President Donald Trump upholds the “One Big Beautiful Act” he signed on the South Lawn of the White House on July 4, 2025 in Washington, D.C. (Photo by Alex Brandon – Pool/Getty Images)
Last weekend’s 250th Independence Day celebration also marked another anniversary: one year after President Donald Trump signed HR 1, also known as the One Big Beautiful Act.
Many sweeping policy changes, including work requirements for some Medicaid beneficiaries and reduced federal aid for administering food benefits, have not yet taken effect. However, the state Department of Human Services estimates that approximately 98,000 Pennsylvanians no longer receive food benefits due to newly imposed legal requirements.
Between July 2025 and May 2026, the most recent month available, enrollment in the Supplemental Nutrition Assistance Program dropped from 1.96 million to 1.74 million, an 11% decline. DHS attributed less than half of these losses to HR 1.
Federal funding for rural health care in Pennsylvania does not compare to the projected loss of Medicaid
Pennsylvania had one of the highest SNAP participation rates nationally in 2022 (the latest data available), meaning almost every eligible resident participated in the program. In the Community, more than half of the beneficiaries are families with children.
Democratic U.S. Rep. Brendan Boyle (PA-2) called the law “morally, ethically and economically the exact opposite” of the sesquicentennial celebration during a press conference call with supporters on Wednesday.
“In fact, we have the largest tax cuts for billionaires in American history, worth over $5 trillion, paid for by the deepest cuts to health care and food aid in American history,” Boyle said. “This bill was really the reverse of Robin Hood: stealing from the poor, taking away their health care (and) food assistance, in order to give money to the ultra and mega rich.”
This fall, Pennsylvanians using the program who have not started documenting time spent working, volunteering or studying may lose their benefits if they do not work at least 20 hours a week. Parents with children under 14 and people with certain disabilities were exempt.
Veterans and former foster care recipients who previously held a pass are also no longer exempt from additional requirements.
Republicans later renamed the bill the Working Families Tax Cuts Act because adopted permanently Trump complied with the tax brackets in 2017 and saved taxpayers an average of $800.
The nonpartisan Congressional Budget Office estimated it would add that $3.4 trillion to the public deficit over the next decade, or $4 trillion when interest on the national debt is included. Progressives have repeatedly criticized the bill for disproportionately benefiting the wealthiest through its focus marginal tax rates and property taxes — although it also eliminates taxes on tips and overtime.
What’s next?
States have yet to feel the biggest impact, primarily from dwindling federal funding for SNAP and Medicaid. In the first case, Pennsylvania and other states would have to foot most of the bill for administrative costs, as much as $400 million.
The community still has time to reduce it Error rate 9.21%. before the penalties take effect next fall and reduce their impact, but the same cannot be said for Medicaid.
Felix White of Montgomery County said Medicaid covers his health expenses for lung disease and diabetes while he cares for his 92-year-old mother.
“I went to college to get a degree in computer science and was hired until a few years ago. I was looking for a job, but over the years my field was changing rapidly and it was very difficult to find a job at my age,” said White, 62. “I currently mow a few lawns and do any odd jobs I can.”
He credited Medicaid for covering his blister-related hospitalization, saying that without his policy, “I would have lost my foot.”
“There is no way I would be able to pay to see a doctor or buy medications,” White continued. “Thanks to Medicaid, I managed to control type 1 diabetes, but I still live in fear of the disease (lung) and the complications it brings. Medicaid saves lives, and losing it would be a death sentence for me.”
State officials estimate Pennsylvania could lose as much as $20 billion over the next decade, while other sources cite a reduction from $34 to $57 billion. Some of that amount will be offset by incoming rural health dollars, though advocates fear it won’t be enough to prevent hospital closures.
That’s what advocates say most people enrolled in Medicaid able to work have a job or other life situation – e.g. parenthood or education – that prevents them from participating in the labor market. They compare the novel work rules to “paperwork requirements,” calling them “significant obstacles” to health insurance.
“Medicaid is the backbone of our behavioral healthcare system. When people lose that protection, they lose access to treatment,” said Jeannine Lisitski, CEO of Mental Health Partnerships, which specializes in treating substance utilize disorders. “People don’t stop experiencing mental health or substance use disorders just because they lose their insurance, they stop getting their medications.”
She continued that the loss of coverage could have a domino effect, resulting in the loss of health care providers and systems that power communities and the economy. Several others noted concerns about the newly published definitions of medical frailty, which the state seeks to overthrow.
AND the latest RAND analysis projects that by 2034, there will be 7.6 million fewer people enrolled in Medicaid, including nearly 370,000 Pennsylvanians. It was also estimated that the implementation of various regulations – including, among others, work requirements and more repeated background checks – will cost the state nearly $15 billion over that time.
“I’m really concerned about our health care systems, especially in rural and urban areas. They won’t be able to withstand the full amount of these cuts when the bill is finally implemented,” Boyle said.
Medicaid work requirements go into effect in January 2027.
