Overview

• The reconciliation law signed July 4 introduces work requirements, a $35 Medicaid co-pay and shifts SNAP costs to states, with implementation set to begin in the coming months
• The Congressional Budget Office estimates up to 5 million Americans could lose Medicaid coverage and adds $3.4 trillion to the national debt over the next decade
• Health experts warn that added administrative hurdles may close rural hospitals, deepen coverage gaps and contribute to as many as 200,000 preventable deaths over ten years
• Republican officials express concern that cuts to Medicaid and food assistance could erode support and jeopardize the party’s slim House majority in the 2026 midterms
• Governors like Illinois’s J.B. Pritzker and nonprofit leaders are planning to plug funding shortfalls, with some states projecting backfill costs exceeding $1 billion