Abbreviated Version of Medicaid and SNAP Cutbacks Impacting Healthcare

This entirety of this piece by Commonwealth Fund covers more than a Jobs cutback. There is a definite meanness in this legislation by President Tru_p and Republicans. It is meant to skew tax breaks to people who do not need tax breaks at the expense of overall healthcare cuts. This will impact more than just those on Medicaid. We already know there is an impact on Medicare.

“How Medicaid, SNAP Cutbacks Would Trigger Job Losses Across States,” Commonwealth Fund

In 2029, cuts to Medicaid and SNAP would cause state gross domestic products to fall by $154 billion, 18 percent more than the $131 billion they would save the federal government. The cuts would result in the loss of 1.22 million jobs nationwide, equivalent to a 0.8-percentage-point increase in the unemployment rate. States with higher rates of poverty would likely be harmed more. State and local tax revenues would fall by $12 billion. Additional fallout from budget cuts to the health insurance marketplaces and the sequestration of Medicare funding will further harm the economy and employment.

Key Finding and Conclusions

• Issue: The budget reconciliation bill recently passed by the House of Representatives (the One Big Beautiful Bill) reduces federal funding for Medicaid by $863 billion and for the Supplemental Nutrition Assistance Program (SNAP) by $295 billion over 10 years.

• Goal: To estimate the impact of the bill on the economies, employment, and state and local tax revenues for every state and the District of Columbia in 2029, when the policies are fully implemented.

• Methods: We compute federal funding reductions for Medicaid and SNAP programs in each state using Congressional Budget Office estimates, along with recent Medicaid and SNAP data. We then use the IMPLAN modeling program to estimate economic effects.

• Key Findings and Conclusions: In 2029, cuts to Medicaid and SNAP would cause state gross domestic products to fall by $154 billion, 18 percent more than the $131 billion they would save the federal government. The cuts would result in the loss of 1.22 million jobs nationwide, equivalent to a 0.8-percentage-point increase in the unemployment rate. States with higher rates of poverty would likely be harmed more. State and local tax revenues would fall by $12 billion. Additional fallout from budget cuts to the health insurance marketplaces and the sequestration of Medicare funding will further harm the economy and employment.

More Detail

On May 22, 2025, the U.S. House of Representatives passed the “One Big Beautiful Bill Act,” its budget reconciliation bill. The Senate has begun to propose potential changes, but it is too early to know what the Senate will end up doing. Narrowly passed in the House on a party-line basis, the legislation includes an estimated $863 billion in budget cuts for Medicaid and $295 billion in cuts for the Supplemental Nutrition Assistance Program (SNAP) for fiscal years 2025 to 2034. The combined cuts exceed $1 trillion. Although President Trump has said he “loves and cherishes” Medicaid and Medicare, he strongly supports the bill.

The Congressional Budget Office (CBO) projects that, if enacted, the bill will cause 10.9 million Americans to become uninsured, either from the loss of Medicaid or from coverage losses in the Affordable Care Act (ACA) marketplace. An additional 5.1 million people will lose coverage when the enhanced marketplace premium tax credits expire at the end of 2025, among other reasons. Together, the number of uninsured Americans could be 16 million higher in 2034 than it would be without these changes. The CBO further projects that the bill will lower SNAP enrollment by an average of 4.7 million, and that Americans remaining in SNAP will see their nutrition allotments reduced.

Cuts to the ACA insurance marketplace will also lower federal funding for health care and increase the number of uninsured people. The end of the enhanced premium tax credits will compound these effects. Finally, the CBO noted that increases in the federal budget deficit caused by the bill could trigger “sequestration,” which could require a $500 billion cut in Medicare funding.

By cutting safety-net programs, the House budget bill reduces resources for low-income households (the lowest 10% of earners) by an average of $1,600. At the same time, the bill’s tax cuts increase resources for high-income households (the highest 10% of earners) by $12,000. Despite the spending cuts, the bill would increase the federal deficit by $3 trillion, including about $500 billion in higher interest costs.

A brief analyzation of the economic, employment, and tax consequences of the One Big Beautiful Bill Act for each state and the District of Columbia, as passed by the House. An earlier brief, written before the House bill was developed, examined the effects of hypothetical changes to Medicaid and SNAP policies, assuming that the changes were broad-based and spready evenly over the 2025–34 period and proportionately across states. The updated brief examines the effects of the specific policies that were approved by the House. The box below summarizes the bill’s key Medicaid- and SNAP-related policies.

Key Medicaid and SNAP Provisions in the House Budget Reconciliation Bill

Medicaid

• Mandates work reporting requirements for adults ages 19 to 64 covered through the Medicaid expansion by end of December 2026.
• Requires cost sharing for Medicaid expansion adults with incomes above 100 percent of the federal poverty level.
• Requires shorter certification periods for Medicaid expansion adults.
• Prohibits implementation of regulations related to eligibility and enrollment in Medicaid, CHIP, and Medicare Savings Programs and related to staffing standards for nursing homes until 2035.
• Cancels future American Rescue Plan Act incentive payments for states that newly expand Medicaid eligibility.
• Cuts the matching rate for expansion populations in states that use their own funds to serve undocumented or nonqualified immigrants.
• Prohibits gender-affirming care.
• Prohibits payments to certain family planning providers.
• Freezes state Medicaid provider taxes at current levels and limits use of state-directed payments.
• Delays disproportionate share hospital (DSH) payment reductions.

Supplemental Nutrition Assistance Program

• Expands work reporting requirements for adults from an upper limit of age 54 to age 64 and lowers the age limit for dependent children from 18 to 7.
• Requires a state match for SNAP benefits of between 5 percent and 25 percent, based on each state’s payment error rate, beginning in 2028.
• Halves federal funding for administrative payments from 50 percent to 25 percent.
• Lowers the tolerance limit for payment errors from $57 to $0.
• Limits increases in SNAP benefits based on the Thrifty Food Plan to the Consumer Price Index.
• Prohibits participation by persons who are not citizens or lawful permanent residents.

Timing and Depth of “State” Medicaid and SNAP Cuts in a Chart Format

A budget reconciliation bill is often described in terms of the federal savings it will produce, the cost of the cuts outlined above will be borne by states, their businesses, and their residents. Since the legislation is phased, the impact of these bills deepens over time, as illustrated in Exhibit 1.