Millions of Americans are now at risk of losing health care coverage or food assistance under the GOP’s recently passed mega-budget, which includes sweeping cuts and new restrictions on critical social safety net programs.

Related Articles

More Americans shift money from checking and savings to accounts with investment income, study says

Microsoft releases urgent fix for Sharepoint vulnerability being used in global cyberattacks

Ford recalls more than 694,000 Bronco Sport, Escape vehicles due to fuel injector issue

Wall Street drifts around its records ahead of a big week for profit reports

Alaska Airlines resumes operations after tech outage grounds all flights

The GOP’s $3.3 trillion budget, dubbed the “big, beautiful bill,” includes $4.5 trillion in tax cuts and approximately $300 billion for President Donald Trump’s defense and immigration enforcement priorities. To partly offset the steep cost, the bill targets reductions across the board — but hits health and food assistance programs hardest.

Medicaid and the Supplemental Nutrition Assistance Program (SNAP) subsidies face deep cuts and work requirements. Affordable Care Act (ACA) subsidies will also be reduced. The burden of these cuts is expected to fall most heavily on existing and eligible recipients, as well as on state health programs, food banks and rural hospitals that depend on federal support to deliver services to vulnerable populations.

The timing of certain changes to social safety net programs isn’t entirely clear — the bill didn’t attach a specific implementation date for SNAP work requirements, for example, but it could be as early as this year. For Medicaid requirements, states have until the end of 2026 to begin enforcing. And the biggest cuts to Medicaid and SNAP won’t begin until 2028.

“We’re not all going to wake up one morning and find millions more people uninsured,” said Larry Levitt, executive vice president of health care policy for KFF, a health care policy and research organization, during a press call on July 9. He added that the impact of changes to Medicaid and the ACA will roll out slowly over the next decade.

With program restrictions and cuts looming, here are the people and programs who will feel the most pain.

 

People who rely on Medicaid for health care coverage

More than 78 million people are enrolled in Medicaid in 2025, according to Medicaid.gov, about 23% of the U.S. population. They include eligible low-income adults, pregnant women, children, older adults and people with disabilities.

The bill’s changes to Medicaid will unfold in two phases.

First, states must enact work requirements by the end of 2026, according to the bill. To stay enrolled in Medicaid, recipients must demonstrate they are working, caring for small children, attending school or work training at least 80 hours per month.

And yet, KFF finds that most people under the age of 65 who receive Medicaid are already working full-time or part-time or attending school. So it’s not lack of work or schooling that would push Medicaid enrollees off their health care coverage, it’s the complex red tape that the new requirements introduce.

That is, at least, how it worked when Arkansas tried to do it.

Arkansas briefly implemented 80-hour-per-month Medicaid work requirements for enrollees ages 30 to 49. The restriction was in place from June 2018 to March 2019, when a federal court struck it down. During that time, 18,000 people — about 25% of the covered population — lost health care coverage, according to a September 2020 study from Harvard T.H. Chan School of Public Health. The losses were largely due to failures in reporting or documentation, not ineligibility.

Moreover, the policy had no effect on employment in the 18 months following the end of the program. But there were significant health and financial consequences for those who lost coverage, compared to those who remained on Medicaid: Nearly 50% reported serious medical debt problems, while 56% delayed health care and 64% delayed taking medications, both due to cost.

At the highest risk for losing coverage are those with chronic illness or disabilities who cannot obtain exemptions; those with mental health conditions; and those whose work hours fluctuate from one month to the next, such as seasonal or gig workers. The Congressional Budget Office (CBO) estimates that 5.2 million adults will lose Medicaid due to work requirement restrictions.

The second rollout of Medicaid changes won’t begin until 2028, but those are the deepest cuts. Provisions include new cost-sharing charges between states and low-income working enrollees for certain health care services. The changes also require states to end non-Medicaid health care coverage for immigrants.

