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Although President Donald Trump’s “One Big Beautiful Bill Act” offers new tax deductions and credits across different income levels, low-income households – the bottom 20% of income earners – are largely excluded from any significant tax benefits. 

“It’s particularly shocking because the law is so big,” said Elaine Maag, a senior fellow at The Urban-Brookings Tax Policy Center. “Typically, when trillions of dollars are spent, you see it really spread across the income distribution.”

The bill was signed into law over the summer.

Benefits that people with low incomes do receive may be outweighed when considered alongside other provisions in the bill, said Andrew Reschovsky, professor emeritus of public affairs and applied economics at the University of Wisconsin-Madison.

This is especially true of cuts to safety net programs such as Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, Reschovsky said.

“This is the dilemma – if you count those things in with the tax side, the net will be that a lot of people are going to be worse off.”

Credits and deductions

A credit is an amount subtracted directly from the tax you owe while a deduction reduces the amount of income that can be taxed. Both can help keep more money in taxpayers’ pockets. 

The bill establishes new credits and deductions. 

The bill increases the: 

• Child Tax Credit from $2,000 per qualifying child to $2,200.  
• Child and Dependent Care Credit, which allows taxpayers to subtract certain costs associated with caring for children under 13 or dependents incapable of self-care. 

The bill introduces new deductions for:

• Workers in jobs where tips are common, allowing them to deduct up to $25,000 of tip income. 
• Individuals who work overtime, allowing them to deduct up to $12,500 of overtime pay. 
• People 65 and older, allowing them to deduct $6,000. 

Limitations

These changes may appear to help people who are financially struggling. But the bill affects federal taxes, so its new deductions and credits apply only to income taxable by the federal government. 

People with low income generally owe little or no federal income tax. 

Older low-income adults, for example, often rely primarily or entirely on Social Security benefits and are generally not subject to federal taxes. This means that a new $6,000 deduction would not benefit them, Rechovsky said.   

Rechovsky noted other reasons the new deductions are misleading or extremely narrow. 

“Yes, you’re a waiter and you benefit from not paying taxes on your tips,” he said. “But take someone in the same income range who works as a home health care worker – they don’t benefit at all.” 

Reschovsky also questions how those with low incomes would benefit from reducing the amount owed on overtime pay. 

“One of the reasons some people are low-income is that they’re lucky to get a 40-hour workweek,” he said. 

The same limitation applies to the new credits. 

An analysis by Maag estimates that in 2025 about 17 million children under 17 – or one in four – will receive less than the full value of the Child Tax Credit because their parents earn too little.

The bill also changes which families qualify based on citizenship status.  

The Child Tax Credit will be limited to children who are U.S. citizens and have at least one parent with a valid Social Security number. 

About 2 million U.S. citizen children will lose their Child Tax Credit because of this new requirement, Maag wrote, citing an analysis from the Joint Committee on Taxation. 

Safety nets

One benefit to people with low incomes from the bill is that it makes permanent many provisions from the 2017 Tax Cuts and Jobs Act, including lower income tax rates and larger standard deductions. 

“It’s true across the board that if taxes go down, your income after taxes goes up,” Reschovsky said. 

But for those with low incomes, the increase is minimal and will likely be outweighed by changes to Medicaid, premium subsidies provided by the Affordable Care Act and changes to SNAP. 

For example, the lowest 10% of earners may see a $1,600 reduction in annual income and benefits, mainly due to cuts in Medicaid and SNAP, according to the nonpartisan Congressional Budget Office. 

“It’s just that classic view … that, ‘Well, these people are just sucking on the teat of the federal government, so we’re going to just make it as hard as possible for them to do that, because they’re just freeloaders,’” said Anthony Myers, program director of the Riverworks Financial Clinic.

Where to get help

For people with incomes under $67,000, free tax assistance is available through programs such as the IRS’ Volunteer Income Tax Assistance, or VITA. 

VITA sites can be found using the IRS Free Tax Prep Help website. 

Maag and Myers recommend making appointments as soon as possible. 

In addition to serving as a VITA site, Riverworks Financial Clinic operates year-round as the City of Milwaukee Financial Empowerment Center. 

Residents of the city who are 18 years and older can get free one-on-one financial counseling there. 

“Anyone that’s struggling with any of these (One Big Beautiful Bill Act) provisions, we can assist them with navigating through this,” Myers said. 

Here’s how Trump’s new tax law affects people with low incomes is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Jess Deis, a nurse practitioner and nurse midwife in Kentucky and Indiana, learned she had cervical cancer after she qualified for Medicaid insurance in 2014. (Sarah Ladd/Kentucky Lantern)

Third in a five-part series.

It had been a decade since Jess Deis’ last women’s wellness exam when Kentucky expanded Medicaid and she finally qualified for the state insurance program.

Physicians recommend a cervical cancer screening — also referred to as a Pap smear, which is a swab of the cervix — as part of a wellness exam once every three to five years for women between the ages of 21 and 65. Deis, 43, was in her last semester of nursing school in 2014 when the test came back with abnormal results. Her doctor ordered additional testing.

“Then I got a call on a Sunday evening from a physician letting me know I had cervical cancer and I needed to see a specialist,” Deis said.

Cervical cancer is one of few cancers that has a known path of prevention after the approval of the first HPV vaccine in 2006. But that also means it falls at the intersection of three cultural issues that are facing strong political opposition — broad access to low-cost or free reproductive health care, access to vaccines for children, and sex education.

Kentucky had the highest cervical cancer incidence rate in the country between 2015 and 2019, according to medical research, and a mortality rate twice as high as the rest of the country. The state tied with West Virginia for the second-highest rate of 9.7 cases per 100,000 residents between 2017 and 2021. Oklahoma topped the list for that five-year period with 10.2 cases per 100,000, according to the National Cancer Institute.

Deis delayed the surgery to remove her uterus until after graduation, and later became a certified nurse practitioner. Now she provides Pap smears to patients multiple times a day at Planned Parenthood clinics in Kentucky and Indiana and other care via telehealth. She recently helped a patient who hadn’t been seen for a screening in 15 years discover she had advanced cervical cancer.

She is troubled by what could happen in the wake of the new Medicaid rule passed by Congress and signed by President Donald Trump in July that barred nearly all Planned Parenthood affiliates from receiving Medicaid reimbursements because some clinics in the nonprofit network provide abortions. Kentucky and Indiana both have abortion bans, but still have Planned Parenthood clinics to provide other reproductive health care.

“I don’t just worry; I know that there’s going to be more folks with stories like mine, but without the happy ending,” Deis said.

‘What we’re really talking about is our daughters getting cervical cancer’

The American Cancer Society recently reported the number of early cervical cancer cases has declined sharply among young people since the vaccine’s introduction nearly 20 years ago. But vaccine adoption rates for children are low in the states where rates are highest — about one-third of boys and girls between the ages of 13 and 17 were vaccinated in Mississippi as of 2020.

The vaccine is most effective when given before engaging in any kind of sexual activity for the first time, because it can prevent the sexually transmitted strains of HPV that present the highest risk of cervical cancer. More than 98% of cervical cancer cases are caused by HPV, and a 2024 study from the Journal of the National Cancer Institute found zero cases of cervical cancer in Scottish women born between 1988 and 1996 who were fully vaccinated against HPV between the ages of 12 and 13.

“We could make (cervical cancer) an eradicated disease,” said Dr. Emily Boevers, an Iowa OB-GYN. “But everything is falling apart at the same time.”

Boevers said limitations on Medicaid coverage and the loss of Title X family planning funding will make screenings and vaccines less accessible for the populations that need them the most, even if clinics don’t close as a result. But it will take years to see the consequences of these changes, she said, because it takes about 15 years on average for HPV to become cancer. 

