San Antonio Rep. Joaquin Castro says GOP lawmakers’ support of Big, Beautiful Bill will cost lives

U.S. Rep. Joaquin Castro, D-San Antonio, lashed out in a Wednesday floor speech at Republicans who are too afraid of retribution from President Donald Trump to push back against deep Medicaid cuts in the president’s budget megabill.

Trump’s Big, Beautiful Bill, now being debated in the U.S. House, is expected to rip healthcare coverage away from 17 million people, according to health policy research organization KFF, making it the federal government’s largest-ever rollback of such coverage. The reductions will affect 1.7 million Texans, according to Castro’s office.

“There are so many folks who have reached out over the last several months, panicking about their disabled children, about their senior citizen parents who are in nursing homes,” Castro said in his speech. “People with cancer, Alzheimer’s, dementia, sickle cell, diabetes, all of these illnesses. You have the power today to make sure that they can live with dignity and stay alive. Or you can choose your career.”

Trump has repeatedly tried to strong-arm his fellow Republicans into supporting his legislative agenda, threatening to fund primary challenges for those who don’t fall in line.

During his speech, Castro said he became acutely aware of the life-or-death nature of medical coverage when he was diagnosed three years ago with neuroendocrine cancer. As a result, he must take a monthly injection with a list price of $24,000.

“For people who don’t have insurance, or Medicaid, or aren’t covered, they’re not getting that shot,” Castro said. “They’re not going to survive, some of them. This is a choice for some of you between your career and saving people’s lives.”

The budget bill — approved by the Senate Tuesday with Vice President JD Vance breaking a tie — cuts spending on Medicaid and the Affordable Care Act marketplaces by about $1 trillion over a decade, according to the Congressional Budget Office.

Experts warn the expulsion of people from Medicaid and the ACA will damage hospitals and other health facilities, especially those in rural areas, as they’re forced to absorb more of the cost of treating uninsured patients.

During a conversation with reporters Wednesday, Castro said Trump’s bill will jettison many families from Medicaid coverage by imposing strict work requirements and adding new administrative hurdles they’ll be unable to meet.

“They’re basically hoping to trip people up so that they can get kicked out of the Medicaid program,” Castro said.

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This article appears in Jun 26 – Jul 9, 2025.