Despite what the Trump administration contends, the Republican budget bill is the exact opposite of what women and children really need.
Bre’Jaynae Joiner is a young single mother from Oakland, Calif. A college graduate, Joiner hopes to get a master’s degree in public health. Like millions of other Americans across the country, she worries about how she’s going to take care of her family’s basic needs: keeping a roof over their heads and putting food on the table.
Since President Donald Trump signed the Republican budget and tax bill into law on July 4, Joiner also worries about losing health coverage for her two daughters, ages 7 and 10.
“My children have always had Medi-Cal [California’s Medicaid program],” she says. “I really don’t know what I would do or how I could afford to keep us covered [without it].”
The Trump administration calls the law “the most pro-family legislation ever crafted,” but according to the Congressional Budget Office, an estimated $1 trillion in federal Medicaid spending will be cut from the program over a 10-year period, and 11.8 million Americans—a majority of them women and children—will lose their coverage by 2034.
The Republican budget also cuts $186 billion from SNAP (the Supplemental Nutrition Assistance Program) through 2034, in what is believed to be the largest cut in the program’s history. SNAP, the federal food stamp program, provides assistance to more than 42 million people nationwide from 22.7 million households—an essential lifeline for millions of children and adults who live with food insecurity.
Rep. Teresa Leger Fernández (D.-N.M.), chair of the Democratic Women’s Caucus, says this budget is the opposite of what American women really need. “The bill is really going to disproportionally impact women because it is women with children who rely on the nutrition programs; it is pregnant women and women in nursing homes and rural women who rely on Medicaid; and it is women who rely on the Affordable Care Act and Medicare. We know women live longer than men, and we can’t forget that [Republicans] just voted to take almost half a trillion dollars from Medicare,” she says.
“The bill is designed to cause a shocking upward redistribution of income,” Heidi Shierholz, president of the Economic Policy Institute, wrote on the organization’s website. “Because … cuts to healthcare and food assistance are so broad and deep, and because the tax cuts for anybody who is not already rich are so paltry, the bill will cause the bottom 40 percent of households to actually lose income on average. … Meanwhile, households in the top 0.1 percent (those making more than $3.3 million per year) will gain $100,000-plus annually under this bill.”
The Rev. Al Sharpton, civil rights activist and president of the National Action Network, says it is by far the most catastrophic piece of social legislation he has seen in his lifetime:
“Because it is the first time that we’ve seen such a blatant disregard for people in need, and such a blatant overemphasis on protecting the super wealthy or over wealthy. Now we’ve seen bad legislation, but I have never seen any that just blatantly and arrogantly says we are going to [renew the] tax cuts of 2017 that will help billionaires and over rich people, and we’re going to add over $2 trillion to the debt … and we are going to do it where we change the rules for Medicaid, which will eliminate millions of people from Medicaid and SNAP.”
Abby J. Leibman, president and CEO of Mazon: A Jewish Response to Hunger, a national advocacy organization working to end hunger among all faiths and backgrounds in the U.S. and Israel, says the massive cuts to Medicaid and SNAP represent an attack on women.
“Any attack on vulnerable Americans, whatever we want to call them—poor, struggling, the working class—those ranks are dominated by women,” Leibman says. “The feminization of poverty was not a glitch. It is, in fact, a longstanding and very deeply entrenched part of the American economy. And when you take that step back and you talk about who’s going to be affected by policies that are concerned about the support of families, you understand that single mothers head a huge percentage of those families.”
By most estimates SNAP cuts will disproportionately impact women, who are 57 percent of SNAP’s recipients compared to the 43 percent who are men.
In addition to outright cuts to SNAP, the new law raises the work requirement age from 54 to 64 and requires that able-bodied adults work at least 80 hours per month. If you fail to meet the work requirement, you will lose SNAP benefits after 30 days upon a notice of noncompliance. Work requirements are particularly challenging for women—especially single mothers, older women and women of color—who are disproportionately burdened by caregiving demands and make up the majority of those in unstable, low-wage jobs.
Essential reproductive healthcare services are also in jeopardy under the law. In an effort to defund Planned Parenthood, the Republican budget denies Medicaid reimbursements to clinics for preventive healthcare services like mammograms, STI screenings, birth control and annual exams if those clinics also provide abortions—even if the abortion care is paid for with private funds. By law, federal funds cannot beused to pay for abortions except under specific circumstances, including rape, incest and life endangerment.
Paige Johnson, president and CEO of Planned Parenthood South Atlantic, which covers South Carolina, North Carolina and most of Virginia and West Virginia, says that in South Carolina, where abortion is banned, PPSAT will continue to provide care to its Medicaid patients while simultaneously pushing back against threats by Gov. Henry McMaster (R) to exclude PPSAT from the state’s Medicaid program.
The feminization of poverty was not a glitch. It is, in fact, a longstanding and very deeply entrenched part of the American economy.
Abby J. Leibman
In a 6-3 decision along ideological lines, the U.S. Supreme Court sided in June with South Carolina in Medina v. Planned Parenthood South Atlantic. The Court ruled that Medicaid patients cannot sue the state to force it to include Planned Parenthood in its roster of Medicaid providers. The National Association of Women Lawyers called the ruling a significant setback for reproductive justice and health equity.
