By LISA MASCARO, Associated Press Congressional Correspondent

WASHINGTON (AP) — On this day in 1965, President Lyndon B. Johnson signed legislation into law that launched Medicaid, creating a U.S. health care safety net for millions of low-income Americans in what would become one of the crowning achievements of his domestic legacy.

FILE – President Lyndon B. Johnson uses the last of many pens to complete the signing of the Medicare Bill into law at the Truman Library in Independence, Missouri, July 30, 1965, with former President Harry S. Truman at his side. At rear are Lady Bird Johnson, Vice President Hubert Humphrey, and former first lady Bess Truman. (AP Photo, File)

A year earlier, he did the same for food stamps, drawing on President John F. Kennedy’s first executive order for the development of “a positive food and nutrition program for all Americans.”

This summer, with the stroke of a pen, President Donald Trump began to chisel them back.

The Republican Party’s big tax and spending bill delivered not just $4.5 trillion in tax breaks for Americans but some of the most substantial changes to the landmark safety net programs in their history. The trade-off will cut more than $1 trillion over a decade from federal health care and food assistance, largely by imposing work requirements on those receiving aid and by shifting certain federal costs onto the states.

While Republicans in Congress argue the trims are needed to rightsize the federal programs that have grown over the decades and to prevent rising federal deficits, they are also moving toward a long-sought GOP goal of shrinking the federal government and the services it provides.

“We’re making the first changes to the welfare state in generations,” House Speaker Mike Johnson said in a recent podcast interview.

As the tax breaks and spending cuts law begins to take shape, it is unleashing a new era of uncertainty for the safety net programs that millions of people in communities across the nation have grown to depend on, with political ramifications to come.

Big safety net changes ahead

Polling shows most U.S. adults don’t think the government is overspending on the programs. Americans broadly support increasing or maintaining existing levels of funding for popular safety net programs, including Social Security and Medicare, according to the poll from The Associated Press-NORC Center for Public Affairs Research.

Local governments are scrambling to figure out how they will comply with the new landscape, calculating whether they will need to raise their own taxes to cover costs, trim budgets elsewhere or cut back the aid provided to Americans.

Pediatrician Irving Phillips, left, examines a 16-month-old boy at a CommuniCARE+OLE clinic Thursday, June 26, 2025, in Davis, Calif. (AP Photo/Godofredo A. Vásquez)

“The cuts are really big, they are really broad and they are deeply damaging,” said Sharon Parrott, president of the Center for Budget and Policy Priorities, a research institute in Washington.

“The consequences are millions of people losing health care coverage,” she said. “Millions of people losing food assistance. And the net result of that is higher poverty, more hardship.”

At the same time, certain people who receive aid, including parents of teenagers and older Americans up to age 64, will have to prepare to work, engage in classes or do community service for 80 hours a month to meet new requirements.

All told, the nonpartisan Congressional Budget Office estimates 10 million more people will end up without health insurance. Some 3 million fewer people will participate in the Supplemental Nutritional Assistance Program, known as SNAP.

“People are really concerned what this means for their fiscal health,” said Mark Ritacco, chief governmental affairs officer at the National Association of Counties, which held its annual conference the week after Trump signed the bill into law.

The organization had pushed senators to delay the start dates for some Medicaid changes, and it hopes that further conversations with lawmakers in Congress can prevent some of them from ever taking hold. At its conference, questions swirled.

“We’re talking about Medicaid and SNAP — these are people’s lives and livelihoods,” Ritacco said.

GOP bill trims back health care and food aid

Republicans insist the law is adhering to Trump’s vow not to touch Medicaid as the changes root out waste, fraud and abuse. A memo from the House GOP’s campaign arm encourages lawmakers to focus on the popularity of its new work requirements and restrictions on benefits for certain immigrants.

“Those safety nets are meant for a small population of people — the elderly, disabled, young pregnant women who are single,” the House speaker said on “The Benny Show.”

He said the years since the Affordable Care Act, or Obamacare, came into law, “everybody got on the wagon.”

