by Jennifer Porter Gore
On Tuesday, Senate Republicans narrowly passed Donald Trump’s spending bill that gives big tax breaks to the wealthy while slashing roughly $1 trillion from Medicaid, food assistance, and other safety-net programs that a disproportionate number of Black Americans depend on.
All Senate Democrats and three Republicans opposed the “One Big, Beautiful Bill,” which ultimately needed Vice President JD Vance’s vote to break a 50-50 tie. Democrats attempted to offer several amendments that would protect the social programs, but they were shot down in an overnight session.
Since the bill was introduced in Congress earlier this year, health advocates and anti-poverty activists stated loudly and often that the bill will endanger the most vulnerable Americans, including women and children. Besides adding trillions of dollars to the federal debt, experts say the bill could cause 11 million to 17 million people to lose access to healthcare insurance.
Dr. Richard Besser, president and CEO of the Robert Wood Johnson Foundation, said in a statement that the Senate “has decided to reverse generations of progress” on the nation’s founding principles of life, liberty, and the pursuit of happiness.
“By its very design, the bill will make our country sicker, put children at risk of going hungry, and make it harder for families to afford basic necessities—all to further enrich wealthy individuals and corporations,” he said. “It is unfathomable to see policymakers intentionally inflict so much damage on the people they represent,” he said.
Experts Warn of Deep Harm to Black Communities
Alexis McGill Johnson, president and CEO of Planned Parenthood Action Fund, said the bill will create “devastating” gaps in reproductive care. Studies show 1 in 3 Black women have used Planned Parenthood for preventative services, like cancer screenings, birth control, and treatment for sexually transmitted infections.
“This bill threatens to close nearly 200 Planned Parenthood health centers” and put “the full range of reproductive care, like birth control, cancer screenings, and STI testing and treatments out of reach for many,” McGill Johnson says. “We watched every single member take every single vote. Planned Parenthood Action Fund will never stop reminding the 19 million Planned Parenthood supporters who are to blame for taking away people’s power to control their reproductive lives and futures.”
Anti-Poverty Programs Gutted to Fund Tax Breaks
The bill would extend roughly $3.8 trillion in tax cuts that Trump signed into law in 2017, during his first term. It would also provide tens of billions of dollars in new funding for border security and the military, and include versions of the president’s campaign promises, such as not taxing tips and overtime.
To pay for it, experts say, the legislation calls for what some describe as historic cuts in anti-poverty programs — achieved primarily through sweeping changes to Medicaid, the joint federal and state program that provides health care for roughly 70 million low-income, elderly, and disabled Americans. Chief among the reforms are requirements that able-bodied adults work in order to receive government-subsidized healthcare.
Medicaid health insurance covers more than one-third of the nation’s population and more than 40% of births. The program enables low-income Americans to have medical care, pays out-of-pocket health costs for low-income retirees, and provides nursing home and in-home care services for the elderly. — including more than half of all births in Louisiana, Mississippi, New Mexico, and Oklahoma.
As a small sweetener to the bill, the Senate’s version added a $50 billion fund for rural hospitals to help health care providers deal with the proposed Medicaid cuts, which are even worse than those proposed by the House last month.
“To be blunt, now is not the time to be slashing the Medicaid program,” Sen. Lisa Blunt Rochester, a Democrat representing Delaware, said during the debate.
“My amendment would stop cuts to Medicaid used for vital hospital services, especially labor and delivery rooms,” she said. “Obstetric units, particularly in rural hospitals, are closing at alarming rates – actually creating maternity deserts in this country. And a reason why? Low Medicaid hospital rates.”
Blunt Rochester’s amendment would have protected state-directed payments, which are funds states use to increase access to vital services. SDPs are crucial supports for maternal health services, including labor and delivery wards.
“Seniors will struggle to afford long-term care. People with disabilities will lose critical healthcare coverage that allows them to work and live independently,” Besser said. ”Rural communities across America will be decimated by hospital closures, and people will lose their lives. It is unfathomable to see policymakers intentionally inflict so much damage on the people they represent,” he said.
Health advocates stated loudly and often that these cuts will endanger the most vulnerable Americans, including women and children. Plans to “defund” Planned Parenthood for America were also approved, which the organization says could shutter almost 200 PPFA health centers. The centers serve more than 1 million patients who mostly live in states where abortion is legal.
Sen. Patty Murray, a Democrat representing Washington state, offered an amendment to strike the devastating “defund” provision from the bill. But it also failed to get any Republican votes.
The legislation now returns to the House so that both chambers can combine their language into a final bill for Trump to sign.