“So what we’re really talking about is our daughters getting cervical cancer,” she said. 

Kentucky’s legislature acknowledged the importance of HPV vaccines as recently as 2019, when representatives passed bipartisan House Resolution 80, which encouraged females and males between the ages of 9 and 26 to get the HPV vaccine and everyone to “become more knowledgeable of the benefits of the vaccine.” Only four legislators voted against it.

But today, the U.S. Department of Health and Human Services is led by Secretary Robert F. Kennedy Jr., who has made false statements about the HPV vaccine’s safety and effectiveness and played a leading role in organizing a mass lawsuit against one of the vaccine’s manufacturers, Merck. The Associated Press reported the judge dismissed more than 120 claims of injuries from Gardasil, the name of one HPV vaccine, because of a lack of evidence. 

“Secretary Kennedy supports renewing the focus on the doctor-patient relationship and encourages individuals to discuss any personal medical decisions, including vaccines, with their healthcare provider,” a Health and Human Services spokesperson wrote to States Newsroom in September. “The American people voted for transparency, accountability, and the restoration of their decision-making power, and that is exactly what HHS is delivering.”

The response did not clarify whether Kennedy still thinks the vaccine is unsafe and what basis there is for that claim. 

Dr. Linda Eckert, a University of Washington School of Medicine professor and practicing OB-GYN, has an extensive background in immunizations and cervical cancer prevention. She served as a liaison for the American College of Obstetricians and Gynecologists to the CDC’s Advisory Committee on Immunization Practices until 2024. Members of the committee were recently dismissed by Kennedy’s agency and replaced by new members, several of whom have reportedly expressed anti-vaccine views. Eckert said the group had plans in motion to present to the ACIP in June a case for administering the HPV vaccine at the earliest age of 9 before it was disbanded. 

Although Black and Hispanic women are affected by cervical cancer at disproportionate rates because of systemic inequities, Eckert said the fastest rising group experiencing late-stage cancer is white women in the Southeast. But she added that Alabama was the first state in the country that launched a targeted campaign to eliminate cervical cancer. 

Treatment for the cancer once it develops can also be difficult to obtain, Eckert said. It can be expensive and require many follow-up visits, and usually leads to infertility either through hysterectomy or invasive radiation treatments. 

“It is a really devastating disease to treat,” Eckert said. “Even if you live, you are permanently changed.”

Recent study showed zero cases of cervical cancer after HPV vaccine 

Dr. Aisha Mays, founder and CEO of a Dream Youth Clinic in Oakland, California, said the services her clinic offers to young people for free includes most of the same services that Planned Parenthood clinics provide, including the HPV vaccine.

“That’s the work of Planned Parenthood and clinics like mine that are encouraging and doing regular Pap smear screenings and vaccines, and having really clear conversations with young people around the importance of these procedures,” Mays said.

The recent turn against vaccines by some segments of the public and members of President Donald Trump’s cabinet who doubt their effectiveness and baselessly claim that they cause injury and developmental issues like autism has made the promotion of HPV vaccines more difficult for Mays. Overwhelming evidence, including from the Centers for Disease Control and Prevention, shows that they are safe and effective.  

The vaccine can also protect against genital warts, anal cancer and oropharyngeal cancer, Mays said. There are about 40 strains of HPV in total that are known to infect the genitals, and more that can attach to certain patches of skin. Most people who have sex will come in contact with one or more of the strains by the time they reach their mid-20s or early 30s.

Mays’ clinic is largely funded by state and local grants, but it received more than $100,000 in federal funding for a sexual health education program through the U.S. Department of Health and Human Services’ Office of Population Affairs. It was a nationally distributed podcast hosted by adolescents, Mays said, and they chose topics to talk about related to sexual health, including HPV.

The program’s grant was one of many that have been cancelled under the Trump administration. An objective laid out in Project 2025, the blueprint document for the next Republican presidency written by conservative advocacy group the Heritage Foundation, was to ensure no subgrantees of sex education programs were promoting abortion or “high-risk sexual behavior” among adolescents. It also stated that any programming should not be used to “promote sex.”

HHS also terminated funding for one of California’s sexual health programs in August over the state’s refusal to remove references in the programming related to gender, including the idea that biological sex and gender identity are distinct concepts. Another directive of Project 2025 was to make sure biological sex is never conflated with gender identity or sexual orientation.

States with high rates of cervical cancer have low density of physicians

States with the lowest incidences of cervical cancer, including Massachusetts, New Hampshire, Connecticut and Minnesota, also have the highest density of physicians per capita. According to the Association of American Medical Colleges’ state physician workforce data, Massachusetts has the highest number of physicians per 100,000 people, and Oklahoma ranks in the bottom three.

Kentucky is in the bottom 15, and so is Indiana, where Marissa Brown works as a Planned Parenthood health center manager in Bloomington. Brown described her clinic as “an oasis in a desert” because there are few options for gynecological care in the area, and even fewer for obstetrics. Brown said they routinely see patients from rural areas two or more hours away, and many of them are coming for wellness exams that include cancer screenings.

Indiana used to have 38 Planned Parenthood clinics, but through 15 years of funding cuts and targeted anti-abortion legislation, the organization closed 21 of them between 2002 and 2017. In the years since then, another seven shut down to consolidate services. Many of them did not provide abortions.

“We hear a lot about patients coming in who can’t get into their gynecologist for four to 12 weeks,” Brown said. “We can do that in a few days to two weeks, and we have walk-in appointments too.”

Health Imperatives, a nonprofit network of seven community health clinics in southern Massachusetts, can no longer bill for Medicaid because they provide medication abortions and received about $800,000 in reimbursements for other services in 2023, like Planned Parenthood. One of Health Imperatives’ clinics is in Martha’s Vineyard, whose working-class residents have to work three to four jobs just to afford to live on the affluent island, said Julia Kehoe, the organization’s president and CEO.

More than a decade ago, she said she noticed a pattern: Their patients would come in for an annual gynecological exam, receive an abnormal cervical cancer screening, but not follow up, because the closest available specialist would require expensive travel off the island. Kehoe said that once their Martha’s Vineyard clinic purchased a colposcopy machine, from privately raised funds, in 2012, they started diagnosing some of their regular patients with now-advanced cancer.

“In the first year that we did colposcopies, we found four individuals who had stage three or four cancer, who we luckily were then able to connect up to Boston for critical care,” she said. “But if we had had that capacity earlier … we would have caught it earlier.”

States Newsroom reproductive rights reporter Sofia Resnick contributed to this report.

Coming Thursday: Telemedicine could help narrow the care gap in rural communities.

The U.S. Capitol in Washington, D.C., is pictured on Tuesday, Feb. 25, 2025. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — Congress’ failure to pass a short-term government funding bill before midnight Tuesday will lead to the first shutdown in nearly seven years and give President Donald Trump broad authority to determine what federal operations keep running — which will have a huge impact on the government, its employees, states and Americans. 

A funding lapse this year would have a considerably wider effect than the 35-day one that took place during Trump’s first term and could last longer, given heightened political tensions. 

The last shutdown didn’t affect the departments of Defense, Education, Energy, Health and Human Services, Labor and Veterans Affairs, since Congress had approved those agencies’ full-year funding bills.

Lawmakers had also enacted the Legislative Branch appropriations bill, exempting Capitol Hill from any repercussions. 

That isn’t the case this time around since none of the dozen government spending bills have become law. That means nearly every corner of the federal government will feel the pain in some way if a compromise isn’t reached by the start of the fiscal year on Oct. 1. 

