, a work requirement would cause many more who are eligible to lose their Medicaid coverage. The current estimate is at least 8.6 million people.
How? The tax cut mainly benefits the wealthy. A major source of funding is at least $715 billion of cuts in healthcare spending, mostly from Medicaid.
It also contains a poison pill that would remove the power of federal courts to hold officials in contempt of court—fining or imprisoning them if they fail to follow court orders. As the courts push back against Trump, this is a critical power.
The bill cuts Medicaid spending by requiring Medicaid recipients to work.
Republicans are spreading lies about this work requirement.
Here are the facts you need to know—and share:
1. 64% of adult Medicaid recipients already work.
Many recipients work in jobs that don’t typically offer health insurance and pay little—which makes Medicaid vital. These people aren’t freeloaders mooching off the system, as Republicans claim. They’re barely scraping by.
2. Adults on Medicaid who aren’t working have good reasons not to.
3. So, 93% of all Medicaid recipients either already working or having good reason not to.
The entire work requirement would affect 7% at most. In reality, a work requirement would cause many more who are eligible to lose their Medicaid coverage. The current estimate is at least 8.6 million people.
4. The work requirement kicks eligible people Medicaid because of its burdensome and confusing reporting requirements.
It’s not really meant to put people to work. It’s a shady way of kicking people off Medicaid to fund tax cuts mainly for the wealthy.
In Arkansas, which tried a work requirement for Medicaid, more than 18,000 people who were eligible lost coverage mainly because of the paperwork reporting hoops they had to jump through.
5. When Arkansas enacted work requirements, there was no significant change in employment rates.
Because, again, Medicaid recipients already have high rates of employment to begin with.
6. If Republicans really want to put people to work, they’d make it easier to get Medicaid—not harder.
After Ohio expanded Medicaid, enrollees had an easier time finding and holding down a job.
Access to healthcare means people can manage chronic conditions, afford medication, or receive mental health treatment—all of which helps people keep their jobs.
Republicans are spouting lies about a work requirement for Medicaid because they’re really trying to push eligible people off it—to help finance their big tax cut mainly for the rich.
Senate Republicans can afford to lose only three Republican votes. Otherwise, the Big Bad Ugly Bill is dead. Please share these facts.