What’s an Executive Order — And What Medicaid Cuts Really Mean

Neera Tanden: We have to be unafraid to make the case that Donald Trump's policies, whether they're tariffs or whether they're other things, are harming you and your family. It is the biggest redistribution of wealth from working class people to the wealthiest people. And this is what I think is the biggest con of Donald Trump, which is the tariffs and Medicaid are going to be borne by working class people when we decide as a country to pull back health insurance and people will die. I know that sounds hyperbolic, but it is actually the case. I do think the fact that President Harding, the January six rioters, insurrectionists, you know, these are the shock troops of an authoritarian and a government. Let's, you know, throw off the doom and gloom and realize that we are again in a, you know, battle for the heart of this country and that Donald Trump's policies do not represent a majority.

Dan Koh: Since taking office, it feels like Donald Trump has made changes to virtually every aspect of our lives, from new tariffs to renaming the Gulf of Mexico. He's done many of these things through what's called an executive order, a term most of us have heard, but few of us really understand. Neera Tanden does. She helped shape President Biden's executive orders. Later oversaw all of his domestic policy and is now president and CEO of the Center for American Progress, a leading policy think tank. Neera explains what an executive order is, how they're meant to be used, and why she believes that Trump's unchecked power may finally be facing real limits. Let's swing into the people's cabinet. Neera Tanden. Neera Tanden, welcome to the People's Cabinet.

Neera Tanden: Great to be with you.

Dan Koh: So we're all familiar now with the scene in the Oval Office, the president declaring something with his staff secretary next to him, a role you formerly held and declaring everything from tariffs to cutting off of funding to penalties against law firms and universities. I think the same thought is going through a lot of Americans heads, which is how is he allowed to do that? And at a higher level, what is an executive order? So as someone who has both on the staff secretary role, you've been domestic policy adviser and someone who's just been working in policy your entire life. Could you explain in layman's terms to listeners what an executive order is?

Neera Tanden: Yes. So executive orders do many different things, but sort of the basic executive order function is to interpret laws. So it is the way in which the president is interpreting a, you know, essentially a legal authority he has been given by the Congress, which may people may ask, what does that mean in this context when it doesn't seem very tethered to any laws? And I think it's really important to remember that, you know, our judiciary system still understands what an executive order is because the president is losing case after case after case. People are bringing temporary restraining orders, which are really sort of emergency actions and very rarely granted. But because judges are recognizing that these executive orders are really not do not have the, you know, they're not lawful, essentially, these are like lawful, lawless acts of the president. You know, the courts are granting temporary restraining orders. And so, like a fascinating thing because, you know, a lot on the right have been saying it's a sign of a run amuck judiciary, that they're against granting €47 or €55 against President Trump. But really, it's a sign of the lawlessness of this administration that judges feel the need to rein that them in, rein in the administration. And that's a function at the added space of the president, issuing a range of executive orders that are fundamentally press releases may be written by Stephen Miller instead of traditional executive orders that function, you know, they are the basic function of them is to direct an interpretation of a statute or presidential power and how that power should be interpreted by the rest of the government.

Dan Koh: And you use an acronym about what judges issue. I want to make sure people understand what it was.

Neera Tanden: Yes, temporary restraining orders, tiara. So a temporary restraining order, as I said, is, you know, it's a kind of there's a very high bar to for judges to issue a temporary restraining order against of any kind of action by the government. And the reason why it's high is because usually the courts have to wait until there is a harm to someone to really litigate the case. It's only when it's really lawless that courts will issue a temporary restraining order. You know, normal courts will issue a temporary restraining order. And what we've seen in the case, like you mentioned, these, there was a kind of press release EO targeting these particular law firms. You know, there is very little legal basis for anything happening in underlying this EO and that's why the courts have actually, you know, every kind of judge, a Trump judge, a Bush judge, a by the judge, an Obama judge issued temporary restraining orders in individual cases being brought by the law firms targeted.

