, citing internal emails, a regulatory listing, and federal officials. The rule had not been finalized in that reporting. ProPublica estimated that as many as 400,000 disabled or older people could have their support cut or eliminated. For Burton, the issue is not an abstract lesson in household economics. It is her room, her father’s paycheck, and the food she buys for herself.
The government had eased this burden two years earlier. A 2024 Social Security Administration rule added the Supplemental Nutrition Assistance Program to its definition of a public assistance household. It also allowed a household with an SSI recipient and one other recipient of listed assistance to qualify. for low-income households and the agency. The proposed reversal would demand more information about rent, relatives, bills, and shared expenses. It would treat family shelter as support that can reduce a disabled person’s payment. I do not use a Nazi comparison casually here. A benefits office in 2026 is not Aktion T4. The connection lies in one premise: a person’s support depends on an official calculation of economic value. That premise has a documented history, and disabled people have paid for it before.
The Idea Before the Killing
The German phrase is unnütze Esser, and the Nazis made it infamous. Its governing idea was already available in respectable publications. Karl Binding, a jurist, and Alfred Hoche, a psychiatrist, published Permitting the Destruction of Life Unworthy of Living in 1920. They compared the care of institutionalized patients with the deaths of young soldiers and industrial workers. Their book described some lives as worthless and others as having negative value. It discussed restrictions and consent, which later Nazi practice discarded. . Money and labor spent on one group could be called waste. Death could then be presented as relief for society.
Carrie Buck was eighteen at the time of her 1924 trial in Virginia. Three years later, the United States Supreme Court affirmed an order authorizing her sterilization. Justice Oliver Wendell Holmes accepted the state’s claim that public welfare could require sacrifices from people described as a drain on its strength. His opinion in Buck v. Bell concluded, “Three generations of imbeciles are enough.” , including the statutory procedure and the Court’s approval of it. This belongs in the origin story. Nazi Germany carried eugenic classification into mass murder. Before Hitler took power, an American court had already allowed the state to treat Carrie Buck’s reproductive capacity as a public problem to be removed.
A Nazi poster puts its price in large yellow numerals. The figure is 60,000 Reichsmarks. A disabled man sits in a chair while another man stands behind him. The caption assigns that sum to the seated man’s lifetime care, then tells the viewer, “Citizen, this is your money.” , which promoted the Nazi Party’s Neues Volk publication. The Race Office supplied a taxpayer with one use for resentment. Care appeared as money taken away. The patient appeared as the person taking it. “Useless eaters” compressed that accusation into everyday speech. A person became a mouth with a cost. The poster never names him.
Aktion T4 and Helene Lebel
T4’s adult killing program used questionnaires. Hospitals, psychiatric institutions, and nursing homes received forms that looked like requests for statistical information. The questions emphasized a patient’s capacity to work. Teams of physicians reviewed the paperwork and selected people for death. Patients were then taken by bus or rail to six gassing installations. , from Hitler’s secret authorization in autumn 1939 to the falsified documents sent afterward. Philipp Bouhler and Karl Brandt directed the operation. Its name came from the Berlin address of its coordinating office, Tiergartenstrasse 4. Staff burned bodies in crematoria attached to the gassing facilities. Families received urns, death certificates, and invented causes of death.
Helene Melanie Lebel loved to swim and go to the opera. She entered law school in Vienna and later worked as a legal secretary. Mental illness interrupted her studies and employment. She was diagnosed with schizophrenia and placed in Vienna’s Steinhof Psychiatric Hospital. Her parents were led to expect her release. Instead, authorities transferred her to Brandenburg in 1940. She was undressed, examined, and taken into a shower room that served as a gas chamber. The museum identifies her as one of 9,772 people gassed at Brandenburg that year. Her recorded cause of death was “acute schizophrenic excitement.” She had been a law student. The official record says she died in her room.
The program kept meticulous totals. T4’s internal calculation listed 70,273 people killed at the six gassing facilities between January 1940 and August 1941. Historians estimate about 250,000 victims across all phases of the Euthanasia Program. Public knowledge and protest disrupted the centralized operation. Bishop Clemens August Count von Galen condemned the killings in a sermon on August 3, 1941, and Hitler ordered a halt later that month. The relief was limited. Child killings continued. Medical professionals later resumed decentralized killing through injections, overdoses, and starvation in institutions across the Reich. The program continued until the final days of the war.
