One year ago, President Donald Trump signed the first piece of legislation Republicans in Congress had introduced at the start of his second term.

Passed using the complicated budget reconciliation process that enabled GOP lawmakers to enact the legislation without Democratic votes, HR 1 paired $4.5 trillion in tax cuts over 10 years with $1 trillion in cuts to federal healthcare programs as well as other initiatives to cut federal spending.

With the legislation’s first birthday on July 4, critics of the Trump administration and Democratic politicians have been using every opportunity to highlight the legislation’s role in driving unpopular results.

Healthcare cuts are among the most prominent of those outcomes. They include a series of changes to Medicaid — the state-federal health insurance program for people at or below the federal poverty guideline, with annual incomes of just under $16,000 per year for a single person or $33,000 for a family of four.

For medical and hospital care, Medicaid is called BadgerCare in Wisconsin. Medicaid also covers long-term care services for people who qualify, including home healthcare for the elderly and people with disabilities, and goes under a variety of names including Family Care and IRIS.

On Tuesday, the anti-Trump political activist group Indivisible and members of the healthcare union SEIU Wisconsin gathered in front of the Wisconsin Republican Party headquarters in Madison with an out-of-service ambulance to denounce  cuts to healthcare attributed to HR 1.

“We are here to give voice to the millions of Americans who have lost access to healthcare and to the tens of thousands of Wisconsinites who have lost healthcare,” said Jean Grow, co-leader of Indivisible’s Milwaukee chapter.

The group aimed its barbs not just at Trump but at Republican U.S. Rep. Tom Tiffany, the party’s nominee for governor in the November 2026 election, who voted with the rest of his party in the U.S. House of Representatives for HR 1.

“Who in this state is primarily responsible for these cuts? Tom Tiffany,” Grow said, to hearty jeers from the crowd of about two dozen during the lunchtime protest.

HR 1 also cut the federal nutrition assistance program SNAP — known as FoodShare in Wisconsin — by 20% by 2034, about $187 billion.

The changes will pass on to most states a portion of the program’s costs, which the Center on Budget and Policy Priorities in Washington says could lead “the lowest-income people, including children, older adults, veterans, and people with disabilities” in every state to lose access to food assistance.

The so-called One Big Beautiful Bill Act “has been brutal for Wisconsin families,” said Secretary of State Sarah Godlewski, a Democrat who is running for lieutenant governor, at a press conference Wednesday at the Democratic Party’s Capitol Square offices that focused on Tiffany’s record.

“We know that the impact it’s going to cause — things like potentially 270,000 Wisconsinites are going to lose healthcare,” said Godlewski. “We know tens of thousands of Wisconsinites are going to lose access to FoodShare.”

While Trump and GOP congressional leaders initially called HR 1 the “One Big Beautiful Bill Act,” critics quickly mocked it as “the Big Ugly Law” or variations on that theme. In September, the Republicans rebranded the bill as “The Working Families Tax Cut.”

The CBPP, however, found that the tax cuts are “tilted to the wealthiest households.”

The Congressional Budget Office “finds that the new law’s program cuts and tax cuts will make households with incomes in the bottom 20 percent of the income scale worse off: they will lose more from the cuts in health coverage, food assistance, and other programs than they will gain in tax cuts,” the  CBPP reported in February.

For the bottom 10% by income, average annual incomes will fall by $1,200 — 3.1% — the CBPP reported, citing the CBO. Meanwhile, the top 10% will see their annual incomes rise $13,600 on average.

HR 1’s advocates said the healthcare spending reductions would only address waste, fraud and abuse.

Sen. Tammy Baldwin (D-Wisconsin) said during a virtual press conference in June that the changes — such as new work-reporting requirements for some Medicaid participants — would impose administrative burdens and red tape that will block people who are qualified to receive benefits.

“They’re trying to kick people who are fully eligible off the program,” Baldwin said. The press conference was organized by the advocacy groups Protect Our Care and Main Street Alliance.

