Federal budget fallout is just beginning

Report sets baseline for tracking long-term impacts of H.R. 1

Originally branded the “One Big Beautiful Bill,” the Trump administration’s signature budget legislation (H.R. 1) is a complex attack on public services, including historically large cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP). A new report from Policy Matters Ohio shows that legislators chose to make these cuts to pay for tax policies that disproportionately benefit high-income households.

“Federal legislators made a conscious decision to sacrifice crucial services to pay for tax cuts that most benefit the wealthiest Americans,” said Policy Matters Senior Project Coordinator Kate Sopko, author of the report. “They made that choice despite knowing that it will seriously harm many of their constituents and meaningfully benefit very few of them in the long run.”

With H.R. 1, Congress extended tax cuts made during the first Trump administration, which were set to expire at the end of this year. Making those cuts permanent will cost $4.2 trillion in lost revenue over the next decade. Nearly three-quarters (72%) of these extended tax cuts will go the richest 20% of households.

Congress partly offset revenues lost to these tax cuts by cutting $1.1 trillion in health care spending (mostly from Medicaid) and $187 billion from SNAP. These programs serve tens of millions of American adults and children every year, with 71.4 million enrolled in Medicaid and 42.6 million enrolled in SNAP as of January 2025. 

Some Ohioans are beginning to feel the impact of H.R. 1, though the worst is yet to come. “We’re already seeing steep increases in the cost of Health Insurance Marketplace plans,” Sopko said, referring Ohioans to KFF’s online tool for calculating their premiums. “Even more concerning is the long-term damage we can expect, since many of the most harmful provisions won’t take effect until after the 2026 midterm elections.” She added, “This report is our baseline for monitoring how legislators’ decision — to sacrifice services that benefit millions to pay for tax cuts that most benefit the wealthiest Americans — will harm Ohioans, now and for a troublingly long time.”