A wave of uncertainty and fear is spreading among millions of Medicaid and Supplemental Nutrition Assistance Program (SNAP) beneficiaries in the United States following the implementation of the new tax law signed by President Donald Trump last week.
The norm, which includes deep cuts to social spending and new requirements to access basic health and food benefits, threatens to leave millions of low-income individuals without medical coverage or food assistance, many of whom are precarious workers, people with chronic illnesses, and single-parent families.
Stricter requirements, fewer beneficiaries
One of the most controversial changes is the imposition of mandatory work requirements for adults aged 19 to 64 who apply for or maintain Medicaid.
To maintain your coverage, you must demonstrate that you are working, studying, or completing at least 80 hours of community service each month.
A similar rule will apply to SNAP beneficiaries, previously known as the "Food Stamp Program," extending the age requirement to comply with this mandate up to 65 years old.
Although there are exceptions -such as for individuals with children under 14 years old- advocates for social rights warn that many will lose their access to these programs due to bureaucratic reasons or because they cannot meet the new standards, even if they legally qualify.
The Congressional Budget Office estimates that up to 11.8 million people would lose Medicaid before 2034.
This includes those who could be excluded from SNAP for failing to submit documentation on time or due to errors in the state systems.
"I am in panic": the human impact of the law
Amanda Hinton, 39 years old, a resident of Missouri and a fibromyalgia patient, expressed her distress to Univisión: "I am in panic. I have incurable chronic illnesses and I depend on my medications to get through the day. Without Medicaid, I wouldn’t be able to afford them."
Cases like yours are common among those who fear they might not meet the requirements or be excluded due to administrative shortcomings.
Julia Bennker, a home caregiver in Wisconsin, shared that she lost her health coverage for a month due to delays in paperwork, which meant being without treatment for a month and forced her to reschedule her appointment with a doctor.
More bureaucracy and less access
One of the most criticized points by experts is the increase in bureaucracy.
According to the new law, eligibility must be reassessed every six months, which increases the administrative burden and the risk of people being excluded from the system due to simple procedural errors.
"For every additional document that someone has to present, people get lost," noted Deborah Steinberg, an analyst at the Center for Legal Action.
Moreover, many conditions such as mental illnesses or substance use disorders are not yet properly recorded in the state Medicaid systems, complicating the exemptions.
States and hospitals under pressure
States must implement the Medicaid work requirement by 2027.
Regarding SNAP, the law requires them to assume a greater portion of the program's administrative costs before 2027 and to pay part of the food assistance benefits starting in 2028.
"It will be a very tight and difficult timeline for many of these states," stated Sophia Tripoli, senior director of health policies at Families USA, a health advocacy organization.
Legal organizations anticipate an increase in the number of people leaving programs due to frustration with the system.
On the other hand, rural hospitals could be financially overwhelmed.
The NGO KFF estimates that Medicaid spending in rural areas will decrease by over $155 billion in the next decade, which could lead to numerous closures.
What does the controversial law One Big Beautiful Bill cover?
President Trump signed on Friday the ambitious bill One Big Beautiful Bill, which will extend tax cuts and gradually implement cuts to Medicaid.
Trump signed the "great and beautiful piece of legislation" at an event held at the White House on the occasion of Independence Day in the United States.
It is a controversial piece of legislation that represents a significant restructuring of the country's fiscal, social, and national security policies.
Among the main points of the law are the tax reforms, which permanently extend the tax cuts implemented in 2017 during Trump's first term, exempting tips and overtime from taxes for workers earning less than $150,000 a year.
It also creates what are known as Trump Accounts for savings, offering tax benefits for education, housing, or job training; increases the child tax credit to $2,500 until 2028; allows for the deduction of up to $10,000 in interest on loans for domestically manufactured cars; and raises the deduction limit for state and local taxes (SALT) to $40,000 for individuals earning less than $500,000 annually.
The OBBB allocates more than $150 billion to the military budget and $170 billion for border security.
It also includes cuts to social programs, including over $1.2 billion in federal spending, mainly on Medicaid. It imposes work requirements to receive medical assistance, reduces subsidies for the Supplemental Nutrition Assistance Program (SNAP), and gradually eliminates tax incentives for renewable energy.
Frequently Asked Questions about Trump's New Law and Its Impacts on Medicaid and SNAP
What are the main changes in Medicaid and SNAP under the new Trump law?
The new law introduces mandatory work requirements for adults between the ages of 19 and 64 who wish to access Medicaid and SNAP, requiring proof of employment, education, or completion of at least 80 hours of community service per month. Additionally, bureaucracy is increased by necessitating eligibility reassessments every six months, which could leave many without coverage due to administrative errors.
Who will be most affected by the changes in Medicaid?
The people most affected by changes in Medicaid are those with low incomes, including precarious workers, individuals with chronic illnesses, and single-parent families. It is estimated that up to 11.8 million people could lose their Medicaid coverage before 2034 due to new requirements and cuts.
How will the new law affect immigrants with legal status?
The new law restricts access to SNAP for certain legally present immigrants, including those under asylum and humanitarian parole. This explicitly excludes those who have been admitted under these categories, who would lose the ability to receive federal food assistance.
What impact will this law have on rural states and hospitals?
States will need to implement work requirements for Medicaid and take on more administrative costs for SNAP, posing a significant financial challenge. Rural hospitals could face Medicaid spending cuts exceeding $155 billion over the next decade, which could lead to widespread closures.
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