Dan Koh: And do you have an example of and this can be under Trump, it can be under President Biden of an executive order that you felt fell well within the bounds of the law and how it compares to maybe one you find most egregious now under Trump.

Neera Tanden: Well, you know, we had executive orders. You know, they're executive orders under President Biden and President Obama that that outlined, you know, how we would interpret a statute or a good example here would be on federal contracting or something called high road contracting. So both President Obama and President Biden issued executive orders saying that people who are doing work with the government should not be abusive employers. And they were they were interpreting a statute that gives the president the power to kind of have broad parameters around contract. Actors. And, you know, they had interpretations of the requirements of the of the law that said, you know, that essentially the contractors had to be effective and efficient. And they interpreted that statute to say, you know, if you're abusing employees, you're not an effective or an effective contractor. So that's a way in which you're interpreting language in a statute. And perhaps it's an expensive interpretation, but it is language in a statute that gives the president the power to say how he's interpreting that statute or he or she, but in that case, you. So that is very different from, say, an executive order that says a particular law firm is not permitted to actually practice in front of any federal agencies, essentially because the president doesn't like the law firm or you know, and this is like kind of so out extraordinary. It's like for my very technical term, it's whack a doodle. You know, you have a an executive order that's targeting two individuals, you know, Miles Taylor and Krebs. And it's and there's those cases are ones where it's just like it's in it's just, you know, some version of insane or inane to think that the administration can really just target two individuals for, you know, basically under threat of Justice Department attack. And, you know, I think that the thing that's really important in these in this moment, I think, is, you know, I think that Donald Trump uses the you know, he basically uses fear as an asymmetric weapon. And he these issues are obviously lawless. But, you know, he's trying to scare people. Right. So he issues these issues and he basically waits for the court to courts to stop him. And he will go as far as he can. But the truth of it is that even when the courts, you know, basically stop him weeks, months later, you know, he scared the living daylights out of a lot of people. And it really is an intimidation tactic. And so what I like to tell people is, you know. Doom is like doom and gloom is like the worst you can do here. Like fear is a terrible, terrible thing to live with. We have to see through that fear. What he is doing is lawless. We should understand it is lawless. And, you know, fear is the mind killer, as they say in Dune. And we cannot let him scare us into cowering or obeying or we cannot allow him to use the. Power of the fear to make us intimidated to the point of fear.

Dan Koh: I think a lot of people when they see this, are just wondering what Congress is doing right now. Right. Because nothing. Because look, I think there's been plenty of times in which, you know, the parties own both houses are the majority in both houses. And there is a Democratic or Republican president on the same party. Congress was created. The Congress by the Constitution is supposed to be a check and balance on the executive branch. And so. I know there's been I think there's 147 or so executive orders so far in the Trump administration. Are there some that come to mind or one or two that comes to mind where you said this? This is something that Congress should be intervening and they're not. And is it just out of fear of retribution? I mean, I'm just curious. You've seen a lot of different houses. You've seen a lot of elected officials. And I think a lot of people just confused. Why isn't Congress more vocal or taking more action right now, even those on the Republican side who believe in the role of Congress being a check on the executive?

