“The failed effort to repeal the Affordable Care Act eight years ago looms over every move Republicans make on Medicaid. They do want to reduce the number of people who get health insurance from the government. But they are more careful now in picking the people who’ll lose out, and they are very confident about a political strategy that portrays Democrats as siding with immigrants. Doing that sets up a distinction that the Trump-era GOP always enjoys: a nationalist “America First” party, versus a party with a more global, more charitable view of who deserves help. Democrats are not directly giving any of those benefits to “illegals,” at the state or federal levels. But they also see upsides in the fight now raging over the GOP megabill: They see a clear-cut case of a bill that would pull people off Medicaid to pay for tax cuts for the rich. In fact, Democrats think that combining those two policies is a mistake Republicans were more careful to avoid in 2017.”