A June 24 assessment by the Congressional Budget Office projects that as a result of all the changes to Medicaid and the ACA (more on that below), approximately 12 million will lose health care coverage.

People who have health coverage through ACA marketplaces

Changes to ACA requirements and subsidies could result in 8.2 million people losing health care coverage through ACA marketplaces, according to CBO estimates.

The first set of changes are stricter requirements: Those who access health care through the ACA marketplace face new annual update conditions for income and immigration status. They’ll also face a shorter window to enroll each year.

The most significant impact is what’s missing from the bill: An extension of the enhanced premium tax credits for ACA marketplace coverage, put in place during the pandemic, which expire at the end of the year. Premium tax credits are a federal subsidy that helps cover monthly premium costs for those who purchase health insurance through the ACA marketplace.

If enhanced tax credits expire, out-of-pocket premiums in the marketplace could increase by more than 75% and up to 90% in rural areas, according to KFF CEO Drew Altman, during the press call. He also said that enrollment could drop as much as 50% in rural areas.

Levitt added that the measures in the bill amount to “what is effectively a partial repeal of the ACA,” which passed 15 years ago. Federal data shows an estimated 45 million people are enrolled in health coverage through the ACA — about 13% of the U.S. population.

State health programs and rural hospitals

Federal cuts to Medicaid and the ACA will shift financial responsibilities onto states, which is likely to add financial strain to state health programs and hospitals — particularly community health centers and rural hospitals.

For decades, states have used provider taxes to help fund Medicaid and state-directed payments. The bill limits how states can do so.

Robin Rudowitz, vice president at KFF and director of the Program on Medicaid and the Uninsured, said during the press call that if states are limited in how they can use provider taxes, they’ll have to come up with other ways to replace that money like increased taxes, cuts to other program spending or further changes to their Medicaid programs.

The cuts would also mean hospitals will receive lower payments, which means hospitals may have to scale back certain services or close altogether. Hospitals with low margins, like rural hospitals, are likely to face the biggest obstacles.

KFF estimates that 12 states with large rural populations and expanded Medicaid could see federal spending on their programs decline by $5 billion or more over 10 years. Kentucky stands to lose $12 billion — the highest among all states.

Kentucky, for example, relies heavily on provider taxes. Kentucky Hospital Association, which represents over 100 hospitals in the state, says the bill’s cuts puts 20,000 people at risk of losing their jobs. A study from University of North Carolina found that 35 rural hospitals in Kentucky could be in danger of closing due to the provisions in the bill.

There is one source of hope for rural hospitals in the bill: States may apply to access a $50 billion fund to support rural hospitals, to be distributed for five years beginning in 2027. But the fund won’t likely offset the cuts. Levitt said “Delayed relief, even if sizable, won’t arrive fast enough to prevent closures.”

People who need food assistance

As with Medicaid, low-income Americans who are eligible for SNAP will face new work requirements as soon as this year and the effects of funding cuts later in 2028. The total reduction in SNAP spending in the bill: $295 billion over the next decade.

More than 42 million people receive SNAP benefits, according to the USDA — about 12% of the U.S. population.

It’s worth noting that there are already work requirements built into the SNAP program — able-bodied people without dependents, ages 18 to 49, must work at least 20 hours per week or 80 hours per month. But the bill raises that upper age limit to 55, which means millions more people will be impacted. It also eliminates or tightens exemption criteria for states to waive work requirements for certain individuals.

The issues that SNAP work requirements present remain, according to the Center on Budget and Policy Priorities (CBPP): increased administrative burdens, more people losing assistance and no improvements in long-term employment outcomes.

While food banks don’t directly rely on SNAP to deliver its services, a loss of SNAP funds could put added pressure on already-strained programs. Feeding America, a nationwide network of food banks, estimates the bill’s provisions could reduce anywhere from 6 to 9 billion meals annually.

