What Trump's ‘beautiful bill' means for Medicaid, food stamps, and Massachusetts

Boston Globe

24-05-2025

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This disruption of the social safety net could cost Massachusetts more than
$1.5 billion a year by increasing state contributions for these benefits and penalizing the state for
continuing to
use its own funds to
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House Republicans say the restrictions in President Trump's
The extension of the tax credits in the bill would also disproportionately benefit the wealthiest Americans. The fifth of residents earning the least would get just 1 percent of the bill's net tax cuts next year, according to the
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'The purpose of this bill is to give tax cuts to the richest people in the country,' said Viviana Abreu-Hernandez, president of the Massachusetts Budget and Policy Center. 'They are doing this by cutting the budget for services that the most vulnerable populations in the country need to be able to survive.'
The bill would require
Work requirements don't increase employment, however, according to
Work requirements would also be levied on more recipients of the Supplemental Nutrition Assistance Program. In addition to those already required to work, recipients with children above the age of 6, including grandparents up to age 65, would have to work — or be enrolled in job training or community service — at least 20 hours a week to receive benefits for more than three months. For parents who can't afford child care or don't have transportation, this is untenable, advocates say.
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Immigrants here legally would also become ineligible for SNAP under the House bill. Undocumented immigrants are already barred from benefits.
All told, more than 250,000 Massachusetts residents, including children, are at risk of losing some or all of their SNAP benefits, according to the
For the first time in the program's history, states would have to pay for a portion of SNAP benefits, ranging from 5 to 25 percent, depending on their payment error rate. States' share of administrative costs would also rise, from 50 to 75 percent. The federal SNAP program, known colloquially as food stamps, has been a stabilizing force during recessions, supporting families and, in turn, local economies when state resources are dropping.
In Massachusetts, SNAP adds more than $2.6 billion a year to the economy, benefiting more than 5,500 farmers and retailers. The proposed cuts — which Erin McAleer, chief executive of the anti-hunger nonprofit
Project Bread calls 'the most devastating attack on food assistance in our lifetime' — would force the state to absorb $710 million in new costs each year, the organization said.
Some states might even opt to stop offering SNAP benefits entirely.
With fewer people on MassHealth, hospitals, nursing homes, and community health centers would get less revenue; people would get sicker and crowd emergency rooms — changes that would also impact patients without MassHealth.
Administrative costs for tracking work requirements, more frequent eligibility renewals, and other changes will put an additional burden on state coffers. To compensate for these changes, states may cut back on benefits or tighten eligibility requirements, advocates said. Some might raise taxes.
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What isn't in doubt is the effect the bill could have on income inequality.
The House measure would decrease household resources in the lowest tenth of the income distribution by 2 to 4 percent over the next eight years — mainly due to the loss of Medicaid and SNAP — and increase resources for households in the top 10 percent by the same margin — largely because of tax reductions — according to the
'It's going to make sick people sicker,' said Kate Symmonds, a senior health law attorney at the Massachusetts Law Reform Institute. 'It's going to make poor people poorer. … It's going to make wealthy people richer.'
Regardless of what the Senate does, the bill will cause harm, said Victoria Negus, senior economic justice advocate at the institute, following an election in which one of voters' biggest concerns was the cost of groceries.
'This package as a whole says to the American people: We are prioritizing the needs of the wealthy and the few, the well connected and the privileged, over every family in this country who is working hard to get by and does not make enough money to put food on the table or afford health care,' she said. 'It is a monumental step back in efforts to end hunger and poverty and
improve health outcomes.'
This story was produced by the Globe's
team, which covers the racial wealth gap in Greater Boston. You can sign up for the newsletter
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Katie Johnston can be reached at