States Newsroom’s Washington, D.C. Bureau offers you a quick guide to what could happen if Republicans and Democrats don’t broker an agreement in time.

How does the White House budget office determine what government operations are essential during a shutdown?

Generally, federal programs that include the preservation of life or property as well as those addressing national security continue during a shutdown, while all other activities are supposed to cease until a funding bill becomes law. 

But the president holds expansive power to determine what activities within the executive branch are essential and which aren’t, making the effects of a shutdown hard to pinpoint unless the Trump administration shares that information publicly. 

Presidential administrations have traditionally posted contingency plans on the White House budget office’s website, detailing how each agency would shut down — explaining which employees are exempt and need to keep working, and which are furloughed. 

That appears to have changed this year. The web page that would normally host dozens of contingency plans remained blank until late September, when the White House budget office posted that a 940-page document released in August calls for the plans to be “hosted solely on each agency’s website.”

Only a few departments had plans from this year posted on their websites as of Friday afternoon.

The White House budget office expects agencies to develop Reduction in Force plans as part of their shutdown preparation, signaling a prolonged funding lapse will include mass firings and layoffs.

While the two-page memo doesn’t detail which agencies would be most affected, it says layoffs will apply to programs, projects, or activities that are “not consistent with the President’s priorities.”

Trump will be paid during a shutdown since Article II, Section 1, Clause 7 of the Constitution prevents the president’s salary from being increased or decreased during the current term.

No one else in the executive branch — including Cabinet secretaries, more than 2 million civilian employees and over 1 million active duty military personnel — will receive their paycheck until after the shutdown ends. 

Are federal courts exempt from a shutdown since they’re a separate branch of government?

The Supreme Court will continue to conduct normal operations in the event of a shutdown, according to its Public Information Office. 

The office said the court “will rely on permanent funds not subject to annual approval, as it has in the past, to maintain operations through the duration of short-term lapses of annual appropriations,” in a statement shared with States Newsroom. 

As for any impact on lower federal courts, the Administrative Office of the U.S. Courts said the federal judiciary was still assessing the fiscal 2026 outlook and had no comment. 

The office serves as the central support arm of the federal judiciary. 

During the last government shutdown from late 2018 into early 2019, federal courts remained open using court fee balances and “no-year” funds, which are available for an indefinite period. 

The Administrative Office of the U.S. Courts has said that if those funds run out, they would operate under the terms of the Anti-Deficiency Act, which “allows work to continue during a lapse in appropriations if it is necessary to support the exercise of Article III judicial powers.” 

Supreme Court justices and appointed federal judges continue to get paid during a government shutdown, as Article III of the Constitution says the judges’ compensation “shall not be diminished” during their term.

What happens to Social Security, Medicare and Medicaid?

The three programs exist largely outside of the annual appropriations process, since lawmakers categorized them as “mandatory spending.” 

This means Social Security checks as well as reimbursements to health care providers for Medicare and Medicaid services should continue as normal.

One possible hitch is the salaries for people who run those programs are covered by annual appropriations bills, so there could be some staffing problems for the Social Security Administration and the Centers for Medicare and Medicaid Services, depending on their contingency plans. 

The first Trump administration’s shutdown guidance for the Social Security Administration showed 54,000 of 63,000 employees at that agency would have kept working. The CMS plan from 2020 shows that it intended to keep about 50% of its employees working in the event of a shutdown. Neither had a current plan as of Friday.

Will the Department of Veterans Affairs be able to keep providing health care and benefits?

Veterans can expect health care to continue uninterrupted at VA medical centers and outpatient clinics in the event of a shutdown. Vets would also continue to receive benefits, including compensation, pension, education and housing, according to the Department of Veterans Affairs contingency planning for a funding lapse that is currently published on the department’s website. It’s unclear if the plan will be the one the Trump administration puts into action.

But a shutdown would affect other VA services. For example, the GI Bill hotline would close, and all in-person and virtual career counseling and transition assistance services would be unavailable.

Additionally, all regional VA benefits offices would shutter until Congress agreed to fund the government. The closures would include the Manila Regional Office in the Philippines that serves veterans in the Pacific region.

All department public outreach to veterans would also cease.

Will Hubbard, spokesperson for Veterans Education Success, said his advocacy organization is bracing for increased phone calls and emails from veterans who would normally call the GI Bill hotline.

“Questions are going to come up, veterans are going to be looking for answers, and they’re not going to be able to call like they would be able to normally, that’s going to be a big problem,” Hubbard said.

“Most of the benefits that people are going to be most concerned about will not be affected, but the ones that do get affected, for the people that that hits, I mean, it’s going to matter a lot to them. It’s going to change the direction of their planning, and potentially the direction of their life,” Hubbard said.

The Department of Veterans Affairs and the Office of Management and Budget did not respond to a request for current VA shutdown guidance.

What happens to immigration enforcement and immigration courts? 

As the Trump administration continues with its aggressive immigration tactics in cities with high immigrant populations, that enforcement is likely to continue during a government shutdown, according to the Department of Homeland Security’s March guidance for operating in a government shutdown.

Immigration-related fees will continue, such as for processing visas and applications from U.S. Citizenship and Immigration Services. 

And DHS expects nearly all of its U.S. Immigration and Customs Enforcement employees to be exempt — 17,500 out of 20,500 — and continue working without pay amid a government shutdown. 

That means that ICE officers will continue to arrest, detain and remove from the country immigrants without legal status. DHS is currently concentrating immigration enforcement efforts in Chicago, known as “Operation Midway Blitz.”

Other employees within DHS, such as those in Transportation Security Administration, will also be retained during a government shutdown. There are about 58,000 TSA employees that would be exempt and continue to work without pay in airports across the country.  

DHS did not respond to States Newsroom’s request for a contingency plan if there is a government shutdown.

Separately, a shutdown would also burden the overwhelmed immigration court system that is housed within the Department of Justice. It would lead to canceling or rescheduling court cases, when there is already a backlog of 3.4 million cases.

The only exceptions are immigration courts that are located within Immigrations and Customs Enforcement, or ICE, detention centers, but most cases would need to be rescheduled. The partial government shutdown that began in December 2018 caused nearly 43,000 court cases to be canceled, according to a report by Syracuse University’s Transactional Records Access Clearinghouse, or TRAC.

And 28 states have an immigration court, requiring some immigrants to travel hundreds, or thousands, of miles for their appointment. 

States that do not have an immigration court include Alabama, Alaska, Arkansas, Delaware, Idaho, Indiana, Iowa, Kansas, Kentucky, Maine, Mississippi, Montana, New Hampshire, North Dakota, Oklahoma, Rhode Island, South Carolina, South Dakota, Vermont, West Virginia, Wisconsin and Wyoming.

Will people be able to visit national parks or use public lands during a shutdown? 

Probably, but that may be bad for parks’ long-term health.

During the 2018-2019 shutdown, the first Trump administration kept parks open, with skeleton staffs across the country struggling to maintain National Park Service facilities.

Theresa Pierno, the president and CEO of the advocacy group National Parks Conservation Association, said in a Sept. 23 statement the last shutdown devastated areas of some parks.

“Americans watched helplessly as Joshua Trees were cut down, park buildings were vandalized, prehistoric petroglyphs were defaced, trash overflowed leading to wildlife impacts, and human waste piled up,” she wrote. “Visitor safety and irreplaceable natural and cultural resources were put at serious risk. We cannot allow this to happen again.”

The National Park Service’s latest contingency plan was published in March 2024, during President Joe Biden’s administration. It calls for at least some closures during a shutdown, though the document says the response will differ from park to park. 

Restricting access to parks is difficult due to their physical characteristics, the document said, adding that staffing would generally be maintained at a minimum to allow visitors. However, some areas that are regularly closed could be locked up for the duration of a shutdown.