Why the Words Became Untouchable
Prosecutors named Karl Brandt first among twenty-three defendants in the Doctors’ Trial. The case, United States v. Karl Brandt et al., was prosecuted in 1946 and 1947. Its charges included medical experiments and the euthanasia of sick and disabled civilians in Germany and occupied territories. Karl Brandt and six other defendants were convicted, sentenced to death, and executed. Nine defendants received prison terms. Seven were acquitted. across about 13,000 pages of Case 1 material. That record explains the taboo around “useless eaters.” Avoiding offense is only part of it. The words belong to a bureaucratic practice that selected disabled people for death.
The Convention on the Rights of Persons with Disabilities entered into force in 2008. Article 10 affirms every human being’s inherent right to life. Article 28 recognizes disabled people’s rights to an adequate standard of living and social protection. Consultation duties appear in Article 4, which requires states parties to involve disabled people through their representative organizations. , including attitudes and the environment. Inaccessible transport and rigid workplaces can exclude a person from employment. That exclusion does not reduce the right to food, housing, or care. The phrase is not under one universal statutory ban. Its place outside acceptable public speech comes from the history and from a legal commitment to inherent dignity.
The New Paperwork
Public Law 119-21 uses the term “community engagement.” President Trump signed it on July 4, 2025. Beginning on January 1, 2027, unless a state starts earlier, certain adults will have to complete 80 hours in a month through work, community service, an approved work program, education, or a combination. Some people will have to show compliance before their applications are accepted. Many covered beneficiaries will also face eligibility renewals every six months. for certain family caregivers, veterans with total disability ratings, and people judged medically frail. States must try to use reliable available information before demanding more documents. These protections are written into the guidance. The practical question is whether an exempt person will be identified before coverage ends.
Arkansas removed about 18,000 people from Medicaid before a federal court stopped its work-reporting policy. The 2018 policy had required certain adults to report work or community engagement online. A later study compared Arkansans subject to the policy with other age groups and residents of three control states. More than 95 percent of the target population already met the requirement or should have qualified for an exemption. Researchers found no significant employment increase after 18 months. Among survey respondents who had been disenrolled, 63.8 percent reported cost-related delays in medication. The figure was 32.8 percent among continuously enrolled respondents. and explains its methods and limitations. Many people whom the policy was supposed to exempt still had to get through the reporting system.
Sarah Palin’s “death panel” post used the language of productivity. She wrote on August 7, 2009, about her parents and her baby with Down syndrome. She imagined bureaucrats judging their “level of productivity in society.” its 2009 Lie of the Year. Republican officials amplified the accusation. The proposed Democratic legislation did not establish panels to decide who was worthy of care. Public Law 119-21 does not create such panels either. Its instrument is the eligibility rule. Sixteen years after Palin’s post, fifty Republican senators voted for H.R. 1. No Democratic senator voted for it, and . The accusation ran in the wrong direction. The documented danger is a coverage termination followed by delayed medication.
The Ruling Class on Record
The Congressional Budget Office examined the same reconciliation law across taxes, cash transfers, Medicaid, food assistance, and other channels. that resources would decrease for households toward the bottom of the income distribution. Resources would increase for households in the middle and toward the top. This finding gives the Medicaid debate its class setting. The law asks some low-income adults to satisfy new administrative tests while the overall distribution of resources shifts upward. Oligarchy does not require a billionaire to draft each form. It describes the political advantage that concentrated wealth has when public choices are made. People receiving Medicaid can be told that their care needs another safeguard. No comparable safeguard tests the households gaining resources.
David Koch financed a more explicit program. He ran for vice president on the Libertarian Party ticket in 1980 and donated $1 million to the campaign, according to . The platform adopted for that campaign called the welfare state “a growing and parasitic burden on all productive people.” It also favored abolishing Medicare and Medicaid and opposed all government welfare programs. , not in an anonymous modern attack ad. These were party commitments rather than a personal quotation from Koch. They still document the program that he financed and represented as a candidate.
Mitt Romney’s donor remarks turned basic needs into an accusation. Speaking at a private fundraiser in 2012, he said 47 percent of voters would support President Obama and described them as dependent on government. He said they believed they were “entitled to health care, to food, to housing.” He also said his job was not to worry about those people. . . The recording still matters because it captured what he said while asking wealthy contributors for support. He treated food, housing, and medical care as signs of bad character.