More From NerdWallet

Splurge Now, Save Later? 4 Things to Buy Before Prices Rise
7 Ways to Keep the Summer Spending Craze Under Control
Making $200K and Still Feel Financially Stretched? You’re Not Alone

Anna Helhoski writes for NerdWallet. Email: anna@nerdwallet.com. Twitter: @AnnaHelhoski.

The article Without a Net: Who Will Feel the Pain From Budget Cuts? originally appeared on NerdWallet.

By BEN FINLEY, Associated Press

Lawyers for Kilmar Abrego Garcia have asked a federal judge in Tennessee to delay releasing him from jail in order to prevent the Trump administration from trying to swiftly deport the Maryland construction worker.

U.S. District Judge Waverly Crenshaw Jr. in Nashville is expected to rule soon on whether to free Abrego Garcia while he awaits trial on human smuggling charges. If the Salvadoran national is released, U.S. officials have said he would be immediately detained by immigration authorities and targeted for deportation.

Brianna O’Keefe yells as she holds a portrait of Kilmar Obrego Garcia during a protest outside the federal courthouse Wednesday, June 25, 2025, in Nashville, Tenn. (AP Photo/George Walker IV)

Abrego Garcia became a prominent face in the debate over President Donald Trump’s immigration policies when he was wrongfully deported to his native El Salvador in March. That expulsion violated a U.S. immigration judge’s order in 2019 that shields Abrego Garcia from deportation to El Salvador because he likely faces threats of gang violence there.

The administration claimed that Abrego Garcia was in the MS-13 gang, although he wasn’t charged and has repeatedly denied the allegation. Facing mounting pressure and a U.S. Supreme Court order, the Trump administration returned Abrego Garcia to the U.S. last month to face the smuggling charges, which his attorneys have called “preposterous.”

The smuggling case stems from a 2022 traffic stop for speeding, during Abrego Garcia was driving a vehicle with nine passengers. Police in Tennessee suspected human smuggling, but he was allowed to drive on.

U.S. officials have said they’ll try to deport Abrego Garcia to a country that isn’t El Salvador, such as Mexico or South Sudan, before his trial starts in January because they allege he’s a danger to the community.

U.S. Magistrate Judge Barbara Holmes in Nashville ruled a month ago that Abrego Garcia is eligible for release after she determined he’s not a flight risk or a danger. Abrego Garcia’s attorneys asked her to keep him in jail over deportation concerns.

Holmes’ ruling is being reviewed by Crenshaw after federal prosecutors filed a motion to revoke her release order.

Related Articles

More Americans shift money from checking and savings to accounts with investment income, study says

Microsoft releases urgent fix for Sharepoint vulnerability being used in global cyberattacks

Ford recalls more than 694,000 Bronco Sport, Escape vehicles due to fuel injector issue

Wall Street drifts around its records ahead of a big week for profit reports

Harvard is hoping court rules Trump administration’s $2.6B research cuts were illegal

Abrego Garcia’s attorneys initially argued for his release but changed their strategy because of the government’s plans to deport him if he is set free. With Crenshaw’s decision imminent, Abrego Garcia’s attorneys filed a motion Sunday night for a 30-day stay of any release order. The request would allow Abrego Garcia to “evaluate his options and determine whether additional relief is necessary.”

Earlier this month, U.S. officials detailed their plans to try to expel Abrego Garcia in a federal court in Maryland. That’s where Abrego Garcia’s American wife, Jennifer Vasquez Sura, is suing the Trump administration over his wrongful deportation in March and is trying to prevent another expulsion.

U.S. officials have argued that Abrego Garcia can be deported because he came to the U.S. illegally around 2011 and because a U.S. immigration judge deemed him eligible for expulsion in 2019, although not to his native El Salvador.

Following the immigration judge’s decision in 2019, Abrego Garcia was released under federal supervision, received a federal work permit and checked in with ICE each year, his attorneys have said. But U.S. officials recently stated in court documents that they revoked Abrego Garcia’s supervised release.

