Critics say millions of working and poor families will lose Medicaid, ACA health insurance and food stamp benefits

By Arkansas Black Vitality Staff

May 25, 2025 – For thousands of poor and working families across the U.S., some of the most significant changes ahead will impact Medicaid and SNAP participants, as well as childcare tax credit recipients who received targeted relief since the pandemic. For example, the 160-page Medicaid reform package inserted in the massive GOP tax reconciliation bill will mimic a work requirement implemented by the state of Arkansas under a waiver granted by the first Trump administration. According to the Urban Institute, it would reduce Medicaid spending by $880 billion and SNAP benefits by $230 billion.

A key provision mandates that able-bodied adults aged 19 to 64 without dependents work at least 80 hours per month or participate in community engagement activities to maintain their Medicaid coverage, with exemptions for pregnant individuals and certain other situations. States that fail to verify citizenship or immigration status among enrollees could lose federal funding for those individuals’ benefits. The proposal would also ban the use of Medicaid and CHIP funding for gender transition procedures for individuals under the age of 18.

Arkansas applied its policy for nine months, from June 2018 through February 2019, before a federal court ruling halted it. Under the new GOP proposal, a work requirement like Arkansas’ would reduce Medicaid enrollment by an estimated 27% at the end of the policy’s first year and by 34%, on average, over the long run. If outcomes under the 2023 House policy mirrored my estimates for Arkansas’ policy, Medicaid enrollment would fall by around 4.5 million nationwide in the long run.

If the House version of the BBL is approved, savings from the Medicaid and SNAP cuts alone would total over $1.1 trillion and be applied to the $4 trillion needed for the so-called billionaire tax cut. Analysis from the Congressional Budget Office indicates the bill could cut Medicaid and Affordable Care Act spending by up to $715 billion over the next decade, resulting in at least 8.6 million people losing insurance coverage by 2034. 

The GOP legislation would reduce federal spending by $263 billion over 10 years for the Supplemental Nutrition Assistance Program (SNAP), which is administered by the U.S. Department of Agriculture, by requiring recipients to work to maintain eligibility. Under the budget bill, states will assume responsibility for a greater share of SNAP expenditures in fiscal 2028, which proponents view as incentivizing better program administration while also shifting more costs down to the states.

Additionally, proposed cost-sharing changes for SNAP benefits would increase states’ obligations, and some states could see a reduced federal match rate for Medicaid expansion. At the same time, proposed work requirements and other adjustments to Medicaid eligibility will likely decrease enrollment, leading to considerable cost savings for states, as they share these expenses with the federal government. However, if certain states decide to expand their social safety nets to benefit those excluded from federal coverage, costs would sharply increase instead.

Under the proposal, states’ share of administrative costs will increase to 75 percent, a shift of about $2.8 billion using the most recent available data, according to the Tax Foundation. Additionally, states would, for the first time, shoulder a portion of the cost of food benefits. Under a new “quality control incentive,” states would be responsible for between 5 and 25 percent of benefit costs, based on their rate of erroneous payments.

More specifically, the SNAP section of the BBL lowers the age cap for work requirements from 64 to 54. Able-bodied adults without dependents would be subject to these rules unless they meet other exemptions. Additionally, only parents with children under age 7 would be exempt from the work requirements, a significant change from the current exemption for children under 18. This means parents with school-age children as young as 7 must work to keep their benefits.

On May 12, the Arkansas Department of Human Services informed SNAP providers across the state that as of April 1, 2026, Arkansans with school-aged children receiving benefits will no longer be allowed to receive Employment and Training. According to the memo, the Arkansas DHS Snap E&T unit will only serve “able-bodied adults without dependents.” 

“This law will have a far-reaching effect on mothers and dads with school-aged children who are on SNAP who can’t afford to attend college,” one SNAP provider told Arkansas Black Vitality. “As taxpayers, we are paying for individuals to remain on SNAP, which will continue the cycle of poverty.”

In 2019, Arkansas GOP lawmakers overhauled the state’s SNAP program with the passage of Act 974. The new law requires able-bodied recipients between 18 and 54 years old to meet more stringent work requirements.

In addition to work requirements that could cut benefits for thousands of Arkansans, Arkansas Gov. Sarah Huckabee Sanders recently submitted a waiver to the USDA to ban soda and candy from Arkansas SNAP, including rotisserie chicken.

The Trump administration applauded and spotlighted that move last month after Secretary Rollins and Health and Human Services (HHS) Secretary Robert F. Kennedy Jr. wrote an opinion piece in USA Today outlining their plan to Make America Healthy Again, including through SNAP waivers like the one introduced in Arkansas.

“President Trump and his administration have put a laser focus on solving America’s chronic disease epidemic, and reforming our food stamp program is a great place to start,” said Sanders. “Banning soda and candy from food stamps will remove some of the least-healthy, most-processed foods from the program and encourage low-income Arkansans to eat better. Arkansas leads the nation in common-sense, conservative reforms and this move is a strong first step toward broader changes to our food stamp program.”

On the plus side, the BBL will eliminate income taxes on any tipped income and overtime pay for millions of hourly workers. In addition, some low-income seniors will be able to deduct an additional $4,000 on their income tax. At the same time, most American families will be able to deduct auto loan interest for American-made cars fully.

Reviews on the expansion of the child tax credit are mixed. The House Republicans’ tax bill would temporarily increase the child tax credit amount to $2,500 from $2,000 through 2028, the last year of Trump’s term. The tax credit would then drop back down and be indexed to inflation.

The 2017 law temporarily doubled the maximum child tax credit from $1,000 to $2,000 per child under 17 and added a $500 nonrefundable credit for children ineligible for the $2,000 credit. Republican and Democratic lawmakers have proposed expanding the credit further to raise the credit amount or expand benefits for lower-income families.