Cuts to Medicaid and Health Insurance Subsidies: Who Stands to Lose?

It could easily be argued that President Trump’s “Big Beautiful Bill” is anything but beautiful for the average American. This bill will be, if the Senate passes it, “the largest transfer of wealth from the poor and middle class to the rich in a single law in US history.”¹ It features $700 billion in cuts to Medicaid (called Medi-Cal in California) and $800 billion in cuts to federal subsidies for Obamacare. 

15 million people stand to lose their health insurance if this bill passes. The Congressional Budget Office estimates that 7.6 million people will lose their Medicaid coverage over the next few years, and another 7.4 million will lose their Obamacare coverage. 

Not only will millions of Americans lose their health insurance, but their Supplemental Nutritional Assistance Program (SNAP) benefits (previously known as Food Stamps)as well. Yes, to save $300 billion, the Congressional Republicans voted to cut SNAP benefits to 42 million Americans. 

These budget reductions will help pay for a tax cut for the richest Americans and corporations. The tax cut amounts to a mind-boggling $4 trillion and is partly bankrolled by cuts to Medicaid, Obamacare health insurance subsidies, SNAP, and ultimately Medicare². 

Who gets the bulk of the tax cut? Not the bottom 20% of Americans who will lose at least $800 a year. In all, 60% of the tax cuts go to the top 20% of households, of which half goes to Americans making more than $460,000 a year. It appears that the rich are not paying their fair share of taxes on income — the wealthiest 400 billionaires paid an average tax rate of just 8%. At the same time, the average taxpayer paid an average of  13% of their income.

So, what does all this mean for our community? In short, proposed cuts in health care coverage and SNAP benefits and associated job losses will be devastating to California and Tuolumne County. It is estimated that at least 2 million people in California, including 30,000 people in Rep. Tom McClintock’s Congressional District, will lose their health insurance. SNAP benefits will be eliminated for 888,000 Californians. 

Twenty-seven percent of the population in Tuolumne County, including 49% of our children, are on Medi-Cal³. It is important to remember that not only does Medi-Cal pay for primary and specialty medical care, hospital stays, and medications, it also pays for some medical services in schools, such as speech and occupational therapy. Medi-Cal also pays for community-based services to help disabled people and older adults remain in their homes, including part-time caregivers (In-Home Supportive Services). It is the main source of funding for nursing home care. Also hidden within this bill is a ban on Medicaid funding for gender-affirming care for children and adults, as well as for any women’s health care provided by Planned Parenthood. 

These cuts will affect someone you know: it may be you, your children, your mother, or the caregiver who keeps your loved one out of a nursing home. They threaten the financial health of rural hospitals and our medical providers. The health of our country and our county is at risk in a way never seen before. If you are outraged by this “Big Beautiful Bill,” please know that the Senate will be debating during June with plans to pass it by early July. 

NOTES

1. Colin Seeberger, Andrea Ducas, and Lily Roberts, “The Devastating Harm of House Republicans’ ‘Big Beautiful’ Bill by State and Congressional District,” Center for American Progress, May 21, 2025.
2. Donna LeValley,  “Four Changes to Medicare in the One Big Beautiful Bill Act,” Kiplinger Letter, May 27, 2025: “The cost of the pending legislation would trigger automatic cuts to Medicare and some other programs… Without congressional intervention, Medicare payments would be reduced by 4%, resulting in a $500 billion cut over eight years, beginning in 2026.” 
3. “California DHCS Medi-Cal Countywide Averages for State Fiscal Year 2023-24 Quarters 1-4,” California Department of Health Care Services.

ADDITIONAL NOTES

• “Do the rich pay their fair share?”, Oxfam, June 2, 2025. 
• Greg Iacurci, “House Republican tax bill favors the rich — how much they stand to gain, and why”, CNBC, May 23, 2025.
• Carson Richards and Sara R. Collins, “Enhanced Premium Tax Credits for ACA Health Plans: Who They Help, and Who Gets Hurt If They’re Not Extended,” The Commonwealth Fund,  February 18, 2025.