Abrego Garcia’s attorneys in Maryland have asked U.S. District Judge Paula Xinis to order the federal government to send Abrego Garcia to that state to await his trial, a bid that seeks to prevent deportation.

His lawyers also asked Xinis to issue at least a 72-hour hold that would prevent immediate deportation if he’s released from jail in Tennessee. Xinis has not ruled on either request.

By NICHOLAS RICCARDI and NADIA LATHAN, Associated Press

AUSTIN, Texas (AP) — U.S. Rep. Vicente Gonzalez, a Texas Democrat who represents a slice of the Rio Grande Valley along the border with Mexico, won his last congressional election by just over 5,000 votes.

That makes him a tempting target for Republicans, who are poised to redraw the state’s congressional maps this coming week and devise five new winnable seats for the GOP that would help the party avoid losing House control in the 2026 elections. Adjusting the lines of Gonzalez’s district to bring in a few thousand more Republican voters, while shifting some Democratic ones out, could flip his seat.

Gonzalez said he is not worried. Those Democratic voters will have to end up in one of the Republican districts that flank Gonzalez’s current one, making those districts more competitive — possibly enough so it could flip the seats to Democrats.

FILE – Rep. Vicente Gonzalez, D-Texas., speaks during a press conference on Capitol Hill, Feb. 6, 2025, in Washington. (AP Photo/Rod Lamkey, Jr., File)

“Get ready for some pickup opportunities,” Gonzalez said, adding that his party is already recruiting challengers to Republicans whose districts they expect to be destabilized by the process. “We’re talking to some veterans, we’re talking to some former law enforcement.”

Texas has 38 seats in the House. Republicans now hold 25 and Democrats 12, with one seat vacant after Democrat Sylvester Turner, a former Houston mayor, died in March.

Gonzalez’s district — and what happens to the neighboring GOP-held ones — is at the crux of President Donald Trump’s high-risk, high-reward push to get Texas Republicans to redraw their political map. Trump is seeking to avoid the traditional midterm letdown that most incumbent presidents endure and hold onto the House, which the GOP narrowly controls.

Trump’s push comes as there are numerous political danger signs for his presidency, both in the recent turmoil over his administration’s handling of the Jeffrey Epstein case and in new polling. Surveys from The Associated Press-NORC Center for Public Affairs Research show most U.S. adults think his policies have not helped them and that his tax cut and spending bill will help the wealthy.

Republicans risk putting their own seats in jeopardy

The fear of accidentally creating unsafe seats is one reason Texas Republicans drew their lines cautiously in 2021, when the constitutionally mandated redistricting process kicked off in all 50 states. Mapmakers — in most states, it’s the party that controls the legislature — must adjust congressional and state legislative lines after every 10-year census to ensure that districts have about the same number of residents.

That is a golden opportunity for one party to rig the map against the other, a tactic known as gerrymandering. But there is a term, too, for so aggressively redrawing a map that it puts that party’s own seats at risk: a “dummymander.”

The Texas GOP knows the risk. In the 2010s, the Republican-controlled Legislature drew political lines that helped pad the GOP’s House majority. That lasted until 2018, when a backlash against Trump in his first term led Democrats to flip two seats in Texas that Republicans had thought safe.

In 2021, with Republicans still comfortably in charge of the Texas Statehouse, the party was cautious, opting for a map that mainly shored up their incumbents rather than targeted Democrats.

Still, plenty of Republicans believe their Texas counterparts can safely go on offense.

“Smart map-drawing can yield pickup opportunities while not putting our incumbents in jeopardy,” said Adam Kincaid, executive director of the National Republican Redistricting Trust, which helps coordinate mapmaking for the party nationally..

Democrats contemplate a walkout

Republican Gov. Greg Abbott called a special session of the Legislature, which starts Monday, to comply with Trump’s request to redraw the congressional maps and to address the flooding in Texas Hill Country that killed at least 135 people this month.

