The real cost of the Big Beautiful Bill: Hunger and health

Business Journals

18-06-2025

The Big Beautiful Bill, currently being considered by the United States Senate, is anything but beautiful. The proposed harms to people are many — jeopardizing millions of Americans' access to Medicaid, food assistance, higher education grants and infringing on the rights of lawful immigrants to pursue the American dream — all to make permanent tax cuts benefiting only the top 1% of earners. But what about the rest of us?
The widespread harms of the bill have garnered bipartisan opposition at a time when polarization is the norm. Kansas Senator Jerry Moran spoke about the negative impacts of the bill on the Senate floor. Missouri Senator Josh Hawley has long been outspoken in opposition to the bill, calling it 'morally wrong.' Other legislators across the political spectrum have also raised grave concerns about this massive bill that will, even after cuts to essential programs, add $3.3 trillion to our national deficit.
The fallacies of this bill show in how the legislature has moved to adopt it. Middle of the night debates and votes, and accelerated processes to move the bill through the House, are contrary to the transparency and sound decision necessary in a true representative democracy. Only through such tactics could legislation that would cut $700 billion from Medicaid and cause an estimated 15 million people to lose their health insurance coverage make it this far in the process. We as Americans must stand up for ourselves and say no.
Impact of work requirements
The addition of work requirements on top of federal spending cuts compound and confuse the issues of Medicaid program efficacy and efficiency. The vast majority of Kansans and Missourians covered through Medicaid are already working. Where states have enforced work requirements, it has resulted in many working Americans losing their coverage, not because they do not qualify, but because of administrative burden and error.
For example, Arkansas removed 18,000 working people from Medicaid shortly after implementing work requirements a few years ago due to overly complicated online filing requirements, lack of awareness and lack of internet access. In Missouri, where Medicaid was expanded in 2020 by constitutional amendment, it is estimated that work requirements would cut off nearly 80,000 people from health insurance for similar reasons. This is an unjust consequence for people working in our communities and positively contributing to our economy.
Cuts to food assistance and job losses
Another cruel element of the bill is its sweeping, unprecedented cuts to food assistance (known as SNAP), totaling nearly $300 billion and projected to cut nutritional support for 28 million children, older adults, and people living with disabilities, impacting Congressional districts across Kansas and Missouri. In the bi-state Kansas City region, well over 30,000 working Missourians with children in school and 15,000 in Kansas would lose life-saving access to food. Research and history show that reducing or losing SNAP benefits altogether increases hunger and makes for worse health outcomes in working families with children.
There is no discernible economic gain to these moves that would justify leaving families sick and hungry. Economists project that the 550,000 in job losses from the Medicaid cuts alone will put us at the brink of a recession. Cuts to SNAP are no better, leading to a loss of 143,000 jobs directly and indirectly associated with our food systems and reduced economic activity of $30 billion. Many of these workers who face lost opportunities and jobs would simultaneously be unable to access safety net benefits like SNAP because of the cuts.
Harming our rural communities
This bill is disastrous for rural communities — where good paying jobs, access to health care and healthy food are extraordinarily hard to come by. Cuts to Medicaid are projected to result in rural hospital closures, as they rely on Medicaid for revenue. Rural health care jobs would be cut by direct extension. An analysis by the National Rural Health Association shows that each rural hospital employee is associated with roughly $200,000 per year in economic activity. While many rural residents are reliant on the Medicaid program for coverage and SNAP for food assistance, even those who are not on Medicaid and Medicare will suffer when the hospital nearest to them closes or other services are cut because of lack of funding.
Impact on workforce development
The bill also changes the eligibility for Pell grants for students in households earning low incomes. Given the physician workforce shortage (and shortages in other health science professions) and that at least 5 percent of students in medical schools would have qualified for these grants, reduced access to funding for higher education will exacerbate work force shortages in rural and other parts of our country.
Infringements on immigration
Legal immigrants, refugees, and asylum seekers are also impacted. People who arrived legally in America would be denied access to Medicaid and Medicare even if they qualify or have satisfied the requirements to utilize these programs.
There is too much at stake for too many people, as this budget bill sacrifices the quality of life for most Americans for the benefit of a small few. We cannot afford to gamble on hypothetical trickle-down economics when the economic benefits of these programs and the positive impact on people's life circumstances are proven. Senators must heed what is best for the American people with whom they are responsible for representing and vote this bill down.
Health Forward Foundation is supporting and building inclusive, powerful, and healthy communities by prioritizing people who experience the greatest injustices in health outcomes. Through leadership, advocacy, and resources, we are championing an equitable future that will serve us all. Since we began grantmaking in 2005, Health Forward has awarded approximately $364 million to nonprofit organizations addressing community health needs.