“All these young, able-bodied, young men who don’t have dependents, riding the wagon,” the speaker said.

Medicaid then and now

When President Johnson established Medicaid alongside Medicare — the health care program for seniors — as part of the Social Security Amendments of 1965, it was meant for low-income families as well as the disabled.

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And it quickly took off. Almost every state signed on to participate in Medicaid by 1970, according to the KFF, an organization focused on health policy. It soon went beyond covering its core population to include pregnant women, school-age children and not just the very poor but also those with incomes just over the federal poverty limit, which is now about $15,650 annually for a single person and $26,650 for a family of three.

In the 15 years since the Affordable Care Act became law under President Barack Obama, Medicaid has grown substantially as most states opted to join the federal expansion. Some 80 million adults and children are covered.

While the uninsured population has tumbled, the federal costs of providing Medicaid have also grown, to more than $880 billion a year.

“There are a lot of effects Medicaid has on health, but the most stark thing that it does is that it saves lives,” said Bruce D. Meyer, an economist and public policy professor at the University of Chicago who co-authored a pivotal study assessing the program.

The law’s changes will certainly save the federal government “a substantial amount of money,” he said, but that will come at “substantial increases in mortality. And you have to decide what you value more.”

Food stamps, which had been offered toward the end of the Great Depression but were halted during World War II amid rationed supplies, launched as a federal program when Johnson signed the Food Stamp Act of 1964 into law.

Today, SNAP provides almost $200 in monthly benefits per person to some 40 million recipients nationwide.

Democratic Leader Hakeem Jeffries, who delivered the longest speech in House history while trying to stall the bill, said the changes will hurt households and communities nationwide.

“Who are these people?” Jeffries said. “Ripping health care away from the American people. The largest cuts in Medicaid in American history. Ripping food out of the mouths of children, seniors and veterans who are going to go hungry as a result of this one big, ugly bill.”

CAMP RIPLEY — Taking shape and nearing the halfway point of completion, the Minnesota Military and Veterans Museum welcomed stakeholders to view its progress outside of Camp Ripley in central Minnesota.

On Wednesday, July 23, the museum gave three tours to around 50 key supporters and members of the media, who were given the opportunity to walk through the construction site, view the museum and hear about the plans for its space.

The Minnesota Military and Veterans Museum at Camp Ripley officially began construction north of Little Falls, Minnesota, on Aug. 1, 2024, following a ceremonial groundbreaking in September 2023. The facility and surrounding grounds are set for completion and grand opening in the summer of 2026 as the United States celebrates its 250th anniversary.

Randal Dietrich, executive director of the Minnesota Military and Veterans Museum, said the space had changed drastically over the last few years, noting the field used to be filled with sunflowers when they broke ground in 2023.

“What used to be a 32-acre sunflower field, donated to us by a local resident, has been a real game-changer for the museum, especially in terms of highway exposure and accessibility to our new museum,” Dietrich said. “Our current museum remains open to support veterans and their families and the general public. But concurrent with that, we’re also finishing up construction.”

He said the new museum will provide easy access to its space, as those who visit the current museum need to pass through a security checkpoint on Camp Ripley, since the museum is located inside its gates.

“Not going through the gate anymore, but simply pulling off the highway using the off ramp and being here in the midst of a lot of military history,” Dietrich said. “So a dramatic change for us to have much more space and much greater accessibility and visibility for what we’re doing.”

The museum will feature numerous macro artifacts, Dietrich said, as he pointed out the conning tower — or raised platform — of the decommissioned USS Minneapolis-Saint Paul, which will be part of an outdoor exhibit visible from the highway.

The museum website states the USS Minneapolis-Saint Paul was a nuclear-powered Los Angeles-class submarine in service between 1984 and 2008. Known with the hull classification of SSN-708, the submarine served with distinction in Operation Desert Shield and the First Gulf War. It was the first submarine to carry Tomahawk missiles specifically designated for use in strikes against Iraq.

The rudder and conning tower are surrounded by a 360-foot silhouette of the submarine rising out of the Minnesota prairie.