But that contingency plan is likely to change before Tuesday, spokespeople for the Park Service and the Interior Department, which oversees NPS, said Sept. 25.

“The lapse in funding plans on our website are from 2024,” an email from the NPS office of public affairs said. “They are currently being reviewed and updated.”

Hunters and others seeking to use public lands maintained by Interior’s Bureau of Land Management and the U.S. Forest Service, which is overseen by the U.S. Department of Agriculture, will likely be able to continue to do so, though they may have to make alternative plans if they’d planned to use facilities such as campgrounds. 

Land Tawney, the co-chair of the advocacy group American Hunters and Anglers, said campgrounds, toilets and facilities that require staffing would be inaccessible, but most public lands would remain available.

“Those lands are kind of open and they’re just unmanned, I would say, and that’s not really gonna change much,” he said. “If you’re staying in a campground, you’ve got to figure something else out.”

As with national parks, access to U.S. Fish and Wildlife Service refuges and other hunting and fishing sites will differ from site to site, Tawney said. The Fish and Wildlife Service doesn’t require permits for hunting on its lands, but access to some refuges is determined by a staff-run lottery drawing. If those drawings can’t be held, access to those sites will be limited, Tawney said.

What happens to the Internal Revenue Service?

How the Internal Revenue Service would operate during a government shutdown remains unclear. 

When Congress teetered on letting funding run out in March, the nation’s revenue collection agency released a contingency plan to continue full operations during the height of tax filing season. 

The IRS planned to use funds allocated in the 2022 budget reconciliation law to keep its roughly 95,000 employees processing returns and refunds, answering the phones, and pursuing audits. 

Ultimately Congress agreed on a stopgap funding bill to avoid a March shutdown, but much has changed since then.

The new tax and spending law, signed by Trump on July 4 and often referred to as the “one big beautiful bill,” made major changes to the U.S. tax code. 

Additionally, the agency, which processes roughly 180 million income tax returns per year, has lost about a quarter of its workforce since January. Top leadership has also turned over six times in 2025.

Rachel Snyderman, of the Bipartisan Policy Center, said workforce reductions combined with a string of leadership changes could factor into how the agency would operate during a funding lapse.

“It’s really difficult to understand both what the status of the agency would be if the government were to shut down in less than a week, and also the impacts that a prolonged shutdown could have on taxpayer services and taxpayers at large,” said Snyderman, the think tank’s managing director of economic policy.

Do federal employees get back pay after a shutdown ends?

According to the Office of Personnel Management — the executive branch’s chief human resources agency — “after the lapse in appropriations has ended, employees who were furloughed as the result of the lapse will receive retroactive pay for those furlough periods.” 

The Government Employee Fair Treatment Act of 2019 requires furloughed government employees to receive back pay as a result of a government shutdown. 

That law does not apply to federal contractors, who face uncertainty in getting paid during a shutdown. 

What role does Congress have during a shutdown?

The House and Senate must approve a stopgap spending bill or all dozen full-year appropriations bills to end a shutdown, a feat that requires the support of at least some Democrats to get past the upper chamber’s 60-vote legislative filibuster. 

Speaker Mike Johnson, R-La., and Senate Majority Leader John Thune, R-S.D., control their respective chambers’ calendars as well as the floor schedule, so they could keep holding votes on the stopgap bill Democrats have already rejected or try to pass individual bills to alleviate the impacts on certain agencies.   

Neither Johnson nor Thune has yet to suggest bipartisan negotiations with Democratic leaders about funding the government. And while they are open to discussions about extending the enhanced tax credits for people who buy their health insurance from the Affordable Care Act Marketplace, they don’t want that decision connected to the funding debate.  

Democratic leaders have said repeatedly that Republicans shouldn’t expect them to vote for legislation they had no say in drafting, especially with a health care cliff for millions of Americans coming at the end of the year. 

Members of Congress will receive their paychecks regardless of how long a shutdown lasts, but the people who work for them would only receive their salaries after it ends. 

Lawmakers must be paid under language in Article I, Section 6, Clause 1 of the Constitution as well as the 27th Amendment, which bars members of Congress from changing their salaries during the current session. 

Lawmakers have discretion to decide which of their staff members continue working during a shutdown and which are furloughed.

A spokesperson for the U.S. Capitol Police, which is tasked with protecting members amid a sharp rise in political violence, said a shutdown “would not affect the security of the Capitol Complex.” 

“Our officers, and the professional staff who perform or support emergency functions, would still report to work,” the spokesperson said. “Employees who are not required for emergency functions would be furloughed until funding is available.”

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Planned Parenthood of Wisconsin will stop scheduling patients for abortions starting next week as it works to find a way to provide the service in the face of Medicaid funding cuts in President Donald Trump’s tax and spending bill, the nonprofit said Thursday.

Abortion funding across the U.S. has been under siege, particularly Planned Parenthood affiliates, which are the biggest provider. Wisconsin appears to be the first state where Planned Parenthood is pausing abortions because of the new law.

The organization warned earlier this year that about half its clinics that provide abortion could be closed as a result of a ban on Medicaid funding for Planned Parenthood for services other than abortion.

The measure was part of the tax and spending law President Donald Trump signed in July. Initially, a judge said reimbursements must continue, but a federal appeals court this month said the government could halt the payments while a court challenge to the provision moves ahead.

Planned Parenthood services include cancer screenings and sexually transmitted infection testing and treatment. Federal Medicaid money was already not paying for abortion, but affiliates relied on Medicaid to stay afloat.

The remaining Planned Parenthood clinics in Louisiana – where abortion is banned – are scheduled to shut down at the end of this month.

Planned Parenthood of Wisconsin said in a statement that it is trying to see as many patients as possible between now and Tuesday. The federal law takes effect Wednesday. It is not scheduling patients beyond that date, and the organization believes the move will allow it to continue seeing other Medicaid patients. The organization said it was working with providers across the state to make sure patients are referred quickly and receive timely care.

It is also considering taking legal action, the group said.

“Planned Parenthood of Wisconsin will continue to provide the full spectrum of reproductive health care, including abortion, as soon and as we are able to,” Planned Parenthood of Wisconsin President and CEO Tanya Atkinson said in the statement. “In the meantime, we are pursuing every available option through the courts, through operations, and civic engagement.”

The abortion landscape has been shifting frequently since the U.S. Supreme Court ruling in 2022 that allowed states to ban abortion. Currently, 12 states do not allow it at any stage of pregnancy, with limited exceptions, and four more ban it after about six weeks’ gestation.

The bans have resulted in more women traveling for abortion and an increased reliance on abortion pills. Prescribers in states where they’re allowed have been shipping the pills to places where abortion is banned, a practice that is facing some legal challenges and is expected to attract more.

The Wisconsin Supreme Court in July struck down the state’s 1849 near-total ban on abortion, saying it was superseded by newer state laws regulating the procedure. The same day it ruled in that case, the court dismissed a lawsuit filed by Planned Parenthood of Wisconsin asking it to find the law unconstitutional.

Wisconsin’s abortion ban was in effect until 1973, when the U.S. Supreme Court’s landmark Roe v. Wade decision legalizing abortion nationwide nullified it. Legislators never officially repealed it, however, and conservatives argued that the U.S. Supreme Court’s ruling that overturned Roe reactivated it.

Planned Parenthood of Wisconsin stopped providing abortions after that ruling for 15 months before resuming them as the lawsuit over the state law played out. It has been providing abortions at three clinics in Wisconsin for the past two years.

Planned Parenthood of Wisconsin serves about 50,000 people across the state. About 60% of them are covered by Medicaid, the organization said.