Most of the Medicaid changes won’t take effect until 2027. Enrollment in the program has already been dropping, however. Federal data tracked by the Georgetown University Center for Children and Families show that in Wisconsin, more than 75,000 Medicaid recipients had left the program in the first five months of 2026.

Dr. Kristen Dall-Winther, a family physician in Birchwood, Wisconsin, also took part in the press conference with Baldwin.

“I see how access to affordable healthcare can make the difference between something that’s a manageable condition and a medical crisis. I also see the difficult choices patients are forced to make when healthcare becomes too expensive, which it generally, universally is now,” Dall-Winther said. “When funding is reduced, healthcare providers face greater financial strain, especially in rural areas where many of our facilities are already operating on razor-thin margins.”

Two years after the U.S. Supreme Court’s Grants Pass v. Johnson decision  — which allowed governments to enforce public camping bans without violating the Eighth Amendment prohibition on cruel and unusual punishment — more than 350 cities and 14 states have adopted laws or measures to crack down on street homelessness.

States have varied in their approaches toward street homelessness since the 2024 ruling, including imposing statewide camping bans on public lands, setting mandates for local governments to enforce those bans and, in some cases, allowing property owners to sue their local government if they do not comply with enforcement of statewide camping bans, according to details gathered by the National Homelessness Law Center.

This year, Louisiana made unauthorized public camping a crime and created a Homelessness Court program, where an unhoused person charged with a crime could seek treatment as an alternative to jail time. Indiana’s new law, which bans unauthorized camping, sleeping and sheltering on state or local public land, goes into effect in July. 

Georgia and Oklahoma enacted Safe Neighborhood laws, which allow property owners to seek compensation from local governments if they fail to enforce laws tied to public camping, loitering and panhandling. Some measures have been modeled after legislation drafted by groups such as the conservative think tanks Cicero Institute and the Goldwater Institute.

There were fewer homeless people in the United States on a single night in January 2025 than in January 2024, but homelessness increased in 28 states, according to the latest federal count. 

Stateline reporter Robbie Sequeira can be reached at rsequeira@stateline.org.

The majority of U.S. states will soon have to pay 5% to 15% of federal nutrition assistance benefits in their state, according to the U.S. Department of Agriculture’s release Wednesday of Supplemental Nutrition Assistance Program payment error rates. 

House Resolution 1, commonly known as the One Big Beautiful Bill Act that was enacted in 2025, stipulated that states with SNAP payment error rates greater than 6% would be required to foot 5%, 10% or 15% of SNAP benefits costs in their state. 

Wisconsin’s error rate was 5.72% in 2025, USDA reported, making it one of nine states with an error rate below 6%. The nine will not have to match a portion of the SNAP benefits they pay out starting in October 2027.

The finding means that Wisconsin will avoid federal penalties of up to $205 million in the 2027-28 fiscal year in the state’s FoodShare program, which is part of SNAP, Gov. Tony Evers said Thursday.

Evers wrote members of Wisconsin’s congressional delegation earlier in June, urging them to eliminate or delay implementing the federal penalty fees imposed in HR 1.

According to USDA, SNAP payment error rates measure the accuracy of states in determining who is eligible for SNAP and how much they receive. The rate is calculated via a series of reviews from state and federal agencies where instances of overpayments and underpayments are identified. 

USDA’s SNAP quality control page says errors are “largely unintentional” and might be the fault of a state agency or a SNAP household. 

Earlier this year Evers signed legislation appropriating an additional $72.7 million for the Wisconsin Department of Health Services to bolster staffing and other resources for operating FoodShare and avoid errors. The appropriation was attached to a bill introduced by Republican lawmakers that authorizes the state to ask USDA to allow Wisconsin to ban using FoodShare dollars to buy soda or candy. A federal judge this week blocked such restrictions in Nebraska, Colorado, Iowa, Tennessee and West Virginia.