Neera Tanden: So, first of all, I think there's we talked about some of the most egregious is, but I think the area where it's kind of most surprising Congress hasn't done anything is the overly expansive definition of national security threat that the president is using President Trump is using on the tariffs. Now, these tariffs are, again, 145%. Tariff on China is a is that it's kind of an insane, crazy pants policy for another very technical term. It is the it's just a very egregious use of that power. And, you know, that is an area where the president is essentially creating a national sales tax. It's a very national sales tax, but it is a national sales tax nonetheless. And Congress, in any normal time would try to take that authority back because they should have the power under the Constitution to issue taxes like that. So that's a clear area where there should be congressional action. You know, I think the big difference between today and eight years ago is that is really just this issue that you've put your finger on, which is where are the Republicans in Congress who just to defend their own authority? And I think there's a combination of things that are happening here, I think ranging from Elon Musk controlling Twitter and really controlling a giant communication vehicle to attack people that disagree with the administration, particularly Republicans. He's also spending a lot of money in elections. He has hundreds of millions of dollars, spent a lot of money in Wisconsin. It didn't work. But he has a lot of money to spend in Republican primaries, which he's threatened to do. And then I will say, you know, and I'm not trying to get conspiratorial, but I do think the fact that the president part in the January 6th. Rioters, insurrectionists, you know, these are the, you know, shock troops of an authoritarian kind of government. And so I think there's that has sent a message of fear to people now. The thing for all of us to do is to create the crass pressure on Republicans so that they have to have a choice. Maybe it's a choice between their primary and their general election, but they have to really understand that they are going to lose their seats if they continue to continue on a path where there's they offer no checks. But, you know, I'll just briefly say we have some moments of optimism here. You know, the president pulled his nomination for the U.S. attorney from the District of Columbia. Now, that guy was a known white nationalist. You know, you'd think that would be like a hard choice. But it is one of the first cases of him really pulling down a nominee because of pressure from the opposition. And, you know, that was a broad coalition of people concerned about anti-Semitism, people concerned about white nationalism, people concerned about just abuse of power. And, you know, he did seem to just be dramatically abusing the power of being a U.S. attorney. But that nomination getting pulled and you know, I think we are beginning to see some cracks in the armor. The fact that, you know, in the house, it's seemingly hard. You know, they're going to go through a lot of iterations. They probably will not cut an $880 billion out of Medicaid. It might be less. You know, our advocacy matters.

Dan Koh: And you touched on Medicaid and it's something obviously you're an expert on. You were one of the architects of the ACA back in the day. You've continued to be involved deeply in health care policy. I just want to make sure people understand what's at stake with Medicaid, because I think, obviously, a lot of Americans are on Medicaid, but there's a lot of people who kind of of this nebulous idea that it's good to help people who need health care, who can't afford it. But I'm not sure they quite understand the next layer or two. And so could you explain what is at stake and what you see as maybe what the fight might be in the horizon on Medicaid?

Neera Tanden: Yeah. So Medicaid is a program that provides health care to people. It's a it's it differs by state, but it's fundamentally a program that offers, you know, health care to its biggest the biggest constituency is actually children. 90% of people on Medicaid are either working or in training. You know, there's this whole thing about how there's all these, like, single adults just sitting around, not get it doing, working or anything. That is just not the picture of Medicaid. Medicaid is helping basically mostly working people who are not getting health insurance through their employer, people who are struggling to make ends meet. They have access to a doctor if they have asthma or cancer screenings only through the Medicaid program. And if they lose the Medicaid program, they will definitely not have health insurance. So we've done a lot of work on what this means. Obviously, it means millions of people will lose health insurance. The largest number of people who will lose health insurance would be children. It means state budgets would be under assault, but it really also means we would have more people die because health insurance actually does keep people alive. When I was fighting on the ACA, I had this I was at a rally in this man came up to me and it was a man's man had never had health insurance. And his whole life, I believe he actually got health insurance from Medicaid expansion. He was a truck driver. He got health insurance from Medicaid expansion and for the first time went to a doctor and he found out that he needed bypass heart surgery. And so he at this rally showed me his scar because he basically said if I didn't have health insurance, I would never have gone to the doctor and I would have just one day had a heart attack. So that's what's at stake. When we decide as a country to pull back health insurance, people will die. I know that sounds hyperbolic, but it is actually the case. And what's crazy about this entire debate is really they are trying to drive take money out of Medicaid and health care for working less people in order to pay for a massive tax cut, you know, for the wealthiest people in America, including billionaires. And so that is the lion's share of the tax cut is really going to help the wealthiest people in the country. So it is the biggest redistribution of wealth from working class people to the wealthiest people. And this is what I think is the biggest con of Donald Trump, which is the tariffs and Medicaid are. To be born by working class people. They are going to pay for these these policies. And the people who are they supposed to benefit are the wealthiest among us. And that is something that we, as you know, people who oppose these policies have to be really clear about and what will happen to the kids. They will just have no health insurance and they're just on their own while some states try to intervene.

