Republicans representing Texas in Congress say proposed reforms to Medicaid and the Supplemental Nutrition Assistance Program are necessary to reduce 性视界传媒渨aste, fraud and abuse性视界传媒 of the safety net programs by requiring able-bodied recipients to work.
Democrats and other opponents of The One Big Beautiful Bill Act, however, say the reforms will amount to draconian cuts of the programs that will jeopardize the health of Americans in need.
The legislation wouldn性视界传媒檛 cut Medicaid and food assistance funding outright. Instead, it would impose new work and eligibility requirements that could cause people to lose those benefits if they don性视界传媒檛 meet the requirements.
Regardless of whether they lose benefits, millions of Medicaid and SNAP recipients across the nation and in Texas will be affected by the reforms, and the Congressional Budget Office estimates that millions could lose coverage from those programs. As a result, the federal government could save close to $1 trillion.
While Republicans champion the overall bill as a way to reduce federal spending by at least $1.2 trillion in the coming decade, it性视界传媒檚 still expected to add at least $2.4 trillion or more to the national deficit during the next decade. President Donald Trump and other Republicans dispute that assertion, however, saying economic gains and growth will be greater.
The U.S. House passed the bill by a vote of 215-214 in May, and it is now in the Senate, where changes are expected.
Here性视界传媒檚 a breakdown of how the bill would affect Medicaid and SNAP and what people have to say about the proposed reforms.
What reforms are proposed?The Big Beautiful Bill Act is a massive legislative package that, if signed into law, would make permanent the tax cuts implemented in 2017, increase funding for the military and border security and reform Medicaid and SNAP eligibility and work requirements.
Medicaid provides health insurance to low-income families, pregnant women, people with disabilities and people who need long-term care. SNAP provides food assistance to working families with low incomes, older adults with low incomes and people with disabilities who have fixed incomes, among other groups.
More than 71 million Americans use Medicaid, which is funded by the federal and state governments, and more than 42 million receive SNAP benefits, which are fully federally funded.
More than 4 million Texans use Medicaid, and about 3.5 million receive SNAP benefits.
Under the bill, Medicaid recipients ages 19 to 64 without dependents would have to work, volunteer, go to school or perform community service for at least 80 hours per month 性视界传媒 about 20 hours per week, .
As an anti-fraud measure, recipients would have to verify their incomes and residencies to prevent them from collecting benefits from multiple jurisdictions simultaneously. Some would have higher co-pays for medical appointments. State governments would have to ensure a person性视界传媒檚 eligibility more frequently, and the enrollment period would be open Nov. 1 to Dec. 15, shortened by one month.
The federal government would give less money to the District of Columbia and the 14 states that provide care for illegal immigrants, affecting an estimated 1.4 million illegal immigrants, the White House estimates. Also, Medicaid funds no longer could be used for abortions or gender transitions.
More able-bodied SNAP recipients would be required to work, ABC News reported. Work requirements already apply to able-bodied recipients 18 to 54, and the latter figure would be raised to age 64. Also, state governments would have to begin paying 5% of the cost of SNAP programs in their states.
Why are reforms proposed?Trump and fellow Republicans in Washington have said the Medicaid and SNAP reforms in the bill aim to eliminate abuse of the safety net systems by removing millions of ineligible recipients.
, Kentucky Republican Rep. Brett Guthrie, chairman of the House Committee on Energy and Commerce, wrote that 1.6 million people are enrolled in two state Medicaid programs simultaneously, 1.4 million illegal immigrants are receiving care in certain states, 1.2 million enrollees no longer qualify for care and 4.8 million able-bodied recipients without children aren性视界传媒檛 working.
U.S. Rep. Nathaniel Moran, R-Tyler, said in a statement that about 74% of able-bodied SNAP recipients aren性视界传媒檛 working, according to a research by the right-leaning based on data from the U.S. Department of Agriculture.
The right-learning Economic Policy Innovation Center in 2024 reported that 62% of able-bodied adults receiving food benefits from 2017-19 . Meanwhile, the USDA reported that around 20% of households receiving SNAP benefits in 2022 , while 26% had countable income from employment. Other households had income from sources such as Social Security.