The federal Hyde Amendment already restricts government funding for most abortions, and less than 5% of the services Planned Parenthood provides are abortions, according to the organization’s 2023 annual report.

Planned Parenthood provides a wide range of services besides abortion. Its most recent annual report shows that contraceptive services and testing and treatment for sexually transmitted infections make up the vast majority of its medical care. It performs more cancer screening and prevention procedures than abortions, according to the report.

Mulvihill reported from Cherry Hill, New Jersey. Associated Press reporter Christine Fernando in Chicago contributed.

Wisconsin Watch is a nonprofit and nonpartisan newsroom. Subscribe to our newsletters to get our investigative stories and Friday news roundup. This story is published in partnership with The Associated Press.

Planned Parenthood of Wisconsin to pause abortions amid federal Medicaid funding cut is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

Elementary school students arrive for the first day of school in September in Minnesota. About 3 in 4 children nationwide relied on government-subsidized health care, and 2 in 5 experience disruptions in health coverage during their childhood, according to a study by researchers at the Harvard T.H. Chan School of Public Health. (Photo by Stephen Maturen/Getty Images)

A majority of children in the United States rely on Medicaid or the Children’s Health Insurance Program at some point by their 18th birthday, and many experience periods of coverage loss, according to a study published Wednesday in the journal JAMA.

By their 18th birthday, about 3 in 4 children nationwide relied on Medicaid, CHIP (which subsidizes health care for children and pregnant women in families that earn too much for Medicaid), or the subsidized insurance marketplaces established through the 2010 Affordable Care Act — or experienced a period during their childhood without health insurance, the study found.

Researchers from the Harvard T.H. Chan School of Public Health conducted estimates based on analyses of national data from 2015 to 2019, looking at cumulative coverage rates over the course of childhood. 

The study comes as states grapple with federal Medicaid cuts under President Donald Trump’s One Big Beautiful Bill Act. The tax and spending law will reduce Medicaid funding by $1 trillion and cut enrollment by 10 million to 15 million people over the next decade, according to projections by the Congressional Budget Office.

About 42% of children suffered a period of losing health coverage at any point in time by their 18th birthday, the Harvard researchers found, and 61% had at some point enrolled in Medicaid or CHIP. About 78.5% were at some point enrolled in employment-based insurance.

Rates of children who lost insurance coverage were higher in states that hadn’t expanded Medicaid income eligibility under the Affordable Care Act, often known as Obamacare. Roughly 59% of children in non-expansion states had periods without any insurance coverage — compared with 36% in expansion states. Overall, about 2 in 5 children experienced periods without health insurance, the study found.

And states with the strictest income thresholds saw the highest share of kids losing coverage who previously were covered by Medicaid or CHIP at birth.

“Upcoming changes to Medicaid could affect a significant portion of children and worsen already substantial insurance gaps,” senior author Nicolas Menzies, an  associate professor of global health and faculty member in the school’s Center for Health Decision Science, said in a statement. 

“We’re particularly worried about explicit loss of public insurance eligibility for noncitizen children; spillover effects through parental Medicaid coverage losses due to work requirements and more eligibility checks; and state-level cuts to Medicaid.”

Stateline reporter Nada Hassanein can be reached at nhassanein@stateline.org.

U.S. House Speaker Mike Johnson answers reporters' questions during a press conference in the Rayburn Room inside the Capitol building in Washington, D.C. on Tuesday, Sept. 16, 2025. Also pictured, from left to right, are California rancher and former president of the National Cattlemen's Beef Association Kevin Kester; Wisconsin Republican Rep. Tony Wied; Republican Whip Tom Emmer, R-Minn.; and Majority Leader Steve Scalise, R-La. (Photo by Jennifer Shutt/States Newsroom)

WASHINGTON — U.S. House Republican leaders released a seven-week stopgap government funding bill Tuesday that’s intended to avoid a shutdown when the new fiscal year begins Oct. 1. 

But GOP leaders opted not to negotiate the legislation with Democrats, who may be needed to approve the bill in the House and will be required to get past the Senate’s 60-vote legislative filibuster. 

Democrats for weeks have called on Republicans to address what they view as critical health care issues, including the expiration of expanded Affordable Care Act tax credits at the end of the calendar year and the effects of the GOP’s “big, beautiful” law on Medicaid recipients.

Speaker Mike Johnson said during a press conference shortly before the bill was released that he views the ACA tax credits as “a December policy issue, not a September funding issue,” even though open enrollment begins in November. 

“They don’t expire until the end of the year and so we have until the end of December to figure all that out,” Johnson said. “But I can tell you that there’s real concern. I have concerns. Republicans have concerns about those policies. 

“If you look at how much they’ve been abused, in my estimation, in some ways. There’s no income cap on it. People who make $600,000 a year get a government subsidy for their health care. I don’t think that’s going to be a popular measure when people understand how that works. There’s a relatively small number of people that are affected by it. But that policy has real problems.”

The tax credits are used by people who purchase their own health care coverage through the Affordable Care Act Marketplace.

Schumer: Republicans ‘want to shut things down’

Senate Minority Leader Chuck Schumer, D-N.Y., said during a floor speech before the bill was publicly released that GOP leaders shouldn’t expect Democrats to help them advance any legislation they didn’t negotiate in a bipartisan way. 

“They can try and play the blame game, but their actions tell a different story. Their actions show clearly they want to shut things down because they don’t want to negotiate with Democrats,” Schumer said. “And it’s more than that. It means Republicans don’t want to help the American people with the crisis they’ve created raising people’s costs, particularly their health care costs.”

Senate Majority Leader John Thune, R-S.D., said the stopgap spending bill, which would keep the government running through Nov. 21, is needed to give lawmakers more time to work out final, bipartisan versions of the dozen full-year government funding bills. 

“The goal here should be to fund the government the way it was intended to be funded — through the normal appropriations process,” Thune said. 

House Appropriations Committee ranking member Rosa DeLauro, D-Conn., and Senate Appropriations ranking member Patty Murray, D-Wash., issued a joint statement shortly after the bill’s release, saying they’re ready to keep working with their Republican counterparts — House Chairman Tom Cole, R-Okla., and Senate Chairwoman Susan Collins, R-Maine — on a bipartisan stopgap spending bill.

“Instead of continuing to work through important issues with us on the continuing resolution and government funding to help the middle class and the working class, House Republican leadership has walked away from negotiations and are now threatening a shutdown by trying to jam through a funding bill on their terms alone,” DeLauro and Murray wrote.

Security for members of Congress

The 91-page stopgap spending bill also includes $30 million in additional funds to bolster safety and security for members of Congress following an increasingly violent year that included the killing of conservative commentator Charlie Kirk, the killing and attempted killing of Democratic state lawmakers in Minnesota as well as some of their family members and arson at the Democratic Pennsylvania governor’s mansion. 

Members of Congress, their staff and their families are subject to thousands of threats each year, according to data from the U.S. Capitol Police. 

Johnson told reporters shortly after his press conference that he views the member security funding as a start and that there will be “more to come” in the full-year Legislative Branch funding bill.

Johnson said he expects the House will vote on the stopgap bill before Friday, when both chambers of Congress are set to leave on a week-long break for the Rosh Hashanah holiday week. 

Lawmakers aren’t expected to return to Capitol Hill until Sept. 29, with just hours to avoid a partial government shutdown if they cannot approve a stopgap bill in the days ahead.

The legislation includes an additional $30 million for the U.S. Marshals Service, which is responsible for the safety of federal judges and courthouses, as well as $28 million “for the protection of the Supreme Court Justices.” A GOP summary of the bill says the Marshals Service funding will go toward “Executive Branch protective services.”