Dan Koh: I mean, I'm just trying to understand what. Yeah. What would a Republican strategist tell you when you would push back and you say like, listen, children are going to lose their health insurance.

Neera Tanden: They'll say things like, look, you know, we're trying to just do work, work, work requirements. So we want people to work and Medicaid and look, that sounds good. And we're after Medicaid fraud. And that looks you know, that might sound good. But really what they're doing, this is a smokescreen. So Arkansas enacted work requirements, 40% of 40% of people lost Medicaid coverage. And really why? Because the work requirements were just a paperwork process to drive people off the rolls and lots of parents got less coverage. And because they lost coverage, their kids lost coverage. So, you know, I know it sounds like it's so crazy that anyone would really want to do this. And that's why they're trying to say things like, oh, we really just want people on Medicaid to work. But of course, people are working already. And I think again, like I know it sounds nuts if people would like to drive people off their health care, but, you know, they think that this is coming from an extreme right position that we shouldn't have the government shouldn't pay for health care. People should do this stuff on their own. And that's why, you know, but that's also why it's important for us to fight tooth and nail against it and demonstrate to the country, like we did in the ACA, that, you know, the decision point here is whether we as a country think we are wealthy enough to actually insure that every kid in America has health insurance. And I am betting that the answer is yes.

Dan Koh: So you talked about Republican messaging and Elon Musk being behind the machine. How did Democrats combat that in this environment, both from a apparatus of what must controls, but then also what kind of messaging Democrats should be using at this stage?

Neera Tanden: Yeah, I mean, I think we should be really focused on actual facts. And, you know, I'm not as negative on you know, I'm not as bleak as some people are about the prospects for the, you know, social media system and and all of those problems. I think actually social media is pretty anti-incumbent, pretty anti institutional. And right now, Donald Trump is the incumbent. Donald Trump is the person who is on his own executing a tariff policy that is driving costs up and that may make it impossible for you to find the child. So your dolls for your children. Right. So he's he is the actor that is behind cutting Medicaid for people. It's to finance a giant tax cut. So I think we just have to be clear and and focused on the actual impact of what he's doing and be clear that it's it's this is a very different movement than it was three or four months ago. Donald Trump's approval ratings have really come down. He's in the low forties, maybe the high thirties. And, you know, a lot of people ask, why does that matter? That matters because it's not like I think that that will affect him, but it affects other Republicans. And you see some cracks develop. And then also it affects institutions that may think about cowering or probing because he doesn't have a majority of the country behind him. You know, he thought attacking Harvard would be one of his easiest fights. Right. But it turns out actually, you know, a majority of the country does not think that the government should be dictating what a school teaches or who they accept. You know, it's a private entity. So my view of this is we have to be unafraid to make the case that Donald Trump's policies, whether they're tariffs or whether they're other things, are harming you and your family.

Dan Koh: And what's the policy and messaging vision that we should lead with as Democrats? What's the alternative vision we should depict?