The average SNAP household received a monthly benefit of $297, according to the USDA.
While Republicans have targeted non-working SNAP recipients, leaders of the left-learning Center on Policy and Budget Priorities say that many SNAP recipients work or are looking for work, and they might participate in the program for only part of a year.
性视界传媒淎dults who receive SNAP often work in occupations and industries with low pay or unstable hours that cause income volatility, such as important frontline service or sales roles like cashiers, cooks, or home health aides,性视界传媒 . 性视界传媒淢any of these jobs often lack benefits such as paid family leave 性视界传媒 or even paid sick days 性视界传媒 which means that a worker性视界传媒檚 own illness or an illness in the family can lead to job loss.性视界传媒
Moran said the programs were created to help people during times of need and increase their upward economic mobility, 性视界传媒渘ot to foster long-term dependence on a nanny state.性视界传媒
性视界传媒淭ime-use data shows that many non-working, able-bodied adults without children are spending large portions of the day outside of the workforce, without engaging in job training, volunteering or looking for work,性视界传媒 Moran said.
性视界传媒淥ur reforms make Medicaid and SNAP work better for the American people 性视界传媒 protecting benefits for veterans, seniors, children and the disabled,性视界传媒 Moran added. 性视界传媒淭hese commonsense changes restore program viability and encourage personal responsibility among those able to work.性视界传媒
Texas Sens. Ted Cruz and John Cornyn also have voiced support for the reforms, calling them commonsense approaches as well. But as the bill heads to the Senate for consideration, some senators have said they oppose changes to Medicaid and SNAP that could cause people to lose benefits.
How could reforms affect people?While Republican lawmakers say work requirements and other changes are justifiable and necessary, leaders of healthcare facilities and food banks say the changes threaten to increase the number of people without health insurance and food assistance.
The Congressional Budget Office estimates that could lose insurance during the next decade if the proposed Medicaid requirements go into effect.
The Kaiser Family Foundation, a left-leaning health advocacy organization, projects that Medicaid under the bill. The Center for Budget and Policy Priorities projects that 683,000 Texas parents and 123,000 Texans between the ages of 55 and 64 .
Some opponents of the bill say the reforms for recipients to navigate and that additional red tape could complicate people性视界传媒檚 healthcare.
Having more uninsured people could burden hospitals and healthcare systems, especially in rural areas, where medical facilities already struggle to stay open because of low reimbursement rates for services, Rick Pollack, president and CEO of the American Hospital Association, .
Texas Hospital Association leaders said they were grateful the bill didn性视界传媒檛 include harsh Medicaid cuts but that the bill would restrict the state性视界传媒檚 ability to finance its Medicaid program in the future. The bill will prevent states from raising provider taxes, which states use to secure more federal funding.
Leaders of the East Texas Food Bank, which provides food to families and people in need throughout several counties in the region, said the proposed SNAP reforms would subject seniors and parents to a harsh three-month limit on benefits and leave families without food.
性视界传媒淧roposed cuts to SNAP will only worsen food insecurity in our region, which already experiences a higher level of food insecurity than the state average,性视界传媒 David Emerson, CEO of food bank, . 性视界传媒淪NAP plays an essential role in supporting vulnerable communities, especially in rural areas like East Texas. Any reduction in this vital program will place even greater strain on those already facing hardship, and it will hurt the economic stability of our entire region.性视界传媒
However, Republicans such as Guthrie and House Speaker Mike Johnson, R-La., said those who lose coverage are those who are ineligible or with requirements.
In its projections of how many people will lose insurance, the Congressional Budget Office assumes that the 4.8 million able-bodied recipients 性视界传媒渨ould rather lose Medicaid coverage than choose to work or give back to their communities,性视界传媒 Guthrie, the Kentucky representative, wrote.
性视界传媒淐ontinuing to direct scarce resources to these ineligible recipients ultimately takes away from Americans truly in need,性视界传媒 Guthrie said, adding that Republicans are aiming to protect Medicaid for the long term.
Trump has said he wants to sign the bill into law by July 4, giving the Senate and House less than one month to approve a final version.
