President Trump’s “big, beautiful” reconciliation bill is the key to an American economic boom. In thinking through the current debate over the bill, I was reminded of a key moment in the 1996 film “Jerry Maguire.”

Tom Cruise and Cuba Gooding Jr. made an amazing film. Mr. Cruise played a desperate sports agent looking for a football player to represent, which was Mr. Gooding. 

Mr. Cruise was nominated for best actor. Mr. Gooding won the Academy Award for best supporting actor. The movie was also nominated for best picture and best screenplay.

The most memorable moment in the movie comes when Mr. Cruise, desperate to keep his client, is forced to shout “show me the money” in his office.

It struck me, that this chant of “show me the money” perfectly fits Washington’s current conversation. An army of interest groups, lobbyists, and elected officials are currently getting money from the taxpayers — and they want to continue to do so.

The budget challenge is made more difficult because President Biden and the Democrats brilliantly maximized spending for their allies. Now, the Republicans are trying to reduce spending, move America off the road to bankruptcy, and get to a balanced budget. It automatically makes Republicans the bad guys at Washington.

Medicaid reform may be the central battle of this struggle. Brian Blase of Paragon Health Institute reported that: “Between the Congressional Budget Office’s 2021 and 2024 baselines, projected federal Medicaid spending increased by 8.6 percent, a sizeable $685 billion, from 2023 to 2034.”

Getting back to 2021 spending levels might seem reasonable. But you can be sure Republican-led efforts to return Medicaid spending to a sustainable path will be met with screams of anguish from medical groups and insurance companies that want Washington to show them the money.

Just consider the New York State Medicaid-funded program for paying people to stay home with aging relatives. Back in 2014, only 20,000 people were paid by the program. When eligibility rules changed in 2015 during the outgoing Obama administration, the number of jumped to 250,000. 

Today, the figure is more than 620,000 people. This taxpayer-funded program now makes up 12 percent of New York City’s private sector jobs, according to Bloomberg.

Governor Hochul was critical of this new taxpayer funded boondoggle back in 2024.

She told Bloomberg, “The problem is now you have individuals taking advantage of a pretty liberal, open-ended process for determining who qualifies. I’m telling you right now, when you look on TikTok and you see ads of young people saying, ‘Guess what, you can make $37 an hour by sitting home with your Grandma. You know, here’s how you sign up,’ it has become a racket.”

In a classic example of “show me the money,” the unions have now convinced Mrs. Hochul that the program should be maintained because it provides jobs they can organize. So now she’s comfortable with this self-defined “racket.”

Across the continent, California has created its own example.

Medicaid long-term care was designed to help the poor in their old age. Congress always surrounded it with reporting requirements to keep rich people from living off the taxpayers.

The California Medi-Cal system is huge. In 2012 it had 7.6 million members. Today, it has 14.9 million members. In fact, Medi-Cal serves 38 percent of all Californians.

In 2021 the California state legislature decided the Medi-Cal program was not generous enough. It voted to dramatically increase the limits on how many assets you could have and still be eligible for taxpayer funding. 

You could have a house worth more than $1 million and still get taxpayer money for your long-term care. By December 2024, enrollment in long-term care under Medi-Cal was 40 percent higher than four years earlier. There are now 1.4 million people on Medi-Cal long-term care.

Of course, efforts to re-establish the national standards for eligibility to ensure that the wealthy paid for their own long term care will be bitterly fought. They want the money and principles simply don’t matter.

Don’t be fooled. Medicaid can be dramatically improved. A new, better Medicaid system could be developed that focuses on helping those who needed it. It could cost dramatically less than the current bloated system.

The real challenge will be making the Republican case over all the chants of “show me the money.”

This is the real force driving opposition to reform.