As Republicans rammed their so-called One Big Beautiful Bill through Congress last year on the way to President Donald Trump’s desk, opponents of the legislation sounded the alarm over the pain it would inflict upon working families for the benefit of the wealthiest Americans. One year in, those warnings have borne out—and experts say the worst is yet to come.
The GOP budget reconciliation package that Trump signed into law last July 4 ushered in the biggest cuts to Medicaid and the Supplemental Nutritional Assistance Program (SNAP) in the programs’ histories in order to fund trillions of dollars in tax reductions that disproportionately benefit the wealthiest Americans.
Senate Democrats said Wednesday that “Republicans stole from the working class to give to the rich,” highlighting how "millions of families are going hungry and how the law’s cuts “are endangering lives.”
“When Republicans passed their ‘Big, Ugly Bill,’ they chose the wealthy elite over working Americans,” US Senate Minority Leader Chuck Schumer (D-NY) said Wednesday in a statement marking the law’s looming anniversary. “It wasn’t beautiful; it was a betrayal."
“Republicans gutted healthcare, SNAP, and low-cost clean energy to benefit billionaires and big corporations,” he added. "Now, Americans are dealing with a cost-of-living crisis, and they have Donald Trump and Republicans to thank for it. While Trump says, ‘I love the inflation’ and affordable housing is ‘a big yawn’ between rounds of golf, Democrats are fighting tooth and nail to lower costs, expand housing, and make life more affordable.”
The law’s Medicaid eligibility restrictions and paperwork requirements are expected to dramatically increase the number of uninsured Americans. The advocacy group Protect Our Care estimates that, since the passage of the GOP legislation, 3.8 million people have lost coverage they previously had under Medicaid and the Children’s Health Insurance Program. Combined with the loss of Affordable Care Act (ACA) subsidies that Trump and congressional Republicans let expire late last year, approximately 8 million more people are now uninsured.
Health insurance premiums have more than doubled for nearly 22 million families, with further increases expected in 2027.
Since enactment of the Republican law, more than 1,000 hospitals, clinics, and nursing homes have been forced to either close or face the prospect of closure, with rural healthcare services hit particularly hard.
“A mind-boggling number of Americans have found themselves joining the ranks of the uninsured. And this is just the beginning," Protect Our Care president Brad Woodhouse said on Tuesday. “As working families continue to get squeezed left and right by GOP-driven healthcare cost hikes and bureaucratic red tape, millions more Americans will lose the care they rely on to stay alive and healthy.”
Meanwhile, more than 3.5 million people have lost food assistance, including 770,000 children, due at least in part to the law’s SNAP cuts. According to a Center on Budget and Policy Priorities analysis of SNAP caseload data, enrollment in the crucial food aid program plummeted by 4 million between the OBBBA’s enactment and March 2026. The result has been what the New York Federal Reserve Bank in late May called a “remarkable increase in food insecurity, particularly among lower-educated and lower-income households and households with young children."
Lindsay Owens, executive director of the progressive economic advocacy group Groundwork Collaborative, said Wednesday that “President Trump promised to lower costs. Instead, his signature legislative achievement has left Americans to foot the bill for tax cuts for his wealthy friends and donors."
“Millions have lost healthcare coverage and food assistance, hundreds of nursing homes and clinics have shuttered, and the prices for basics like groceries continue to climb,” Owens added. "One year later, the Republican tax law has proven to be a callous bill that punishes working families to reward billionaires.”
There is much more pain to come. The research organization RAND estimates that impending Medicaid cuts under the OBBBA will result in 7.6 million fewer program enrollees by 2034. Overall, roughly 15 million people are projected to lose health coverage and become uninsured by 2034 due to Medicaid and ACA marketplace cuts in the OBBBA, according to estimates from the nonpartisan Congressional Budget Office.
“We weren’t being hysterical. We knew this would happen,” Congresswoman Sara Jacobs (D-Calif.) said this week. “When Republicans passed the Big Ugly Bill and cut funding for healthcare, they literally signed away millions of Americans’ ability to afford health insurance. And now it’s happening.”
On Tuesday, the Washington Center for Equitable Growth published an analysis examining the OBBBA’s impacts on the overall economy. The research nonprofit noted that the legislation “makes enormous cuts to critical income supports on which Americans depend to survive,” while at the same time “is a windfall for corporations and wealthy households, making it the most regressive tax and budget law in at least 40 years.”
As Common Dreams reported, the OBBBA is expected to give the wealthiest 1% of Americans $1 trillion in tax cuts while adding $4.6 trillion to the federal deficit over the next decade.
“Even so, its tax cuts were not paid for,” the Washington Center said of the law. “By increasing the federal budget deficit, the law not only limits the nation’s ability to invest in future needs but also drives up interest rates on mortgages, car loans, and business loans.”
“Thus far, implementation guidance from the Trump administration has been faster and harsher than anticipated, with looming consequences for state budgets—which will necessitate further cuts to state initiatives that support families and that lead to longer-term state economic growth,” the center added.
The American Federation of State, County, and Municipal Employees (AFSCME)—a union representing 1.3 million public sector workers and retirees—said Monday that the year of harm wrought by the OBBBA “is only the beginning.”
“Some of the law’s cuts hit immediately, while extreme changes and cuts to Medicaid, for example, won’t happen until after November this year. But working families are already feeling its impact,” the union said.
“You feel it when you ask yourself whether the energy bill gets paid or the rent does—because you can’t always do both,” AFSCME continued. “You feel it when you watch your health insurance premiums climb while your neighborhood clinic cuts its hours.”
“For AFSCME members, you feel it at work too—when you talk to families and have to break it to them that new policies mean they will lose food assistance, Medicaid, and other life-sustaining support,” the union said. “You feel it when low pay drives high turnover, so you’re forced to work mandatory overtime. And you feel it when states, cities, and towns say they don’t have the resources to compensate you fairly for your work or invest in our schools, hospitals, and roads.”
AFSCME asserted that the Republican law and its harms should sound “a nationwide call to action for working families to get organized and demand more.”
“The labor movement is how working people have always asserted that we are not spectators in our own lives,” the union added. “That we have a voice, a vote, and the power to drive change.”
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