Tens of thousands of low-income residents in Central Texas are at risk of losing critical access to Medicaid, marketplace health insurance, and food benefits if the Senate passes President Donald Trump’s proposed “One Big Beautiful Bill Act” without modifications.
The budget reconciliation bill seeks to advance various elements of Trump’s domestic policy agenda, introducing new restrictions on Medicaid. Proponents of the bill argue that these measures will help reduce waste and fraud in the program.
“What we’re doing is shoring up this program so that it will survive in the long term for the core population who needs it,” stated Texas Congressman Brandon Gill, a Republican from Flower Mound, during an interview with CBS News.
However, critics warn that many of the proposed changes could create unnecessary barriers to aid, ultimately denying essential coverage to those who need it most.
According to Texas Health and Human Services, over 4 million low-income Texans depend on Medicaid for their health care needs, which includes routine doctor appointments. Congressman Lloyd Doggett, a Democrat from Austin, estimated that approximately 36,000 individuals in his district alone could lose their benefits if the bill is enacted as is.
“Even in a city as prosperous as Austin, about half the babies born at Ascension Seton have their birth financed through Medicaid,” Doggett noted at a news briefing last month.
The bill encompasses several provisions that will directly affect Texas Medicaid, such as a rule prohibiting states from imposing new taxes on healthcare providers to offset costs. Additionally, Medicaid recipients would be required to re-establish their eligibility biannually instead of once a year, which would contribute to increased bureaucratic red tape.
The health policy research organization KFF warns that Texas could face a loss of around $28 billion in federal Medicaid funding over the next decade if the bill passes in its current form.
Lynn Cowles, a health policy expert at Every Texan, indicated that states will likely have to find ways to compensate for these drastic cuts. This could put funding for nursing homes and long-term care services for disabled Texans at risk, as these services are often the first to face reductions when federal Medicaid funding diminishes.
“Those tend to be the first services that get cut by states when there are large federal reductions in Medicaid funding, and it’s because those are optional services by federal law,” Cowles explained during a press briefing in May.
In addition to changes in Medicaid, the Supplemental Nutrition Assistance Program (SNAP) stands to receive $300 billion in cuts across the country. The proposed legislation would also escalate the administrative costs for states managing the program, prompting fears that some states may opt to curtail benefits due to the increased expenses.
Beth Corbett, vice president of government affairs for the Central Texas Food Bank, expressed concern that her organization may see a surge in demand if the proposed changes to SNAP are approved.
“Our organization knows from experience that when access to those programs decreases, demand for food bank services significantly increases,” she said.
Health insurance obtained through the Affordable Care Act marketplace would also be adversely affected. The bill does not renew the premium tax credits established in 2020, potentially leading to higher premiums for many individuals and families.
Walter Moreau, executive director of Foundation Communities, a nonprofit serving Central Texans seeking health insurance, is preparing for significant surprises during the next enrollment period.
“People that have coverage right now in the marketplace and like it are going to get sticker shock,” Moreau stated, voicing concerns about a provision that would reduce the marketplace enrollment period from 10 weeks to just six.
Individuals will also be required to provide more documentation to qualify for the remaining enhanced tax credits each year, complicating the renewal process that previously allowed for automatic re-enrollment.
“I fully expect that [demand] is going to increase this year because of confusion around coverage,” added Moreau. “And now, we’ve only got six weeks to provide help for people.”
KFF projects that around 1.7 million Texans could lose their insurance due to the proposed alterations to the Affordable Care Act.
While Foundation Communities is gearing up for a rise in demand for its services, the organization is simultaneously grappling with a loss of federal funding previously allocated for healthcare navigation services. Moreau mentioned that layoffs are underway as he seeks local partners to bridge the funding gap before the upcoming enrollment season.
Despite the challenges, Moreau remains hopeful that the Senate will amend the bill to mitigate its negative impact on health coverage. With a narrow majority, Republicans will require every vote to ensure the passage of the bill.
Notably, some conservatives, including Senator Josh Hawley of Missouri, have voiced their opposition to cuts in Medicaid. Others have criticized the legislation for failing to actually lower the U.S. budget deficit, a priority publicly emphasized by the Trump administration. While the bill proposes cost cuts through Medicaid, it simultaneously extends Trump’s 2017 tax cuts primarily benefiting high earners.
In fact, the non-partisan Congressional Budget Office estimates that the bill could increase the deficit by approximately $3 trillion over the next decade.
Doggett urged senators to reconsider cuts to healthcare and food security, suggesting they could save substantial funds by reassessing the tax cuts.
“If we made changes on the revenue side, we would not have to make the draconian cuts that are being proposed here in health care and food security, and we could still deliver some tax benefits to those in the middle class,” he proposed.
President Trump has called for Congress to finalize the bill before July 4, intensifying the urgency surrounding its potential passage.
image source from：https://www.kut.org/health/2025-06-13/medicaid-congress-budget-bill-affordable-care-foundation-communities-snap-austin-tx
