Deep Cuts to Our Foundation: How the House-Passed Budget Undermines Health and Wellbeing for Young People and Families
July 9, 2025
On July 3rd, the House passed the final Budget Reconciliation Bill, stripping away essential supports like health coverage and food assistance from millions of young people and families. These cuts to programs including Medicaid, the Affordable Care Act (ACA) marketplace coverage, and the Supplemental Nutrition Assistance Program (SNAP), will leave young people and families without health coverage and other foundational health supports.
These cuts are significant and will have an impact on the daily lives and health of people across the country. Without health coverage, families will lose access to health care. A three-year-old who is struggling to speak will miss the chance for early intervention at a time when the additional support will be most helpful. A young person with asthma will go without the care they need and experience more regular asthma attacks that disrupt their education and work. A new mother experiencing postpartum depression will be unable to see a therapist who can help her manage stress, improve her overall wellbeing, and ensure she can care for and nurture her child as she would like to. And a parent facing unexpected surgery will have the added burden of medical debt—causing stress, delaying their recovery, and leaving them with uncertainty about their financial future.
In total, an estimated 17 million people will lose health coverage, including millions who will become uninsured due to deep Medicaid cuts.¹ These coverage losses stem from sweeping and harmful policy changes that are designed to limit access to coverage and care, including Medicaid work reporting requirements for adults ages 19 to 64. We know these work requirements are counterproductive and cause people to lose health insurance and other critical benefits that are foundational to health and wellbeing. They also significantly increase health-related costs, stress, and time burdens for families forced to navigate the paperwork and logistical hurdles created by work requirements, while imposing significant cost and administrative burdens on the state agencies that implement and administer these rules.
The bill also makes it harder for people to maintain coverage by requiring them to prove their Medicaid eligibility every six months instead of annually. These requirements are designed to push people off of their health plans. Research shows that more frequent eligibility checks (e.g., every 6 months instead of annually) increase the risk of procedural disenrollments—where people lose coverage not because they’re ineligible, but due to administrative errors or processing delays, or missed paperwork and deadlines. Meanwhile, continuous eligibility – like 12-month continuous coverage for children – has been shown to reduce churn, improve access to care, and it is cost-effective.
The bill also targets immigrant families by further limiting access to health care for many. Only a limited number of lawfully present immigrants will remain eligible for Medicaid, CHIP, Medicare, SNAP, and premium tax credits under the ACA.² Meanwhile, the bill removes eligibility for many immigrants lawfully present in the United States, including those here as refugees or granted asylum.³ These provisions add to current restrictions, including the five-year waiting period for green card holding adults, that already block access to benefits – such as Medicaid and SNAP – for many lawfully present immigrants.
The bill also imposes new burdens on adults enrolled through Medicaid expansion. It does so by raising the out-of-pocket costs for Medicaid expansion enrollees by requiring states to impose new cost-sharing for many services for those with incomes above the poverty line. Research shows that even small co-payments force many to make tough choices between seeking care and buying the basics like groceries or making a car payment. This means a young adult may face higher fees for doctor visits, prescriptions, and other medical care – making it harder to afford essential treatments and adding extra strain to their already tight budget.
Marketplace coverage is also weakened. The bill shortens the open enrollment period, giving people less time to enroll in coverage, poses burdensome verification requirements that make it harder for eligible people to keep their coverage, and would lead to higher costs for enrollees. The shortened open enrollment period means a young adult may not have enough time to complete the sign-up process, risking gaps in coverage during critical periods of transition or new employment. Stricter verification rules create hurdles for a gig worker and freelancer with fluctuating income, who may struggle to provide consistent documentation—putting their coverage at risk simply due to administrative barriers. At the same time, a family running a small business could face higher premiums and increased out-of-pocket costs, forcing difficult choices between paying for essential medical care or meeting basic living expenses like rent and groceries.
The bill also threatens access to reproductive and preventive care. Although federal dollars already cannot be used for abortion care, the bill defunds Planned Parenthood clinics that provide critical health care including cancer screenings, prenatal care, and contraception—particularly in rural and underserved areas.⁴ Because many Planned Parenthood centers rely heavily on these federal funds to operate, losing this support would force a significant number—estimated at about one in four providers of reproductive health services nationwide—to close, leaving a significant gap in access to essential health care.
The detrimental impact of these cuts goes beyond healthcare and coverage. Critical programs that provide foundational health supports were also dramatically cut, for example, programs that provide food assistance. The bill includes billions of dollars in cuts to SNAP, reducing or threating benefits for more than 22 million families. It shifts administrative and benefit costs to states—forcing states to raise taxes, cut access, or reduce funding for other essential programs. It freezes future SNAP benefit increases, even as food prices continue to rise, and imposes harsh new time limits on parents of school-aged children over age 13 while stripping current time-limit exemptions from individuals, including young adults aging out of foster care.
These are just some of the many ways this budget takes direct aim at the health and wellbeing of millions of young people and families. A budget bill may sometimes seem like something removed from the day-to-day life of people, but it is absolutely critical to supporting the health and well-being of young people and families. This budget bill shifts costs to states, and often directly to people, it cuts critical programs that support the health and nutrition of young people and families, it makes significant cuts to health coverage directly, and it increases administrative burdens that will lead to a reduction in health coverage, among many other dangerous policy choices.
Young people and families in this country deserve more. We need policies that support—rather than hinder—the ability of young people and families to access health coverage, care, and other supports they need to be healthy, happy, and well. The federal budget is an opportunity to invest in the things that families need – it is hard to imagine something that is more foundational to what young people and families need than the opportunity to be healthy.
¹Estimates vary. The Center on Budget and Policy Priorities estimates that between 9.7 million and 14.4 million people would be at risk.
²These include Lawful Permanent Residents, Certain Cuban and Haitian nationals considered to be “Cuban and Haitian Entrants” for benefits purposes under existing benefits law, and People residing in the US under a Compact of Free Association with Palau, Micronesia, and the Marshall Islands.
³These include people resettled in the United States as refugees, granted asylum or withholding of removal, survivors of domestic violence with a pending or approved application for lawful status under the Violence Against Women Act, survivors of trafficking with a pending or approved T visa, and people with Temporary Protected Status and valid visa holders.
⁴On July 7, Planned Parenthood won a temporary injunction against the Department of Health and Human Services (HHS), the Centers for Medicare & Medicaid Services (CMS), and their directors, enjoining them from enforcing the law blocking Medicaid funding for Planned Parenthood under the budget reconciliation act. The temporary injunction will stay in effect for 14 days.