Texas Gov. Greg Abbott speaks as President Donald Trump listens during a roundtable discussion with first responders and local officials at Hill Country Youth Event Center in Kerrville, Texas, during a tour to observe flood damage, Friday, July 11, 2025. (AP Photo/Jacquelyn Martin)

Democratic state lawmakers are talking about staying away from the Capitol to deny the Legislature the minimum number needed to convene. Republican Attorney General Ken Paxton posted that any Democrats who did that should be arrested.

Lawmakers can be fined up to $500 a day for breaking a quorum after the House changed its rules when Democrats initiated a walkout in 2021. Despite the new penalties, state Rep. Trey Martinez Fischer, who led the walkout in 2021, left open the possibility of another.

“I don’t think anybody should underestimate the will of Texas Democrats,” he said.

Texas is not the only Republican state engaged in mid-decade redistricting. After staving off a ballot measure to expand the power of a mapmaking commission last election, Ohio Republicans hope to redraw their congressional map from a 10-5 one favoring the GOP to one as lopsided as 13-2, in a state Trump won last year with 55% of the vote.

GOP sees momentum after 2024 presidential election

Some Democratic leaders have suggested that states where their party is in control should counter the expected redraw in Texas. “We have to be absolutely ruthless about getting back in power,” former Texas Rep. Beto O’Rourke said Sunday on CNN.

But Democrats have fewer options. More of the states the party controls do not allow elected partisans to draw maps and entrust independent commissions to draw fair lines.

Among them is California, where Gov. Gavin Newsom has floated the long shot idea of working around the state’s commission.

The few Democratic-controlled states that do allow elected officials to draw the lines, such as Illinois, have already seen Democrats max out their advantages.

Trump and his allies have been rallying Texas Republicans to ignore whatever fears they may have and to go big.

On Tuesday, the president posted on his social media site a reminder of his record in the state last November: “Won by one and a half million Votes, and almost 14%. Also, won all of the Border Counties along Mexico, something which has never happened before. I keep hearing about Texas ‘going Blue,’ but it is just another Democrat LIE.”

Texas has long been eyed as a state trending Democratic because of its growing nonwhite population. But those communities swung right last year and helped Trump expand his margin to 14 percentage points, a significant improvement on his 6-point win in 2020.

Michael Li, a Texas native and longtime watcher of the state at the Brennan Center for Justice in New York, said there’s no way to know whether that trend will continue in next year’s elections or whether the state will return to its blue-trending ways.

“Anyone who can tell you what the politics of Texas looks like for the balance of the decade has a better crystal ball than I do,” Li said.

Aggressive redistricting also carries legal risks

One region of the state where Republican gains have been steady is the Rio Grande Valley, which runs from the Gulf of Mexico along much of the state’s southern border. The heavily Hispanic region, where many Border Patrol officers live, has rallied around Trump’s tough-on-immigration, populist message.

Related Articles

FDA names former pharmaceutical company executive to oversee US drug program

Trump threatens to hold up stadium deal if Washington Commanders don’t switch back to Redskins

Did money or politics cause Colbert cancellation? Either way, the economics are tough for TV

New York settles lawsuit with ex-aide who accused Andrew Cuomo of sexual harassment

EPA eliminates research and development office, begins layoffs

As a result, Gonzalez and the area’s other Democratic congressman, Henry Cuellar, have seen their reelection campaigns get steadily tighter. They are widely speculated to be the two top targets of the new map.

The GOP is expected to look to the state’s three biggest cities to find its other Democratic targets. If mapmakers scatter Democratic voters from districts in the Houston, Dallas and Austin areas, they could get to five additional seats.

But in doing so, Republicans face a legal risk on top of their electoral one: that they break up districts required by the Voting Rights Act to have a critical amount of certain minority groups. The goal of the federal law is to enable those communities to elect representatives of their choosing.