Elon Musk reached for the language of crime. During his February 2025 appearance on The Joe Rogan Experience, he said, “Social Security is the biggest Ponzi scheme of all time.” Musk was then a White House adviser. , explaining that Social Security is transparent, operates under law, and has multiple forms of oversight. Calling it a Ponzi scheme does more than dispute its financing. It casts a public insurance program as a fraudulent enterprise. Benefit cuts become easier to defend when the program itself has been made to sound criminal.
Peter Thiel wrote about this conflict in plainer terms in 2009. “I no longer believe that freedom and democracy are compatible,” the technology investor said. His essay named welfare beneficiaries among the constituencies that had made capitalist democracy an oxymoron. He later clarified that he did not want any class of people disenfranchised. ran through cyberspace, outer space, and seasteading. His essay does not advocate killing anyone, and it does not use the Nazi phrase. Its value as evidence concerns democratic power. Citizens can vote to tax wealth and guarantee social protection. A doctrine that treats democracy as an obstacle can regard those collective decisions as something to escape.
Britain’s Two Tiers
Britain has written claim dates into disability income. The Universal Credit Act 2025 changed the health element from April 6, 2026. New claimants can now receive a higher or lower amount. The higher rate generally protects people already in the system, people with severe and lifelong conditions, and people nearing the end of life. and their exceptions. For claimants outside those protected categories, declaring a condition on or after April 6 leads to the lower amount. For people outside the protected categories, the declaration date can determine how much support the state provides.
Disabled people told the Timms Review that Personal Independence Payment assessments were stressful and dehumanising. The review’s September 2026 update says nearly 4,000 people registered interest in its workshops. About 2,000 responded to its commissioned survey. include advocacy, fewer unnecessary reviews for lifelong conditions, and offline alternatives to digital services. Their final recommendations were still pending in that update. The review also has to remain within the Office for Budget Responsibility’s projections for future PIP expenditure. Disabled testimony has entered the review. No spending increase is promised in that update.
What Resistance Has to Do
More than sixty disabled activists left their wheelchairs and mobility aids at the United States Capitol on March 12, 1990. They crawled up the steps in a protest organized by ADAPT. The action became known as the Capitol Crawl. to pass the Americans with Disabilities Act. Lawmakers could discuss accessibility in the abstract. The activists put bodies on the stone steps that kept them out. Their protest also challenged the familiar picture of disabled people waiting quietly for help. They organized the action, chose the location, and made the obstruction impossible to overlook.
The next fights will happen inside Medicaid rules and SSI regulations. Health care and food assistance should not depend on a work test. Agencies should use information already in their possession before asking a disabled person for more proof. Benefits should continue during an appeal. Claimants need working telephone and paper channels, along with paid advocates who can stay with a case. Disabled people need paid authority in drafting the rules that classify them. Independent living services need funding so that a family’s inability to absorb another cut does not end in institutional placement. These proposals can be written into statutes, regulations, and budgets. Their results can be checked in individual cases like Burton’s.
The CBO finding points back to the tax code. Progressive taxation, estate taxes, and enforcement against tax avoidance can fund social protection without presenting care as an unbearable cost. Public campaign financing and lobbying disclosure can reduce the conversion of private fortune into political veto power. Unions can organize around the fact that a worker’s health and hours can change across a lifetime. Mutual aid can keep a person housed during an appeal, though it cannot replace an enforceable public guarantee. The aim is not admiration for disabled people after another inspiring speech. It is food, treatment, accessible housing, and legal rights that remain available on a bad month.
The Arkansas study gives journalists and advocates a concrete assignment. A savings estimate should be followed by questions about missed medication, medical debt, and people who qualified for exemptions but lost coverage anyway. Officials should have to identify who receives a tax benefit and who receives a termination notice. Calling every cruel policy Nazi would make the historical charge easier to evade. The stronger description is closer to the documents. A rule imposes an economic test, predicts savings, and shifts the cost of failure onto a person with less power. The Arkansas respondents have already supplied some of those answers.
The 1941 halt warns against celebrating a procedural retreat. Centralized gassing stopped, and the killers moved their work into hospitals and wards. A delayed regulation can return. An exemption can fail in practice. A government can change its vocabulary while leaving the underlying test intact. Disabled organizations, lawyers, researchers, families, and allies have to remain after the announcement. Their work includes publishing individual cases, filing appeals, monitoring implementation, and returning to the same offices when a promised protection does not arrive.
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