A Planned Parenthood clinic in Salt Lake City is pictured on Wednesday, July 31, 2024. (Photo by McKenzie Romero/Utah News Dispatch)

WASHINGTON — Planned Parenthood clinics throughout the country began telling Medicaid patients Friday that their routine health care appointments will no longer be covered as a federal court order takes effect. 

The change, which could remain in place for months, if not longer, will likely impact the hundreds of thousands of Medicaid enrollees who go to Planned Parenthood clinics for health care not related to abortion. 

“This decision is devastating to patients here in the state and across this country. And it is compounding what is an already broken and overstretched health care system,” said Shireen Ghorbani, president and CEO of Planned Parenthood Association of Utah. “We know that cancers will go undetected, STIs will go untreated.”

Dominique Lee, president and CEO of Planned Parenthood League of Massachusetts, said there is no plan for other health care providers to absorb the Medicaid enrollees. 

“There’s no one waiting in the wings to take care of our patients,” Lee said. “Planned Parenthood is the safety net.”

Planned Parenthood has identified at least 200 clinics out of about 600 that could close if they cannot treat Medicaid patients and receive reimbursements from the state-federal health program for lower-income people and some people with disabilities.

“We are working, you know, feverishly with our colleagues and teams to mitigate that number,” Alexis McGill Johnson, president and CEO of Planned Parenthood Federation of America, said. “We have to remember 50% of Planned Parenthood patients use Medicaid for their health care insurance. And so that is a very meaningful impact to the health centers that also rely on reimbursement in the same way every other single health care provider relies on reimbursement for the services provided.” 

GOP law targets Planned Parenthood

Federal law for decades has barred funding from going toward abortion services with limited exceptions for rape, incest, or the life of the pregnant patient. 

Earlier this year, Republicans in Congress included a provision in their “big, beautiful” law that prevents Medicaid funding from going to certain health care organizations that provide abortions and received more than $800,000 in reimbursements from the program during a recent fiscal year. 

The language, which originally applied for 10 years but was reduced to one year in the final version of the bill, appeared to specifically target Planned Parenthood. It prevents the organization from receiving any Medicaid funding for health care services unrelated to abortion, like annual physicals, cancer screenings and STI testing.

Planned Parenthood quickly filed a lawsuit in the federal district court in Massachusetts in July, shortly after President Donald Trump signed the legislation.  

A district court judge issued a temporary restraining order and then a preliminary injunction that month, blocking the Department of Health and Human Services from implementing that one aspect of the law and allowing Medicaid patients to continue going to Planned Parenthood for routine health care services.

On Thursday, a three-judge panel from the U.S. 1st Circuit Court of Appeals overturned the lower court’s ruling, clearing the way for the Trump administration to stop reimbursing Planned Parenthood for Medicaid patients while the case continues. 

Peyton Humphreville, senior staff attorney at Planned Parenthood Federation of America and one of the lawyers handling the lawsuit, said on a call with reporters Friday the organization is evaluating all of its options but doesn’t expect additional rulings until later this year at the earliest. 

“The 1st Circuit Court of Appeals has entered a briefing schedule on the preliminary injunction appeal that will be fully briefed by mid-November,” Humphreville said. “From there, the court will schedule oral argument and will at some point after the oral argument rule on the preliminary injunction appeal.”

Planned Parenthood signage is seen in New York City on April 16, 2021. (Photo by Michael M. Santiago/Getty Images)

WASHINGTON — The Trump administration can block Medicaid funding from going to Planned Parenthood after an appeals court on Thursday overturned a lower court’s preliminary injunction. 

Republicans in Congress included the one-year funding prohibition in their “big, beautiful” law, which President Donald Trump signed in early July. 

The Department of Health and Human Services, however, has not been able to implement that policy change after a district court judge blocked it from taking effect in a lawsuit filed by Planned Parenthood. 

The Trump administration appealed that ruling to the 1st U.S. Circuit Court of Appeals, which released a two-page order Thursday without explaining its decision. 

The three-judge panel comprised Gustavo A. Gelpí, Lara E. Montecalvo and Seth R. Aframe, all of whom were nominated to their current position by former President Joe Biden. 

“The July 21, 2025 preliminary injunction and the July 28, 2025 preliminary injunction are hereby stayed pending disposition of the respective appeals,” they wrote.  

The Trump administration did not immediately return messages seeking comment.

Planned Parenthood Federation of America President and CEO Alexis McGill Johnson wrote in a statement the court’s decision means that patients, “who rely on the essential health care that Planned Parenthood health centers provide, can’t plan for their futures, decide where they go for care, or control their lives, bodies, and futures — all because the Trump administration and its backers want to attack Planned Parenthood and shut down health centers. 

“This is a blow, but the fight isn’t over. For over 100 years, Planned Parenthood has faced unrelenting attacks, but we’re still here providing care, information, and resources. We will continue to fight this unconstitutional law, even though this court has allowed it to impact patients.”  

Federal law for decades has barred funding for abortion services with exceptions for rape, incest, or the life of the pregnant patient. 

The new law blocks Medicaid funding from going to Planned Parenthood for other types of health services, like annual physicals, cancer screenings, or birth control.

Wisconsin already doesn’t allow immigrants without legal authorization to apply to BadgerCare. There are two programs, Medicaid Emergency Services and BadgerCare Plus Prenatal Plan, that will provide coverage for those without legal status. (Photo by Thomas Barwick/Getty Images)

A Republican bill that seeks to stop Wisconsin from using public funds to support health services for immigrants who lack legal authorization to reside in the U.S. is poised to advance on Tuesday. 

The bill — AB 308 — would prohibit state, county, village, long-term care district and federal funds from being used to subsidize, reimburse or provide compensation for any health care services for a person not lawfully in the U.S.

It is the latest bill that Republican lawmakers have introduced targeting immigrants. Another bill introduced and passed earlier this year seeks to require local law enforcement officers to cooperate with Immigration and Customs Enforcement. 

The bill is coauthored by Rep. Alex Dallman (R-Markesan) and Sen. Van Wanggaard (R-Racine) and currently has 25 other Republican cosponsors. No Democrats are signed onto the bill. 

During the bill hearing last week, Dallman focused mostly on Wisconsin’s Medicaid program, BadgerCare, arguing that he wants to prevent the state from ever taking steps similar to Minnesota and other states that expanded their Medicaid programs to cover immigrants who lack legal status. Wisconsin already doesn’t allow immigrants without legal authorization to apply to BadgerCare.

In 2023, Minnesota expanded its Medicaid program to cover residents without citizenship or legal residency status, but that was repealed after Republicans threatened a government shutdown to force Democrats to eliminate the expansion. 

The cost estimate for the program was nearly $200 million, Dallman noted.

“These are enormous price tags for individuals who are not here lawfully. This condition should not be the case here in Wisconsin with a state budget that is currently already very lean,” Dallman said. “We must prioritize our citizens over those who are here unlawfully. While Wisconsin currently does not allow undocumented immigrants to enroll in BadgerCare, this bill preemptively… ensures that Wisconsin does not become like Minnesota or Illinois.”

Dallman noted that the bill includes a carve out to ensure that it won’t lose Wisconsin money or put it out of step with federal law.

According to the Legislative Fiscal Bureau summary, the prohibitions in the bill would not apply to the extent that a payment is required under federal law or the application of the prohibitions would result in the loss of any federal funds.

“This bill is not about immigration,” Dallman said, but it is about “protecting our constituents and their hard-earned tax dollars that they send into our state.”

In written testimony, Wanggaard said the bill would extend the current restrictions to “all other health services paid for by the State of Wisconsin.” Wanggaard, who did not attend the public hearing, wrote that the bill would ensure Wisconsin “is not the next test dummy extending health benefits to illegal aliens.”