Eighteen states had payment error rates above the national average of 10.62%. Per the quality control process, these states will have to either pay USDA a determined amount, or invest 50% of that amount into activities that will fix the root causes of the payment errors. 

USDA said that while the 2025 average payment error rate is a “modest” decrease from the 2024 average error rate of 10.93%, it represents $10.1 billion in improper payments. 

Secretary of Agriculture Brooke Rollins said the latest payment error rates show that “state accountability is severely lacking” in SNAP. 

“USDA has taken historic action to help interested states curb SNAP waste, and I hope other states, regardless of political leadership, prioritize needy families and the American taxpayer over politics,” Rollins said in a news release. 

An analysis of H.R. 1 from the Congressional Budget Office estimated that the law, which included several changes to SNAP benefits in addition to the error rate cost share, would reduce federal spending on the SNAP benefits by $255 billion between 2025 and 2034. CBO also estimated that state spending on SNAP benefits would increase during the same period by $85 billion. 

Critics of the bill said the cost shift to states would endanger the SNAP program and stress state budgets. 

According to the 2025 error rates from USDA, 41 states had payment error rates above the 6% threshold set by the 2025 law. South Dakota had the lowest error rate at 2.47%. Idaho and Wyoming had error rates below 4%, and Iowa, Kentucky, Nebraska, Utah, and Vermont were the other states with rates below 6%. Alaska had the highest error rate of 23.15%. 

The higher the error rate, the greater the share, up to 15%, the state will have to pay of its SNAP benefits, which are otherwise 100% footed by the federal government. 

In addition to the cost share, states with a payment error rate in excess of 6% are required to submit a corrective action plan to the Food and Nutrition Administration, formerly known as the Food and Nutrition Service, to explain the root cause of the payment errors and how the state plans to correct the errors. 

The days of ground beef and chicken legs are long gone at the Ritenour Co-Care Food Pantry just outside of St. Louis. The nonprofit has swapped out those staple proteins for cheaper ground chicken and hot dogs as it faces higher food costs and surging demand.

“We have to adapt just like everybody else,” Executive Director Angela Gabel said about rising grocery prices.

Last year, Ritenour spent about $120,000 on food. The pantry budgeted $180,000 for this year, though Gabel said that may not be sufficient.

And the number of people looking for food has increased: The pantry signed up seven new families on a recent weekday morning and expected to add 15 by the end of the day. Gabel said more people are traveling further to visit multiple food pantries each month to stock their shelves.

Families are facing rising grocery prices at the same time that many of the most vulnerable are losing access to the nation’s largest food assistance program, the Supplemental Nutrition Assistance Program, or SNAP. More than 4 million Americans lost SNAP benefits between February 2025 and this February, according to analyses of the most recent federal data. The numbers are expected to increase as states whittle the rolls further as required by the broad tax and spending law President Donald Trump signed last summer, known as the One Big Beautiful Bill Act.

“I’m absolutely terrified,” Gabel said. “We will absolutely do our best, but I think we were meant to supplement SNAP or to help in emergency situations. I just don’t think we can replace the government.”

After One Big Beautiful Bill Act, 100,000 Tennesseans’ lose SNAP food aid

Since the fall, states and counties that administer SNAP have been notifying residents who rely on food stamps that they must meet new work requirements or lose their food assistance. The federal tax and spending law ended exemptions to work requirements for older adults, homeless people, veterans and some rural residents, among others. The changes will put more pressure on states, likely leading to further benefit cuts as they reevaluate eligibility and begin paying for more program costs. The new rules also will further stress the already-stretched charitable food system.

Gina Plata-Nino, SNAP director at the Food Research & Action Center, a nonprofit working to combat hunger, noted that children, older adults and people with disabilities are most reliant on the program. The left-leaning Center on Budget and Policy Priorities estimated the average benefit per person this year would be $188 per month, or $6.17 per day.

