WASHINGTON (AP) — EDITORS/NEWS DIRECTORS:
In the summer of 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. 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, Congress approved President Donald Trump's big tax breaks and spending cuts bill that may bring some of the most significant changes yet to those landmark safety net programs. Trump signed the bill into law July 4.
The main goal was to extend some $4.5 trillion in tax breaks — and add new ones, including no taxes on tips and a larger deduction for some senior citizens. But the law will also cut more than $1 trillion over a decade from federal health care and food assistance, largely by imposing work requirements on those receiving aid, including certain older Americans up to age 64, and by shifting larger shares of the federal costs onto the states.
Local governments are scrambling to figure out how they will comply with the new landscape. If they have to cover potential new costs, they are calculating whether they will need to raise their own taxes, trim other programs or cut back the health care and food aid they provide to residents.
The nonpartisan Congressional Budget Office estimates 10 million more people will go without health insurance and some 3 million will no longer receive food stamps.
Here’s data and resources you can use to localize the projected impact of this law in your communities.
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READ AP’S STORY
Medicaid was signed into law 60 years ago. Trump’s big bill is chiseling it back
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CONSIDER THESE QUESTIONS
How are states, counties and service groups preparing for the One Big Beautiful Bill Act, or OBBBA? What approach is your state governor taking? Are state legislatures proposing changes?
With the federal government cutting funds for Medicaid health care and the Supplemental Nutritional Assistance Program, known as SNAP, local entities have choices ahead. The National Association of Counties has produced a report, “ The Big Shift ”, that outlines some of the questions facing local governments. You can find it here.
Will local governments be able to absorb costs? Or will they need to adjust their own budgets, services or taxes to provide services? How are local governments preparing to implement the new verification requirements for aid recipients?
Under the law certain people receiving Medicaid and food stamps will need to fulfill work requirements — 80 hours a month of work, training or community service. How will this work?
What are health care and food aid service providers saying? Check with local hospitals, clinics and food pantry services.
What are local state and county officials saying about how they will deliver health care, food aid?
Are any of these local governments or service organizations working with members of Congress to change any aspects of the law? Do they have enough time to prepare to make the changes?
For information on the various tax breaks in the bill, try Tax Policy Center, a think tank in Washington that is producing a number of reports and analyses of various provisions in new law.
What tax breaks will have the most impacts on families in your communities? Will they put extra money in people’s pockets?
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CONSIDER THESE RESOURCES
— The nonpartisan Congressional Budget Office provides overview data of the legislation analyzing its impacts on the federal budget.
— KFF, a health policy organization, has a number of tools available to dive into Medicaid. Here is an overview of Medicaid 101 from KFF, and also a map of the states with fact sheets on the types of services provided and residents enrolled in the health care program. You can use this link to see a KFF analysis on the latest figures from the Congressional Budget Office, after the act was passed.
— USDA, which oversees the food stamps program, has information on SNAP here.
— The Center for Budget and Policy Priorities, a think tank in Washington, has analyzed the law's expected impact on the Medicaid and food stamps programs. The food stamps information from CBPP can be found here.
— In addition, your elected officials at the federal, state and local level as well as the national associations of counties, cities and state legislatures can be potential resources.
— You can also reach out to associations of hospitals, clinics, nurses and other health care providers as well as groups that deliver food assistance, including food banks and pantries.
— The business community, including the area Chamber of Commerce, and other industry groups representing retailers, hotels or other local employers, are also a possible resource.
— You could ask an accountant or an accounting professor to help explain the impact of the tax policies on households, and the interaction between the tax breaks and the changes to Medicaid or food stamps.
— Here is recent polling on attitudes toward Medicaid and SNAP from The Associated Press-NORC Center for Public Affairs Research.
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SOME PREVIOUS AP COVERAGE OF THE LEGISLATION AND ITS IMPACT
Medicaid, food aid recipients worry about safety net cuts in bill sent to Trump
What’s in the latest version of Trump’s big bill that passed the Senate
Here’s how millions of people could lose health insurance if Trump’s tax bill becomes law
Americans want Medicaid and food stamps funding maintained or increased, AP-NORC poll shows
A look at how Trump’s big bill could change the US immigration system
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Localize It is a reporting resource produced by The Associated Press for its customers’ use. Questions can be directed to the Local News Success team at localizeit@ap.org.