The Texas GOP already is facing a lawsuit from civil rights groups alleging its initial 2021 map did this. If this year’s redistricting is too aggressive, it could trigger a second complaint.

“It’s politically and legally risky,” Li said of the redistricting strategy. “It’s throwing caution to the winds.”

Riccardi reported from Denver.

LONDON (AP) — Twenty-five countries including Britain, France and a host of European nations issued a joint statement on Monday that puts more pressure on Israel, saying the war in Gaza “must end now” and Israel must comply with international law.

The foreign ministers of countries including Australia, Canada and Japan said “the suffering of civilians in Gaza has reached new depths.” They condemned “the drip feeding of aid and the inhumane killing of civilians, including children, seeking to meet their most basic needs of water and food.”

Related Articles

A Bangladesh Air Force training jet crashes into a Dhaka school, killing at least 19

Russia launches a major aerial attack on Kyiv hours before high-level talks on support for Ukraine

Iran will hold nuclear talks with European nations in Turkey, the first since ceasefire with Israel

Today in History: July 21, verdict reached in Scopes ‘Monkey Trial’

Today in History: July 20, Neil Armstrong and Edwin Aldrin walk on the moon

The statement described as “horrifying” the deaths of over 800 Palestinians who were seeking aid, according to the figures released by Gaza’s Health Ministry and the U.N. human rights office.

“The Israeli government’s aid delivery model is dangerous, fuels instability and deprives Gazans of human dignity,” the statement said.

“The Israeli government’s denial of essential humanitarian assistance to the civilian population is unacceptable. Israel must comply with its obligations under international humanitarian law,” it added.

Gaza’s population of more than 2 million Palestinians is in a catastrophic humanitarian crisis, now relying largely on the limited aid allowed into the territory. Many people have been displaced multiple times.

Most of the food supplies Israel has allowed into Gaza go to the Gaza Humanitarian Foundation, an American contractor backed by Israel. Since the group’s operations began in late May, hundreds of Palestinians have been killed in shootings by Israeli soldiers while on roads heading to the sites, according to witnesses and health officials.

The statement’s signatories included the foreign ministers of about 20 European countries as well as Canada, Australia and New Zealand, and the EU commissioner for equality, preparedness and crisis management, Hadja Lahbib.

Notably absent from the list were the U.S. and Germany.

The signatories called for an immediate ceasefire, adding they are prepared to take action to support a political pathway to peace in the region.

The statement from so many of Israel’s Western allies deepens its isolation 21 months into its war against Hamas, which has pushed Gaza to the brink of famine, sparked worldwide protests and led to an international arrest warrant against Israel’s Prime Minister Benjamin Netanyahu.

Israel rejects criticism of its wartime conduct, saying its forces have acted lawfully and blaming civilian deaths on Hamas because they operate in populated areas. Israel says it has allowed enough food in to sustain Gaza and accuses Hamas of siphoning much of it off. The United Nations says there is no evidence for widespread diversion of humanitarian aid.

Hamas triggered the war when terrorists stormed into southern Israel on Oct. 7, 2023, killing around 1,200 people and taking 251 others hostage. Fifty remain in Gaza, but fewer than half are thought to be alive.

Hamas has been designated as a terrorist organization by the United States, Canada and the European Union.

Israel’s military offensive has killed more than 59,000 Palestinians, according to Gaza’s Health Ministry. Its count doesn’t distinguish between militants and civilians but the ministry says more than half of the dead are women and children. The ministry is part of the Hamas government, but the U.N. and other international organizations see it as the most reliable source of data on casualties.

Israel and Hamas have been engaged in ceasefire talks, but there appears to be no breakthrough and it’s not clear whether any truce would bring the war to a lasting halt. Israeli Prime Minister Benjamin Netanyahu has repeatedly asserted that expanding Israel’s military operations in Gaza will pressure Hamas in negotiations.