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.