“By blocking Planned Parenthood as a provider, our patients will have very few options to turn to other than our state-run health departments, and few providers are willing to accept Medicaid,” Johnson says. “If you call and try to schedule an appointment for preventive healthcare, you are going to be waiting a long time because they are already overburdened. We don’t live in a region that invests heavily in public health.”
Rural hospitals and health systems across the country will also be hurt by Medicaid cuts. According to the American Hospital Association, rural hospitals are often the single source of care in many rural communities, where nearly 50 percent of children and 18 percent of adults rely on Medicaid, and close to 50 percent of births are covered by the program. The National Rural Health Association estimates that nearly half of all rural hospitals have negative profit margins, and more than 400 rural hospitals are at immediate risk of closure.
These numbers are significantly impactful when you consider that more than 100 rural hospitals have stopped delivering babies since the end of 2020 or announced they will stop in 2025. In a report issued by the Center for Healthcare Quality and Payment Reform, less than half (42 percent) of the country’s rural hospitals still offer labor and delivery services, and in 11 states, less than one-third do, which is especially concerning for Dr. Caitlin Gustafson, a family physician and president of the Idaho Coalition for Safe Healthcare Foundation.
Gustafson says she has a lot of trepidation about what the future will bring for her state under the Republican budget.
“Here we have a provider shortage, and now this is a very real threat,” she says.
At least three labor and delivery units in Idaho have closed, which Gustafson notes can be intense for both doctors and their patients—forcing doctors to practice obstetrics somewhere else and leaving patients scrambling to figure out where they will deliver their babies.
“We have a heavily working Medicaid population,” she says. “When it comes to young families, we have a number of struggles besides healthcare. We don’t have great access to childcare and early childhood education. We have no state-funded services in that way. There’s just a ton of stress on families who are barely making it.”
She adds, “Not a day goes by in my practice where I don’t refer someone with direct, immediate healthcare needs to our patient advocate team to consider their financial options. ‘Do you qualify for Medicaid? Do your kids qualify for Medicaid?’ These questions are an everyday part of my practice.”
This dilemma is not unique to Idaho. Sen. Raphael Warnock (D-Ga.) says the new law will be devastating for his state, particularly for rural communities, where 19 percent of the population relies on Medicaid for healthcare coverage.
“I often say that public policy is a matter of life and death. And in a tragic way, fewer bills that I have seen in my lifetime demonstrate this more clearly,” he says. “If you cut $900 billion out of Medicaid, people are going to die. Plain and simple.”
According to Warnock, as many as 63 rural hospitals in Georgia alone will be threatened by the new law.
“So think about the impact of that on maternal healthcare, on moms delivering babies in communities where the maternal death rate is already higher than anywhere else among wealthy nations, and for Black women, it’s three times the rate,” he notes. “This bill will exacerbate those issues. If you are having a stroke, you’ve got to drive farther because your hospital is closed. Even if you have health insurance, your health is impaired by this bill because we’re going to see hospitals closing.”
According to the American Health Care Association and the National Center for Assisted Living, which together represent more than 15,000 nonprofit and for-profit nursing home facilities and assisted living communities, an overwhelming majority of nursing home providers are deeply concerned about the impact of Medicaid reductions on their own operations. Roughly two in three nursing home residents in the U.S. rely on Medicaid to pay for their long-term care, according to the health policy nonprofit KFF, and 62 percent of residents are women.
In an AHCA survey conducted in May, 52 percent of nursing homes identified as independent single-facility operators, and 60 percent are in rural communities. Some 55 percent of providers said they would have to limit available beds for low-income seniors and individuals with disabilities because of the Medicaid reductions, and more than a quarter of respondents reported that the cuts would force them to close.
These findings come as no surprise to Lori Smetanka, executive director of the National Consumer Voice for Quality Long-Term Care, a national advocacy organization that represents the residents of long-term care facilities in the U.S. Smetanka called the Republican budget cruel and unnecessary and says it will hurt people who need long-term care services and who rely on Medicaid to help them access and pay for those services.
“It cuts a significant $900 billion out of the Medicaid budget,” she notes. “Long-term care is extremely expensive, particularly nursing home care. It’s more than $100,000 a year, and few people have those resources to get the care that they need without that additional support from Medicaid.”
If you cut $900 billion out of Medicaid, people are going to die. Plain and simple.
Sen. Raphael Warnock (D-Ga.)
As opponents of the budget grapple with the impact of the law on vulnerable communities—people who live in nursing homes, single mothers, children, seniors, individuals with disabilities—Paula Combs of Hayward, Calif., a disabled mother of four adult children and 10 grandchildren, worries about the $35 per month she receives in food assistance. She gets by with help from her church, her family and the food bank where she volunteers one day a week.
Combs says if she had the chance to speak directly to the president and the lawmakers who voted to pass the bill, she would first say, “‘You know you messed up, right?’” Then, she says, “I would tell them how [they] messed up. And then I would explain how it has affected me and the next generation, if you want to get technical about it.”
Rep. Fernández of New Mexico says supporting policies to mitigate the harm families will face under the Republican budget will make a big difference in women’s lives. She and the 95 other members of the Democratic Women’s Caucus are advocating for reforms that will actually help women—like paid family and medical leave, comprehensive maternal healthcare and access to affordable, high-quality childcare.
This article also appears in the Fall 2025 issue of Ms. Join today to get our newest issue delivered straight to your mailbox—and fuel another year of our reporting, rebelling and truth-telling.