Democrats and advocates said they are concerned about the sweeping effects the bill could have on all Wisconsinites. 

William Parke-Sutherland, government affairs director at Kids Forward, said the bill would be unworkable as law and would affect every health care provider in the state.

“This bill is entirely short sighted, and nobody has thought about how this would create a state in which we do not want to live,” Parke-Sutherland said. “If a child is at the school and is sick, does the school nurse need to figure out how to verify their status before they provide any degree of care?… I just don’t think that people have thought through the consequences of us in Wisconsin having to live in a situation where we all need to carry our papers.” 

Parke-Sutherland noted that there are already strict citizenship requirements people need to meet to enroll in nearly all Medicaid programs.

The Wisconsin Department of Health Services (DHS) outlines the restrictions on its website as well as  two programs available to noncitizens. One is Medicaid Emergency Services, which provides short-term medical coverage for people who have a medical emergency and aren’t eligible for BadgerCare Plus or Wisconsin Medicaid, and the other is BadgerCare Plus Prenatal Plan, which provides health care coverage for pregnant mothers who are not eligible for BadgerCare Plus due to immigration status or being in prison or jail.

“This is trying to solve a problem that doesn’t exist, and it’s creating way, way, way more problems,” Parke-Sutherland said. “If you are creating a situation where you’re prohibiting funding for services for people who are unlawfully present, then you are creating a need for people to verify their status in order to receive health care.” 

In a fiscal analysis, the Department of Corrections said it is concerned the bill could violate the 8th Amendment. A 1976 Supreme Court decision in Estelle v. Gamble established that the deliberate failure to deal with an inmate’s medical needs constitutes cruel and unusual punishment. 

Wanggaard refuted the analysis in written testimony, saying the bill language means it would only apply to state programs that require enrollment. 

“It does not mean that, for example, an illegal immigrant in the state prison system could not receive health care services from DOC,” Wanggaard said. 

The language of the bill, however, says that “no funds of this state or of any county, village, town, or long-term care district… and no federal funds passing through the state treasury shall be authorized for or paid to any person to subsidize, reimburse, or otherwise provide compensation for any health care services for an individual who is not lawfully present in the United States.”

Rep. Karen Kirsch (D-Greenfield) said her Republican colleagues are taking a page from President Donald Trump and his administration by downplaying the effect of the bill. 

“They’re watching how Trump handles things,” Kirsch said. “They’re pushing the envelope on every interpretation of every word and every piece of legislation to go target people, to go after people… They’re watching how he handles things, and I think that they’re mimicking that at the state. They’re trying to make it sound like, ‘Well, this is all so reasonable. This is not a big deal. Don’t worry about it.’ And then if it passes, then we’re going to see it’s way… way worse.”

Kirsch said she is concerned about the potential “chilling effect” that the bill could have, discouraging individuals and families from seeking care when they need it. 

“[Republicans are] trying to raise this to the public consciousness, and then people are going to be confused,” Kirsch said. “‘Is this a way that they’re going to find me, if I’m an undocumented person?… Even if I do qualify for care, maybe something’s going to happen to me?’ It can have this overall chilling effect of confusion of whether or not people feel safe enough to get care.”

Kirsch took issue with the argument that the bill would protect taxpayers’ money. 

“When they do have access to health care, that also keeps our health care prices down because they’re not showing up in our emergency rooms, they’re doing preventative care, they’re taking care of their diabetes, and they’re not showing up with some serious diabetes complication in our emergency room,” Kirsch said. 

Kirsch also noted that undocumented immigrants pay sales tax and contribute to the state’s economy. She referenced a 2024 report from the University of Wisconsin School for Workers that found that undocumented immigrants specifically contributed $240 million in state and local taxes in 2022.

According to the Wisconsin Lobbying website, the American Civil Liberties Union of Wisconsin, Inc., Kids Forward, the Wisconsin chapter of the National Association of Social Workers, the Wisconsin Association of School Nurses and the Wisconsin Council of Churches are registered against the bill. The only group registered in favor is FGA Action, a Florida-based nonprofit that advocates for conservative policies in statehouses around the country.

David Gwidt, Deputy Communications Director for the ACLU of Wisconsin, said in a statement to the Examiner that the legislation if enacted “could result in absurd circumstances for medical and mental health providers across the state and exacerbate this fear and uncertainty experienced by our immigrant neighbors.” 

The Assembly State Affairs Committee plans to vote on whether to advance the legislation Tuesday, setting it up for a floor vote later this week.

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Americans who earn less than $18,000 are estimated to see a slight federal tax cut under President Donald Trump’s big bill, but the net effect of the bill is likely to lead to a loss in household resources.

The average federal tax change from current levels for the bottom 20% of American earners is a reduction of $150 by 2026 and a reduction of $160 by 2030, according to estimates from the nonpartisan Tax Policy Center. In contrast, the average income earner will receive a $2,860 cut while the top 1% of earners will see a $75,410 cut on average. 

Lower income earners already pay little in taxes. Reductions in Medicaid and SNAP benefits are likely to affect lower income earners disproportionately, resulting in a projected net decline of 2.9% in their household resources.

This fact brief is responsive to conversations such as this one.

Sources

• Tax Policy Center: T25-0231 – Reconciliation Bill, One Big Beautiful Bill Act (OBBBA), As Passed by the House and Senate, Distribution by ECI Percentile, 2026
• The Budget Lab at Yale: Tax Provisions in the Reconciliation Bill: Combined Distributional Impacts
• Penn Wharton Budget Model: President Trump-Signed Reconciliation Bill: Budget, Economic, and Distributional Effects
• The Budget Lab at Yale: Distributional Effects of Selected Provisions of the House and Senate Reconciliation Bills

Will the bottom 20% of American income earners pay more in taxes under Trump’s big bill? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

The Transporting Students with Disabilities and Special Needs (TSD) Conference in Frisco, Texas this fall looks to address the unique challenges and considerations of transporting this at-risk population.

Providing the best care for the students, empowering the transportation staff, and building an operational culture of communication and clear policies will be discussed by industry veterans, transportation consultants, and school district and bus company staff members.

In the driver training category, session topics include how to model behavior interventions in transportation settings, training for empathy of children’s needs, providing training for the service of medically fragile riders, and other proactive training educational discussions.

For upholding legal requirements and federal standards, speakers will plan to address topics such as impact of the updated National School Bus Specifications and Procedures on operations, alternative transportation, Medicaid reimbursement funding, and developing policies for proper and safe usage of student restraint and seclusion practices.

To address collaborating with contractors or other resources to aid student transportation, examples of topics include how to avoid one-size-fits-all solutions, how to create successful partnerships between school districts and contractors, and the OT/PT Transporter Forum on multidisciplinary policy development.

In addition to the hands-on training classes that cover wheelchair securement, school bus evacuations and use of child safety restraint systems on school buses, instructors from the Texas School for the Deaf will provide training for student transporters on using American Sign Language to communicate.

For a full list of 2025 TSD conference topics, visit tsdconference.com.

Save $100 on regular conference registration with Early Bird registration by Oct. 3. The TSD Conference will be held November 6-11 in Frisco, Texas at the Embassy Suites Dallas-Frisco Hotel and Convention Center. Find more information on daily agenda, unique experiences, hotel and registration at tsdconference.com

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Related: TSD Conference Registration is Open for Event in November
Related: TSD Evacuation Class Emphasizes Importance of Training
Related: (STN Podcast E236) TSD 2024 Recap: Supporting Students with Special Needs as Unique People

The post TSD Conference Topics Plan to Cover Unique Aspects of Transporting Students appeared first on School Transportation News.