“Visitors will get a sense of that, the full length of that submarine, 360 feet, of what that submarine was,” Dietrich said. “Then, in coming to the museum, you’ll get to hear stories of Minnesotans who served on board that very submarine, and what that was like.”

The group was then led across the parade grounds on the south end of the building before entering the museum through what will eventually be its entrance.

As Minnesotans have served with distinction since the Civil War, Dietrich said the new museum will give them the opportunity to showcase Minnesota service through the years.

“The chance to move from a 5,000 square foot gallery space to a 40,000 square foot building is a game-changer,” Dietrich said.

Walking in through what would eventually become the front entrance, Dietrich pointed out that some of the offices at Camp Ripley would be moving over to the new museum building, such as a new ID card center and some environmental stewardship offices.

With metal studs taking shape to outline what will eventually be the different sections of the museum, Dietrich said they would have a Huey helicopter in their Vietnam exhibit to showcase what veterans dealt with in Vietnam.

“We’re working to tell their stories,” Dietrich said.

Dietrich said they had finished working on interviewing Paul Nakasone, a retired four-star general. He said Nakasone’s father had been having breakfast with his family on Pearl Harbor the morning of Dec. 7, 1941, and Paul Nakasone had been at the Pentagon the morning of Sep. 11, 2001.

“Telling those stories is really important to us,” Dietrich said. “That’s work’s worth doing, and that’s what we’re really about.”

Though it was just an empty space he was pointing to in the building, Dietrich said the area would have large glass windows to allow the public to observe the artifacts through a large window in their archive area.

There will be a private library space, suited for conversations with donors and family members who wish to view a family heirloom in private.

Day by day, the museum continues to take shape and as they grow closer to finishing the 40,000 square foot building, they will begin moving in exhibits that have yet to be seen by the public, as their current building limits all they can do and show.

The museum is planning to open in the summer of 2026. More information about the Minnesota Military and Veterans Museum can be found at mnvetmuseum.org.

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By MATTHEW PERRONE, AP Health Writer

WASHINGTON (AP) — The Food and Drug Administration’s polarizing vaccine chief is leaving the agency after a brief tenure that drew the ire of biotech executives, patient groups and conservative allies of President Donald Trump.

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Dr. Vinay Prasad “did not want to be a distraction” and was stepping down from his role as the FDA’s top vaccine regulator “to spend more time with his family,” a spokesperson for the Department of Health and Human Services said in a statement late Tuesday.

Two people familiar with the situation told The Associated Press that Prasad was ousted following several recent controversies. The people spoke on condition of anonymity to discuss internal personnel matters. Prasad did not immediately respond to requests for comment Wednesday morning.

Prasad joined the FDA in May after years as an academic researcher at the University of California San Francisco, where he frequently criticized the FDA’s approach to drug approvals and COVID-19 vaccines.

His contrarian approach appeared to match FDA Commissioner Marty Makary, who repeatedly praised Prasad’s work and intellect.

But in recent weeks Prasad became a target of right-wing activists, including Laura Loomer, who flagged Prasad’s past statements criticizing Trump and praising liberal independent Senator Bernie Sanders.

“How did this Trump-hating Bernie Bro get into the Trump admin???” Loomer posted on X last week.

Trump previously fired several national security officials a day after Loomer raised concerns about their loyalty.

Prasad also attracted scrutiny for his handling of a recent safety issue surrounding the only approved gene therapy for Duchenne’s muscular dystrophy.

Under his direction, shipments of the therapy were briefly halted after a series of patient deaths, then resumed late Monday following vocal pushback from families of boys with the fatal muscle-wasting disorder.

Prasad has long been skeptical of the therapy and other muscular dystrophy drugs sold by the drugmaker, Sarepta Therapeutics. As an academic, Prasad gained prominence by attacking the FDA for being too lenient in its standards for approving cancer drugs and other new therapies.

That approach is at odds with Trump’s Republican supporters, who generally favor speedier approvals and unfettered access to experimental treatments. During Trump’s first term he signed the “ Right to Try ” law, a largely symbolic piece of legislation that won popular support from conservatives seeking to give dying patients expanded access to unproven drugs.