“And a majority of them are making less than $1,100 a month,” she said. “So when you lose your SNAP benefit, it really does exacerbate your situation of having to choose between shelter, food, and other basic needs.”

Rising need for food

National data on hunger is limited since the Trump administration terminated the annual Household Food Security report last year. But other measures indicate that more people are missing regular meals.

In May, the federal Reserve Bank of New York found a “remarkable” increase in food insecurity across the country, with more people struggling than during the peak of the pandemic. Its national surveys last October and this February found more households dipped into savings accounts, relied on food donations or had trouble finding enough food to eat or had kids who missed meals.

Democrats and anti-hunger advocates have been urging Congress to rescind SNAP cuts for months. Current negotiations over reauthorizing the federal farm bill, which includes SNAP, have put the issue front and center in Congress. The House has passed a version of that legislation that won’t reverse the cuts.

Republicans have downplayed the effect of the changes and defended the SNAP cuts, arguing they are aimed at rooting out fraud and abuse.

U.S. Rep. Derrick Van Orden, a Wisconsin Republican, said he was raised in “abject, rural poverty,” by a single mother who relied on food stamps, subsidized lunches and government cheese.

But in late April, he urged support of the farm bill that cements cuts to the food stamp program.

“We do have to know that there is a tremendous amount of fraud that takes place in SNAP,” he said on the House floor, “and we want to make sure that every single dollar that is allocated to go to a hungry child or a veteran or one of our senior citizens goes to them.”

Last week, 23 state attorneys general wrote to Senate leaders who are now considering the farm bill, saying the Senate has an opportunity to “reverse course and reaffirm a bipartisan commitment that no American should go hungry because they cannot afford food.”

In Nebraska, where SNAP participation has dropped by about 11%, state lawmakers this year proposed legislation to ask the federal government for waivers from some of the new restrictions. Those bills, which did not advance, sought to protect benefits for veterans, former foster youth, homeless people and refugees.

But the problem demands a federal response, said Megan Hamann, the senior community organizer for food and nutrition access at Nebraska Appleseed, an advocacy nonprofit that works against poverty and discrimination.

“We’re going to be working with patchwork solutions in the meantime,” Hamann said. She described “a real reckoning as a result of loss of federal support and programming that has for a long time in our state and others offered stability and consistency that is no longer present.”

She said putting food on the table has become a widespread challenge for many in Nebraska as the price of housing, utilities and other everyday necessities squeezes household budgets.

“I talk to people on the daily who say, ‘I’m worried about the price of groceries, I’m worried about the price of gas, I feel like everything except for my wage is going up,’” she said.

Though generally focused on housing, the Omaha organization Restoring Dignity has launched a new food assistance program to help refugees who lost SNAP benefits late last year.

“A big chunk of what we do now revolves around food,” said founder and executive director Hannah Vlach.

Community donations allow Restoring Dignity to provide grocery store gift cards to those refugees. But the organization, which generally serves about 5,000 refugees per year, is helping only about 200 of the most vulnerable.

“Right now we’re just focused on the families who absolutely will be evicted and will be on the streets if they don’t get any assistance,” she said, “and I have no idea how those other families are surviving.”

Vlach emphasized that the federal government has specifically sanctioned the arrival of refugees her organization serves, many of whom served with U.S. troops in Afghanistan.

“This can’t become our new normal — this just can’t,” she said. “It’s unethical, it’s immoral.”

States triaging needs

West Virginian Raine Gibbons said she relies more on cheap staples such as pasta and pasta sauce, trimming the amount of meat and treats she buys.

She said her family of five recently saw a reduction in monthly SNAP benefits, which now provide just over $300 per month.

Gibbons supervises an in-home education program for parents at one of the state-run Family Support Centers, which provide parenting classes, baby supplies such as diapers and emergency food aid.

Aside from grappling with higher prices and reduced SNAP eligibility among clients, the West Virginians who rely on those 57 federally funded centers face an uncertain future because of unresolved state contracting issues.