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For over a decade, Wisconsin has heard the same message from Republicans regarding full Medicaid expansion: Accepting 90% federal reimbursement to cover more low-income people will only set Wisconsin up for failure if the federal government abandons its part of the deal. 

At first glance, President Donald Trump’s recently signed big bill appears to validate that argument. The 40 states that have fully expanded are now expected to lose billions of dollars in federal aid while getting tagged with additional administrative costs to create work requirements and eligibility assessments required in the bill. 

But it turns out Wisconsin is still going to be subject to the new federal mandates without the higher federal reimbursement rate that expansion states will continue to receive. In other words, at a time when the Republican-controlled federal government is supposedly pulling out the rug from expansion states, Wisconsin is still left holding the bag.

A look back

Back in 2014, then-Gov. Scott Walker and Wisconsin Republicans made the controversial decision not to accept full Medicaid expansion.

At the time, Walker explained his goal “is to get more people out into the workplace, more people covered when it comes to health care and fewer people dependent on the government, not because we’ve kicked them out, but we’ve empowered them to take control of their own destiny.”

But he also argued that the federal government would eventually pull back on its commitment to fund Medicaid at 90%.

“That commitment is not going to be there and taxpayers all across America will be on the hook,” Walker said. “They are not going to be on the hook in Wisconsin.”

At the time, Wisconsin was one of 25 states not accepting expansion. Now, the state is one of the 10 remaining holdouts, with most of the others in the deep red South. Even reliably red states, like Arkansas and Louisiana, have accepted full expansion. 

Instead of accepting full expansion, Wisconsin chose to cover individuals through BadgerCare, the state’s Medicaid-supported health insurance program for low-income residents set up by former Gov. Tommy Thompson, a Republican. 

Walker and Republicans lowered Medicaid coverage to 100% of the federal poverty line from the previous 200% and eliminated the waiting list for childless adults. Those above the poverty line without employer-sponsored insurance could purchase it through the Affordable Care Act marketplace using federal subsidies, according to the Wisconsin Policy Forum.  

But Wisconsin taxpayers are paying more to cover individuals below the poverty line: 39.3% of costs rather than 10% under full Medicaid expansion. In 2023, Medicaid accounted for 15.7% of state taxpayer spending, according to the policy forum.

Under its approach, Wisconsin doesn’t have an eligibility gap like some states, something Republicans highlight as a reason the state doesn’t need to expand.

But that has come with a loss of federal funds. Over the past decade, Wisconsin’s Department of Health Services estimates, the state has spent about $2.6 billion more to cover the costs of a partial expansion compared with the projected cost under a federal expansion.

Under an expansion, more individuals would be able to access Medicaid. But the Wisconsin Policy Forum found it would have a somewhat modest impact on coverage levels — the percentage change in Medicaid enrollees would be 7.2%, compared with nearly 30% or more in other non-expansion states. 

Work requirements still in effect under Trump bill

With the recent federal bill, Walker and other Republicans still argue Wisconsin was right not to accept federal expansion. The state is going to experience the impacts to a lesser extent than fully expanded states. 

But because Wisconsin receives federal waivers for its Medicaid program, the state is still subject to some provisions under the new law, including the work requirements, eligibility determinations and provider taxes.

Under the new work requirements, individuals covered by Medicaid are required to prove they are working 80 hours per month — parents with dependent children or people who are medically frail are exempted.

As a result, some 230,000 Wisconsin residents could lose coverage while the state incurs administrative costs to account for the new requirements, according to an estimate from U.S. Senate Democrats based on data from the Congressional Budget Office.

The work requirements don’t stop at individuals covered by Medicaid alone; it also extends to coverage through marketplace subsidies, affecting over 200,000 Wisconsin residents. 

Work requirements used to be required for Wisconsin residents to access coverage through federal waivers, but in 2021 then-President Joe Biden removed the work requirement. 

The labor force participation rate has dipped from about 68% in 2017 to a little over 65% as of May 2025 but has remained higher than the national average, which is about 62%. Some reports suggest that decline is due to the aging workforce in the state.

Work requirements have also been found to increase the uninsured rate.  

The Wisconsin Policy Forum reports that one of the main reasons work requirements may lead to higher uninsured rates is that they are confusing and time-consuming. Some people may choose to get rid of coverage altogether to avoid unnecessary paperwork. 

What could happen with the federal bill?

The Kaiser Family Foundation also found that implementing work requirements will be costly for states, costing anywhere from $10 million to over $270 million, depending on the size of the state. DHS estimates the state will pay $6 million annually to implement work requirements, while receiving a lower federal match rate than fully expanded states to reimburse for administrative costs.

With a lower federal match rate, Wisconsin has increased Medicaid funding through hospital taxes, which the new state budget just increased from 1.8% to the federal maximum of 6% for the 2025-27 biennium budget.

Republican lawmakers in the state were quick to approve the hospital tax increase, despite their previous opposition to Medicaid expansion as a means for drawing down additional federal funding. If they hadn’t, the state’s 1.8% tax would have been frozen under Trump’s big bill. The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.

States that expanded will not lose the 90% federal match rate, but those like Wisconsin that didn’t will now miss out on an additional incentive to expand created during the Biden administration.

The incentive would have raised the federal match rate to 95% for two years, but was eliminated by Trump’s big bill. Instead Wisconsin will remain at about 60% reimbursement, while still facing the same bureaucratic requirements as expansion states.

Wisconsin still losing out from not expanding Medicaid — even under Trump’s big bill is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.

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Wisconsin will receive an estimated $1 billion more annually in federal funds for Medicaid because the state budget includes a change that pre-empts a provision in President Donald Trump’s big bill.

Trump’s bill would have prevented Wisconsin from raising its hospital tax.

But days before Trump signed it, the Republican-led Legislature and Democratic Gov. Tony Evers approved a 2025-27 state budget that raises Wisconsin’s hospital tax from 1.8% to 6%.

The increase will raise some $1 billion more annually in federal matching funds that the state can use to pay hospitals for care they provide Medicaid patients.

Wisconsin’s largest Medicaid program is BadgerCare Plus, which provides health insurance to about 1 million low-income people age 64 and under.

Republican U.S. Rep. Derrick Van Orden, who represents western Wisconsin, claimed that Trump’s bill “secured” the $1 billion.

The bill cuts roughly $1 trillion over 10 years from Medicaid, which costs nearly $900 billion annually.

This fact brief is responsive to conversations such as this one.

Sources

• Wisconsin Hospital Association: WI State Budget Bill Includes Historic Medicaid Rate Increase for Hospitals
• Milwaukee Journal Sentinel: Derrick Van Orden claims credit for Wisconsin's extra Medicaid dollars after voting to cut the program
• Milwaukee Journal Sentinel: Ron Johnson laments Wisconsin's reach for Medicaid funds, spurred by the Trump bill he voted for
• Wisconsin Department of Administration: Wisconsin Health Services Department budget
• Wisconsin Legislature: Health Services budget
• Wisconsin Department of Health Services: BadgerCare Plus
• Wisconsin Department of Health Services: BadgerCare Plus
• X: Derrick Van Orden post
• Axios: Trump's spending bill cuts Medicaid: Here's what it's called in your state
• Kiplinger: What to Know About New Medicaid Cuts: Is Your Local Hospital Closing Soon?
• Wisconsin Watch: Have millions of nondisabled, working-age adults been added to Medicaid?

Does Donald Trump’s big bill provide an additional $1 billion annually for Wisconsin’s Medicaid program? is a post from Wisconsin Watch, a non-profit investigative news site covering Wisconsin since 2009. Please consider making a contribution to support our journalism.