Prasad’s decision to pause Sarepta’s therapy was criticized last week by a columnist and the editorial board of The Wall Street Journal.

Separately, Prasad’s division issued rejection letters this month to three small biotech firms seeking approval for new gene therapies.

Those therapies have been vigorously embraced many of the anti-abortion groups in Trump’s base for their potential to address intractable diseases that sometimes lead parents to terminate pregnancies.

Prasad’s predecessor in the role, Dr. Peter Marks, oversaw a dramatic rise in approvals for new gene therapies, which aim to treat or prevent disease by replacing or modifying a portion of patients’ genetic code.

Prasad has been an outspoken critic of Marks’ leadership at FDA, which included overseeing the approval of the first COVID vaccines and therapies.

The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

By STAN CHOE, Associated Press Business Writer

NEW YORK (AP) — U.S. stock indexes are drifting on Wednesday as Wall Street waits to hear from the Federal Reserve later in the afternoon about what it will do with interest rates.

The S&P 500 was edging up by 0.1% in early trading, coming off its first loss after setting all-time highs for six successive days. The Dow Jones Industrial Average was up 21 points, or less than 0.1%, as of 9:35 a.m. Eastern time, and the Nasdaq composite was adding 0.3%.

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The bond market saw a bit more action, where Treasury yields rose after a report suggested the U.S. economy’s growth was much stronger during the spring than economists expected. It grew at a 3% annual rate, according to an advance estimate, a full percentage point more than forecast. But underlying trends beneath the surface may be more discouraging.

“Cutting through the noise of the swings in imports, the economy is still chugging along, but it is showing signs of sputtering,” said Brian Jacobsen, chief economist at Annex Wealth Management.

It reinforces the dilemma facing the Fed as officials prepare to vote on what to do with interest rates. They could lower rates, which would give the boost to the economy. That’s what President Donald Trump has been angrily calling for. But lower rates could also give inflation more fuel when Trump’s tariffs may be set to increase prices for U.S. households on their own.

Trump on Wednesday announced a 25% tariff on imports coming from India, along with an additional tax because of its purchases of Russian oil, beginning on Aug. 1. That’s when stiff tariffs Trump has proposed for many other countries are also scheduled to kick in, unless they reach trade deals that lower the rates.

The widespread expectation on Wall Street is that the Fed will stay on hold with interest rates on Wednesday, as it’s been doing so far this year following its cuts late last year. Fed Chair Jerome Powell has been insisting that he wants to see more data about how tariffs are affecting inflation and economy before the central bank makes its next move.

The yield on the two-year U.S. Treasury note rose to 3.91% from 3.86% late Tuesday. It tends to closely follow expectations for what the Fed will do with its overnight interest rate.

The 10-year Treasury, which also takes into account longer-term expectations for the economy and inflation, edged up to 4.36% from 4.34%.

On Wall Street, stocks were mixed as most big U.S. companies continue to report profits for the spring that were bigger than analysts expected.

Humana rose 4.9% after the insurer and health care giant reported stronger results for the spring than expected. It also raised its forecasts for profit and revenue over the full year.

Starbucks reported a weaker profit than analysts expected as it tries to turn around its fortunes. But its stock nevertheless rose 1.6% amid hopes that improved store operations and new products — including a cold foam protein drink — will boost its performance.

Companies are under pressure to deliver solid profit growth. They need to in order to justify the big jumps in their stock prices during recent months, which has caused some critics to say they look too expensive.

On the losing end of Wall Street was Old Dominion Freight Line. The trucking company dropped 6.2% after reporting profit and revenue that came in just short of expectations. CEO Marty Freeman said the results “reflect the ongoing softness in the domestic economy” and that a tough operating environment “has persisted for longer than anticipated.”

In stock markets abroad, indexes were mixed across Europe and Asia. Hong Kong’s Hang Seng fell 1.4%, and South Korea’s Kospi rose 0.7% for two of the bigger moves.

AP Business Writers Matt Ott and Elaine Kurtenbach contributed.