“It’s really, really stressful,” Gibbons said. “It’s so hard to stay present and be the parent that you want to be when you’re worried about those daily struggles of just how to feed your family.”

Gibbons said SNAP is not a luxury, but an essential support for many families.

“It’s really what’s keeping families like mine — who do work outside of the home, who do have a full-time job — afloat to be able to feed our families and our babies, and try to just get through this economy.”

California lawmakers are trying to help fill some of the federal void in their state. Democratic Assemblymember Alex Lee is pushing to add $100 million to a state program that doubles the purchasing power of SNAP when used for fresh fruits and vegetables. Separate pending legislation would petition the federal government for a waiver, allowing California to maintain an exemption from work requirements for former foster youth.

In California, nearly one-third of all families with young children struggled to put food on the table between July 2024 and January 2026, according to survey results from the Stanford University Center on Early Childhood.

“States are in a position of trying to triage what is the most important need for families, when really families have all of these needs that are considered pretty basic,” said Abigail Stewart-Kahn, managing director of the center. “It puts states in an untenable position to try to make decisions of which gaps to fill and for whom.”

Stewart-Kahn said many families face immediate decisions of which bills to pay and which needs to forgo, but that the parental stress and childhood distress will have long-term consequences for society.

“Every time we make a policy change that potentially increases stress in the lives of a child, we are deciding as a society that we’re okay with harming their healthy development, so that the next generation will struggle further with everything from educational attainment to mental health challenges,” she said.

Stateline reporter Kevin Hardy can be reached at khardy@stateline.org.

A survey of more than 3,800 people nationwide who gave birth in 2023 and 2024 found those using Medicaid described worse outcomes than those on private insurance, that access to care remains limited for some, and that women often feel unheard and disregarded during pregnancy and labor and delivery.

The Listening to Mothers survey, conducted by the nonpartisan nonprofit National Partnership for Women and Families, was released earlier this month. The partnership says the survey is the largest of its kind, and it’s the fourth time the organization has published this type of survey since 2002. The organization says its survey represents approximately 90% of the childbearing population, defined as those at least age 18 who gave birth in a U.S. hospital to a single baby whom they lived with.

The survey highlighted what it called “hard-won gains” in policy changes, such as the expansion of Medicaid coverage from 60 days to 12 months postpartum in all but one state, as well as expanded state paid leave programs and new investments in maternal health and perinatal quality. But it said those gains are threatened by hospital maternity units closing in many states, as well as deep cuts to Medicaid programs at the state and federal levels.

Report: Arkansas child well-being improves in some areas but lags behind overall

“While preventing catastrophic outcomes rightly commands attention, surviving childbirth is the floor and not the ceiling,” the survey said. “Extensive evidence shows that precious few childbearing families are getting the care and support they need to truly thrive.”

Most respondents — 61% — said they received prenatal care by eight weeks’ gestation, which is earlier than the generally accepted recommendation to see a provider before 10 weeks. About 19% said they saw a provider between nine and 11 weeks, while 21% didn’t see one until after 12 weeks, which is past the end of the first trimester. About 1% said they received no prenatal care at all.

Among those respondents, 25% indicated they were unable to receive prenatal care as early as they wanted to, and about one-third of those were covered by Medicaid. The most common reasons for receiving care later were that no earlier appointments were available and that the provider wanted to see the patient at a later gestation. Others said they had to find a clinic accepting new patients or accepting Medicaid, or they had to wait to be enrolled in Medicaid.

Medicaid patients also had higher rates of complications such as high blood pressure and gestational diabetes during pregnancy, and higher rates of mental health issues such as depression and substance abuse disorders. 

About 43% of respondents said they received less than optimal care during pregnancy because their knowledge and experiences were not valued, while 42% said their providers did not respond in a timely manner to requests for help, and 40% said they generally felt unheard by providers.

