When issues such as abortion were raised on the 2024 campaign trail, President Donald Trump would often wave away his allies’ hardline anti-abortion stances, hiding behind his professed belief in states’ rights to make their own decisions about whether to maintain or restrict access to reproductive health care. Post-election, the truth came out: Trump was definitely going to be interfering further with reproductive care access from the Oval Office.
But with his multi-trillion dollar tax cut legislation — a version of which passed out of the Senate Tuesday and is moving toward a final vote in the House before landing on Trump’s desk — the president and Congress actually are letting the states decide the fate of key programs. Yet the range of options the bill leaves them with, after making its sweeping cuts, makes that choice almost impossible, state officials warn. Those decisions include whether or not and how to adequately fund Medicaid, Medicare and the Supplemental Nutrition Assistance Program (SNAP) in the face of historic federal cuts.
As Congress rushes to pass Trump’s agenda before its arbitrary self-imposed July 4 deadline, state legislatures and governors across the country have been passing their own budgets, while anticipating federal government funding shortfalls and weighing in on the so-called “One Big Beautiful Bill” from their own vantage points. Most of the loudest warnings have come from Democratic officials, while state Republicans seem to be largely standing by Trump, despite the pain the megabill will cause in their states.
On Tuesday, Democratic Arizona Gov. Katie Hobbs signed her state’s budget bill. At a press conference that day, Hobbs said if Trump’s tax cuts and spending bill passes, it will impact everyone in her state.
“This budget bill will be devastating for Arizona in so many regards, but primarily [for] the hundreds of thousands of Arizonans that will lose their health care,” the Democratic governor said. “We don’t have the capacity to mitigate the cuts,” she added. “We don’t.”
New York Gov. Kathy Hochul in a press release pointed a finger at New York Republicans who support the bill.
“Over one million people in our state would lose their health care,” Hochul said. “A quarter million would see cuts to SNAP. Nursing homes will close. Food prices will rise. Hospitals will shutter. All during a national affordability crisis.
“Every single New York Republican in Congress backed this disaster.”
The Associated Press reports a number of states factored in federal losses by reserving additional funds and creating entire new bodies to monitor the state and local impacts of economic policy in Washington.
New Mexico, the AP reports, created a trust fund worth as much as $2 billion to help mitigate cuts to Medicaid and subsequent coverage or benefits losses. A budget passed by Vermont’s state legislature earmarked up to $110 million to cover federal losses, while Hawaii officials set aside an additional $200 million safety net in their state budget. A March analysis from Moody’s Ratings found Maryland was the state most at risk from federal spending reductions, due in part to the state’s significant share of federal workers.
Following the Senate passage of the reconciliation package this week, Democratic Pennsylvania Gov. Josh Shapiro questioned whether the state can continue its SNAP program.
“There’s real question as to whether or not we’d even be able to operate SNAP any longer, given the change in the formula and given the people that are going to be knocked off,” Shapiro said at a non-budget-related press conference, according to the Philadelphia Inquirer.
Currently, the federal government covers the entire cost of SNAP benefits and shares the cost of administering the program with states. The reconciliation package increases the state share of administration costs and requires states to share in the cost of benefits, too, something that hasn’t been done historically. Those moves decrease federal spending on SNAP by $65 billion according to the New York Times, or just 1% of the federal budget, but stand to significantly increase costs for states.
An analysis by the progressive think tank the Center on Budget and Policy Priorities (CBPP) found 40 million people would be impacted by the reconciliation package’s cuts to SNAP, nearly half of whom would be children. According to another analysis by the New York Times, the package guts federal health care spending on Medicaid, Medicare and Obamacare by more than $1 trillion over 10 years. Just one provision in the federal tax cut bill — one that decreases the amount of federal spending on Medicaid enrollees covered under an expansion — would cost states $93 billion between 2031 and 2034 alone, according to the CBPP.
Democratic New Mexico Gov. Michelle Lujan Grisham told ABC that 20% of hospitals and health care providers were at risk for closing because of the federal cuts.
“No state can afford to do this by itself, that’s the point,” Lujan Grisham said. “This is going to have generational lasting negative impacts.”
In addition to stock-piling cash reserves, some legislatures chose to just spend less.
Virginia Gov. Glenn Youngkin, a Republican who has aligned himself with Trump, sliced $900 million from his state’s budget, at the same time praising Trump for “rightfully [resetting] trade imbalances and [restoring] fiscal responsibility in D.C.,” the Virginia Mercury reports. In the days after the passage of the reconciliation bill, Youngkin remained quiet about his public stance on the legislation.
Missouri Gov. Mike Kehoe, another Republican who also appears to have said little to nothing publicly after the passage of the bill, either vetoed or froze $500 million worth of general fund spending, the AP reports.
Some Republican governors came out in support of the legislation, despite the ways it may impact their constituents. A health care program director in Nebraska named Sarah Maresh said as many as 55,000 state residents could lose health care, according to the Nebraska Examiner. But in a tweet, Nebraska Gov. Jim Pillen called the passage of the bill a “huge step forward” that supports families and preserves “federal safety net programs.”
Not every GOP governor appeared to be so enthusiastic. Several were mum after the reconciliation package passed. Gov. Kevin Stitt of Oklahoma and Gov. Spencer Cox of Utah both expressed concern about an AI regulation provision that the Senate scrapped in the hours before the bill passed that chamber.
And while lawmakers in Washington work feverishly to pass the bill, gutting health care, food benefits and clean energy incentives, before the July 4 holiday and ahead of a coveted late-summer recess, state lawmakers are considering truncating their summer recesses to return for emergency sessions.
