Have They No Decency?

Larry Levitt of the Kaiser Family Foundation called the bill “the biggest rollback in federal support for health care ever.”

Here are seven things everyone should know about Trump’s spending bill:

1. Trump’s bill will cut $980 billion from Medicaid

Approximately 71 million people rely on Medicaid for healthcare. In rural communities, “where Medicaid covers 1 in 4 adults.” The bill uses two primary mechanisms to cut Medicaid spending. It would also slash federal spending to states that have expanded Medicaid under the Affordable Care Act.

First, it imposes paperwork to comply with exemptions for work requirements for individuals with disabilities, pregnant women, and certain other groups.  It strips health insurance from individuals who are either unable to find work or are unable to meet the bureaucratic requirements to prove they have been employed. As a result, millions of Americans will lose their Medicaid coverage.

Second, the Senate bill severely restricts the taxes that states can charge healthcare providers that pay for rural hospitals, a tactic that many states rely on to increase federal funding and, ultimately, the resources available to reimburse providers. However, the change would reduce funding for Medicaid by hundreds of billions of dollars. It will force hospitals in rural communities to close. Others would see a reduction in the quality of care provided.

2. Trump’s bill would increase the number of people without health insurance by 11.8 million

A new analysis by the Congressional Budget Office (CBO), which provides non-partisan budget analysis to Congress, estimates that Trump’s bill “would increase by 11.8 million the number of people without health insurance in 2034.” This is due to both the Medicaid cuts and changes to the Affordable Care Act marketplaces that make it harder for people to enroll. An additional 4.2 million people will lose their health insurance because the bill allows the enhanced premium credits under the Affordable Care Act, implemented during the Biden administration, to expire.

3. Trump’s bill would slash nutrition assistance to poor families by $186 billion

Trump’s bill slashes funding for the Supplemental Nutrition Assistance Program (SNAP) by $186 billion. It also imposes work requirements on individuals with children aged 14 or older, and those between the ages of 50-64.

SNAP “provides monthly payments for food purchases to low-income residents generally earning less than $1,632 monthly for individuals, or $3,380 monthly for a household of four.” In February 2025, “22.5 million households were enrolled in SNAP, receiving an average monthly household benefit of $353.”

5.Trump’s bill would mean lower incomes for the poorest 40% of households

For the bottom 40% of earners, the tax cuts are swamped by the healthcare, nutrition, and other benefit cuts in other provisions of the bill. That means, according to a new analysis by Brendan Duke of the Center on Budget and Policy Priorities, the bottom 40% of earners will end up with less income.

Trump’s tariff policy, which is a tax on American consumers, will make the situation worse. An analysis of Trump’s bill by the Budget Lab at Yale found that only those in the top 10% will be better off.

6. Trump’s bill includes $45 billion for concentration camps and new jails

Trump’s bill includes an eye-popping $172 billion to which exceeds the annual military spending of every other country on earth, except for China.

The massive influx of funding would give ICE a larger budget for jails than the Federal Bureau of Prisons and enough money to hire more agents than the FBI.

The figure includes $45 billion for ICE for new immigration jails, more than 13 times the current budget. An additional $14.4 billion is allocated to ICE for enforcement and removal actions, and $8 billion for hiring and retention.

Another $50 billion would be allocated to completing a wall along the southern border, a project that has proven to be both ineffective and dangerous.

7. Trump’s bill would send billions to defense contractors for dubious projects

Most of this money will be funneled from the Department of Defense to military contractors.

Trump’s bill includes $158 billion in new defense spending including $25 billion on the “Golden Dome,” a space-based missile defense system many experts believe will be ineffective and may ultimately cost as much as $500 billion.