About 6% of respondents said some kind of discrimination played a role in those feelings, with the most common area being discrimination based on race, including a lack of respect for the pregnant patient’s culture. American Indian and Alaska Native groups were most likely to report a lack of respect for their culture.

Stateline reporter Kelcie Moseley-Morris can be reached at kmoseley@stateline.org.

As states enact stricter work requirements for the federal food stamp program, a new analysis suggests those requirements won’t enhance employment and will push more people off of food assistance. 

The researchers conducted a review of studies on work requirements and concluded that “the best evidence shows they do not increase employment. Moreover, this research finds work requirements cause a large decrease in participation in SNAP.”

The research from The Hamilton Project, an economic policy initiative at the left-leaning Brookings Institution, comes at a time of major upheaval for the Supplemental Nutrition Assistance Program, or SNAP. Participation is already declining as states implement changes mandated by the president’s major tax and domestic policy law enacted last summer. 

Since the fall, states and counties that administer SNAP have been notifying residents who rely on food stamps that they must meet work requirements or lose their food assistance. Those changes affected exemptions to work requirements for older adults, homeless people, veterans and some rural residents, among others. 

Known as the One Big Beautiful Bill Act, the law mandated cuts to social service programs, including Medicaid and food stamps.

While SNAP enrollment is declining nationally, more people will likely lose food assistance as states continue to implement the work requirements and recertify participants, said Lauren Bauer, a fellow in economic studies at Brookings Institution and the associate director of The Hamilton Project. 

“Everything that we know about work requirements is that they do not increase employment among the groups that are subject to them,” she told Stateline. “All they do is make it more likely that they are disenrolled from the program. And so, should these work requirements continue to be rolled out and implemented, we would expect to see declining enrollment and no changes in employment.”

Bauer said the growing body of research on SNAP has changed her mind about its ability to affect employment. While food stamps reach millions of people each year, the program’s work requirements have proven ineffective, confusing and burdensome, she said. 

“I am now of the mind that SNAP should be an anti-hunger program, and there are many, many ways to do workforce development, career ladders, career training, job search — all of those things. That’s not an anti hunger program and it shouldn’t be associated with it.”

What’s more concerning to her is how the stricter work requirements will affect people who lose jobs in an economic downturn. Traditionally, SNAP has been one of the most effective social supports for the unemployed, helping people who lose their jobs quickly gain food assistance. But laid-off workers will increasingly be told they cannot receive benefits without working. 

“It’s just this dissonant, unhelpful interaction that you have with the government,” Bauer said. “I lost my job, I need food benefits. Well, you can only get food benefits if you have a job.”

At least 2.5 million low-income people, or 6% of those enrolled, have lost SNAP benefits since the legislation was signed into law, according to a study by the left-leaning Center on Budget and Policy Priorities published Wednesday.

Bauer said it’s unclear how much of that decline is directly related to the federal legislation. That’s because SNAP participation generally declines during times of economic prosperity and increases during downturns.

But the program is facing unprecedented changes: Under the new law, states have also lost funding for nutrition education programs, must end eligibility for noncitizens such as refugees and asylees, and will lose work requirement waivers for those living in areas with limited employment opportunities. States are also forced to cover more of the costs of the program. 

Earlier this week, a USDA spokesperson applauded the drop in SNAP participation, noting the program’s rolls had fallen below 40 million for the first time since the pandemic. The spokesperson told States Newsroom the program would continue “to serve those with the greatest need while also strengthening program integrity.”

Republicans, including  U.S. House Speaker Mike Johnson of Louisiana, have defended the legislative changes to SNAP, arguing they will help eliminate waste and fraud in the program.

In a June news release, he characterized SNAP as a “bloated, inefficient program,” but said Americans who needed food assistance would still receive it.

“Republicans are proud to defend commonsense welfare reform, fiscal sanity, and the dignity of work,” Johnson said in the release.

Stateline reporter Kevin Hardy can be reached at khardy@stateline.org.