Aaron Schwartz/Sipa USA via AP Images
Sen. Joni Ernst (R-IA) at the Capitol in Washington, April 10, 2025
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The Relief Pitcher and Joni Hearse
Yesterday, the Yale School of Public Health sent a letter to Senate Democratic leaders with a new analysis showing that the One Big Beautiful Bill’s changes to federal health care programs would kill more than 51,000 Americans annually. Nearly 15 million are liable to lose health coverage as a result of the bill, due to enrollment changes on the Affordable Care Act exchanges, Medicaid cuts that are the largest in U.S. history, and the end of support for the Medicare Savings Program, which grants access to subsidized prescriptions. Those cuts would cost about 29,500 people their lives, the Yale researchers estimate. Another 13,000 largely poor nursing home residents would die from the repeal of the Biden administration’s safe staffing rule, which would remove the minimum number of nurses on call in those facilities. And close to 9,000 would die from the government’s failing to extend enhanced premium support for the ACA that expires at the end of the year, making health coverage unaffordable for another five million Americans.
It’s not easy to wring a compelling message out of legislation that will cause 51,000 deaths. You can lie that the cuts aren’t cuts, but that only gets you so far. Sen. Joni Ernst (R-IA), for example, was clearly flummoxed when confronted at a town hall in Butler, Iowa, last Friday with the fact that people will die because of the bill. So she went philosophical.
“Well, we all are going to die,” Ernst said, in one of the most misguided attempts to quiet constituent fears I’ve seen in my political lifetime.
The reaction was immediate both in the room and on social media. And instead of walking back the comments, Ernst doubled down with a creepy “apology” video of her walking through a cemetery. “I made an incorrect assumption that everyone in the auditorium understood that yes, we are all going to perish from this Earth,” she said, before snarking about the tooth fairy and making a pitch for embracing Jesus Christ as a personal savior who guarantees life in the hereafter.
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About 200 miles from Butler, in Sioux City, state representative J.D. Scholten was getting ready for the funeral of a local Democratic activist named Gary Lipshutz. Former Sen. Tom Harkin, whose seat Ernst now holds, was at the memorial service. “What she said was going viral as I walked in,” Scholten told me in an interview. “I thought about all the work Gary was doing, and at a funeral you question your life and your purpose. When she doubled down, which was very disrespectful, I was like, game on.”
Scholten, 45, who nearly beat anti-immigrant nationalist Steve King in a northwest Iowa congressional seat Donald Trump won by 27 points in 2018, had been mentioned on short lists of potential challengers to Ernst. But his timeline was set to later in the year, in part due to his summer gig as a pitcher on the minor league Sioux City Explorers. Then Ernst implanted her foot directly in her mouth. “She was not wrong in that we all are going to die, but we don’t have to die so billionaires can have a bigger tax cut,” Scholten said.
He decided to immediately announce a campaign for Senate, thereby making clear it was a direct response to the choices Republicans are making to skyrocket inequality and harm millions of vulnerable Americans.
In 2020, when Scholten ran for Congress a second time, he got Kevin Costner to narrate a campaign ad. This time, that wasn’t possible on such short notice, so he found a friend to tape a video. The sound was screwed up, so J.D. reshot and edited it himself. “I think I’ve shown in 2018 that we’re not a polished, consultant-driven campaign, and we set the tone with that announcement,” he said with a laugh.
So far, only one other candidate has stepped forward to challenge Ernst: Nathan Sage, the executive director of the Knoxville Chamber of Commerce. State Sen. Zach Wahls and state Rep. Josh Turek could also join the race. But Scholten argues that his legislative experience, and proven ability to win votes in a state that has gotten away from Democrats in recent years, sets him apart. His state House seat is in a Trump district, and he has outrun the top of the ticket in all four of his elections. There are 42 counties in his section of Iowa, and he’s the sole Democrat to represent one.
“I’m the only Democratic blueberry in a bowl of tomato soup,” Scholten said, noting his strengths at welcoming rural voters and young men into his coalition. He gets a lot of insights from being in the dugout with the Explorers, he told me. (Iowa’s legislative session went long this year, so Scholten, normally a starting pitcher, is coming out of the bullpen for now.)
“Being around my teammates, going back to 20 years ago, these guys are more progressive but more likely to vote for Trump,” Scholten said. “It’s what gets in their feed in social media.” But while they don’t follow politics closely, many reached out to Scholten about Ernst after her comments.
Senate Republicans have the numbers to pass their Big Beautiful Bill, but the Ernst gaffe is the first hint of looming political repercussions if they do. It took something as outlandish as “We all are going to die” to break through the static and give Democrats a focal point for their criticisms of the sprawling bill. While some Republicans have expressed concern, particularly over the deep cuts to Medicaid, Ernst’s callousness makes her a giant target. Scholten’s handlers say a new nickname for Ernst has been floating around the state: Joni Hearse.
Scholten’s strategy is to continue to pile on. “The thing that’s going to hit in Iowa, nursing homes and rural hospitals will be devastated,” he noted. “People who lived their whole lives in a town will have to move 45 minutes to a nursing home in the bigger town. Why are we doing this? Just so a billionaire can have a second or third yacht?”
Scholten says the outpouring of support in the first 24 hours has been remarkable. It’s obviously an uphill battle, given the Republican swing in Iowa. But there’s a certain symmetry at work. In 2014, then-Rep. Bruce Braley, a Democrat running to succeed Harkin in the Senate, questioned at an out-of-state fundraiser whether longtime Sen. Chuck Grassley should chair the Senate Judiciary Committee, despite being “a farmer from Iowa who never went to law school.” The remarks smacked of elitism—ironically, Braley was the founder of the House Populist Caucus at the time—and stuck with Braley throughout the race. He ended up losing the Senate race … to Joni Ernst.
Now, Scholten’s team is fired up to hang Ernst’s words on her for the next 18 months. “We all are going to die” is the kind of statement that can really resonate when talking about a political party looking to deprive poor people of food and medicine to pay for tax cuts for rich people. There’s a way for Republicans to defuse the backlash, but it would involve walking away from Donald Trump’s calamitous agenda.
Other Big Beautiful Thoughts
• Well, Elon Musk isn’t exactly going quietly out of politics, calling the Big Beautiful Bill “a disgusting abomination.” This is the problem Republicans still face; they’re locked between loud voices like Musk who want to cut more spending and make the bill even more unpopular, and self-preservationists who know that would cost them their political careers. (The Washington Post)
• Case in point: Rand Paul, who says, “I want to see the tax cuts made permanent, but I also want to see the $5 trillion in new debt removed from the bill.” He says he has the votes to ensure that, but it’s an actual impossibility: Making the tax cuts permanent creates new debt! (X)
• Apparently we’re getting text from the various Senate committees this week on their version of the bill, but there’s no indication that there will be any markups. (Politico)
• Trump is starting to arm-twist lawmakers. Really we’re talking less about legislation and more about a loyalty test. (Bloomberg)
• Sen. Thom Tillis (R-NC) really needs clean-energy manufacturing credits to stick around, because his state relies on them. (Canary Media)
We want to hear from you. If you’re a Hill staffer, policymaker, or subject-matter expert with something to say about the Big Beautiful Bill, or if there’s something in the legislation you want us to report about, write us at info(at)prospect.org.