Neera Tanden: Well, I think on issue after issue, we do have to offer and an alternative, as you said. You know, I fundamentally think that it's a great thing that the country is actually rejecting the president's President Trump's policies on, you know, pulling people off the streets and deporting them to El Salvadoran gulags. I think it's a great thing that the American people recognize that due process is actually something that protects your civil liberties, your civil rights, as well as everyone else's. So I think that's really important. But we shouldn't lose sight of the fact that people want solutions. And as Democrats, we all should believe in solutions for people. So we have to offer our own ideas of. You know what we would do on a complicated issue like immigration? How would we solve for both the border but also expand legal immigration? Because that's also a problem in our country. How would we do both of those things? How would we reform our government to work better for consumers? You know, is a smokescreen for cuts. But actually, we could make this government work a lot better for seniors, for people who need benefits. And I think I'm excited about the fact that CAP will be putting out ideas in the space. And fundamentally, how do we have an economic program or what is our economic program where we're committed to ensuring, you know, not just fairness. Fairness is important, but opportunity, growth, success for families. You know, I'm really taken by the fact that some of the biggest erosion and support for, like, Democrats this cycle was among immigrant communities, people, you know, recent arrivals were voting. And we have to have a message of opportunity and, you know, success for those families. And, you know, but I think we also have a lot of opportunity in the sense that Trump's policies are making things more expensive, weighing them down their money. They are much more pessimistic than they used to be. And that's an opening. That's an opening that we can only take advantage of if we actually offer a choice. Like here are two different visions of change. Trump's wrecking ball or positive vision?

Dan Koh: And is there a specific I know there's so many that cap will be rolling out and talking about, but is there one in particular that comes to mind when you say this is one that I think that Democrats should really be going out with that really resonate with people?

Neera Tanden: Well, we're going to have a variety of ideas. It's hard to pick among my children here, but on how to improve our schools, how to ensure how to reduce costs for housing, how to address the middle class squeeze of high costs like housing, health care costs, and how to how to address issues of public safety. We're going to put out a lot of ideas because we believe we need to offer an alternative, not just opposition. That's kind of one of our taglines almost. But I also think that, you know, I think political leaders will emerge who will take, you know, our ideas, I hope, and some selection of our ideas and really pressure test some of the country. But we want to have a we want to have a whole, you know, agenda that addresses, you know, the real problems people face in their lives. And I think, again, as Democrats, it's really important for us to do that, because if we believe in government, we have to make sure it works, works well and addresses people's needs wherever they are.

Dan Koh: My last question to you is, you know, there's a lot of people who are feeling very hopeless with what's going on. They turn on the TV, they're overwhelmed by the news. They're distressed with what they see as Trump just unchecked power. You've given us a lot to think about today, but if there are people who are listening right now who say, I want to go to the people, the neighbors that I know, reengage them in what the Democratic Party stands for, or even talk to MAGA voters who are now expressing some regret. What's your message to them to get people involved?

Neera Tanden: Well, first, I'd say the most important thing for any country that faces any kind of authoritarian threat is to build a united front. So I think it's important to reach out to all Americans, MAGA supporters, people who voted for Trump that might regret their vote, you know, normal based Democrats and for each one, you know, try to persuade them about what's wrong with the direction of our country under this president. So if you live in a state where there's a Republican member, you have friends and a family or you have friends or family in a place that has a Republican House member, this is the time to make the call and say you do not want Medicaid slashed. If you're in a Republican state or a state with a Republican senator, make a call. You know, the whole strategy of the other side is to make us feel like their actions are inevitable. You know, this is the whole strategy. They're going to pass this bill. It's going to do this thing no matter what you do. That is a strategy to vote, to demobilize us. And it's really crucial that we remember that these are all in the house. They are all up in two years. Senators like Thom Tillis in North Carolina is up in two years, and it's vital that they are held accountable now. And, you know, again, we do see cracks. There's opportunities here. So let's, you know, throw off the doom and gloom and realize that we are, again, in a, you know, battle for the heart of this country and that Donald Trump's policies do not represent a majority. They represent a hard right minority. And I think increasingly some people, you know, may have who voted for him are recognizing that. And that's the opportunity for us. 

Dan Koh: Neera Tanden, thank you for coming on The People’s Cabinet.

Neera Tanden: Thank you.

Dan Koh: I’m Dan Koh and that's it for The People's Cabinet today. Follow us on social media, subscribe wherever you get your podcasts, and see you on Tuesdays for new episodes. Let's Go.