President Donald Trump marked the 250th anniversary of the nation’s founding on July Fourth with a speech praising a roaring stock market, urging election reforms and hailing military interventions in Venezuela and Iran, while another anniversary went unmarked: the passage of the One Big Beautiful Bill Act, signed into law by Trump exactly one year earlier.
The bill is now landing where these packages always land first — on ordinary people who need healthcare, food assistance and a little breathing room. Its cutbacks to Medicaid and food stamps have fueled criticism, while Trump and Republicans try to dress it up as a “Working Families Tax Cut Bill.” The rebrand says plenty. The damage is harder to hide.
Who Pays for the Deal
Historic reductions to federal Medicaid spending and changes to eligibility requirements quickly became the most politically fraught part of the legislation. The law, known as OBBBA, is projected to slash roughly $1.2 trillion from Medicaid through 2035, leaving 7.5 million more people without coverage by 2034, according to the Congressional Budget Office. The most notable provision adds a federal work requirement to Medicaid. That’s the apparatus speaking in its cleanest language: work, qualify, obey, or lose access.
In California’s battleground 22nd District, Democrat Randy Villegas made the fallout from the Medicaid cuts a centerpiece of his campaign against incumbent GOP Rep. David Valadao. “We’re the most impacted in the entire country, where two out of every three of our constituents rely on Medicaid,” Villegas said. “Almost 70,000 people stand to lose healthcare in our district,” he said, adding that local clinics he’s spoken to are “worried about the possibility of shutting down and not being able to provide services to our community.”
Valadao, for his part, said OBBBA will preserve Medicaid long term. “One of my goals representing the Central Valley is to protect Medicaid for those who truly need it the most: seniors, vulnerable children, and disabled Americans,” he said in a statement to CNN last month. The language is familiar. The cuts are still there.
In Iowa’s competitive US Senate race, Democrat Josh Turek has hammered Republican Rep. Ashley Hinson over her vote for the legislation and its reforms, which have stressed healthcare providers. Turek, who uses a wheelchair because of his spina bifida, attributed to his father’s exposure to Agent Orange during the Vietnam War, has referenced his own experience navigating the healthcare system to underscore his opposition. “I certainly know firsthand the importance of access to quality healthcare,” he has said.
The Rural Fix That Doesn’t Fix Much
The final package created a $50 billion Rural Health Transformation Program as a concession. Hinson and her allies have touted the program to voters. An ad from the National Republican Senatorial Committee said it secures “more than $209 million for rural healthcare in Iowa.” The fund should provide a much-needed, though temporary, investment in communities that have long lacked adequate healthcare services, experts said. States plan to use the funds to address chronic disease, beef up workforces and expand telehealth services, among other uses.
But the numbers don’t flatter the rescue operation. The program doesn’t come close to replacing the estimated $137 billion in federal Medicaid funding that rural areas are projected to lose over a decade, according to KFF. Iowa is expected to lose more than $3.8 billion in federal Medicaid spending during that period. Timothy McBride, a health economics professor at Washington University’s School of Public Health, said, “There’s no doubt that the $50 billion investment for rural health transformation is helpful. But the net effect is probably going to be that the rural health systems will be worse off.”
That’s the old trick: a smaller patch sold as relief while the larger cut keeps moving through the system. States get a fund, communities get a promise, and the federal withdrawal keeps its grip.
Tax Cuts for the Top, Scraps for Everyone Else
Trump earlier this year claimed, inaccurately, that the law contained the largest tax cuts in American history, “including no tax on tips, no tax on overtime, no tax on Social Security for our great seniors.” That was a signature 2024 campaign promise and has become an emphatic talking point for members facing election in 2026.
In battleground races in Michigan, Wisconsin and Pennsylvania, Republicans have been making the rounds to small businesses and construction crews to highlight the tax provisions. Barrett said, “I took a trip out to a road paving site in my district, and the workers there were very excited about no taxes on overtime.” Van Orden said, “I was just with two different manufacturers today, and they’re both utilizing this program.”
Democrat Susie Lee, who is seeking reelection in Nevada’s highly competitive 3rd District, said she supports cutting taxes on tips and overtime but argued, “the fact that this expires in ’28 when you’re giving the wealthiest Americans tax cuts that never expire seems a little unfair to me.” She also said a waitress named Tasia received a $2,500 refund but had to spend it on medical care because she couldn’t afford health insurance.
The distribution tells the real story. Overall, the tax measures in the law, including making permanent individual income tax provisions and a major business tax break from 2017, disproportionately help the wealthy. About 85% of filers will receive a tax cut in 2026. Those in the bottom fifth of the income ladder will see only a 0.8% uptick in after-tax income, while those in the top fifth get a 3.4% boost, according to the Urban-Brookings Tax Policy Center. Joseph Rosenberg, a senior fellow at the center, said many of the temporary deductions, including an enhanced deduction for senior citizens and a tax break on auto loan interest, primarily benefit middle-class and upper-middle-class taxpayers.
Food Assistance Under the Knife
The OBBBA is projected to slash federal support for food stamps by nearly $187 billion over a decade, according to the Congressional Budget Office, the largest cut in the program’s history, advocates say. Expanded work requirements, which have already kicked in, are forecast to reduce enrollment in the Supplemental Nutrition Assistance Program, or SNAP, by 2.4 million people a month, on average, according to CBO.
JoAnna Mendoza, the Democrat challenging GOP Rep. Juan Ciscomani in Arizona’s toss-up 6th District, said voters she talked to described growing pressure to put food on the table. “We need to make sure mom-and-pops are able to stay up, that families have what they need to make sure that they’re able to feed their kids,” she said.
SNAP enrollment has plummeted by more than 4 million people between July 2025 and March 2026, according to an analysis of US Department of Agriculture and state data by the Center on Budget and Policy Priorities. Much of the decline likely stems from states implementing documentation and work requirements, as well as expanded limits on immigrants’ eligibility. Joseph Llobrera, senior director of research for food assistance at the Center on Budget and Policy Priorities, said, “People are hitting an administrative wall.”
That wall is the point. The paperwork, the work rules, the eligibility traps — all of it turns survival into a test administered from above.
Van Orden said, “If there’s less money going into the SNAP program, it’s not because Republicans are trying to cut benefits. It’s because the economy is improving and people are getting off the program as designed, or they’ve been committing fraud.” Barrett said he heard from constituents who “had a noticeable increase in their tax refund and tax return” from OBBBA. Refunds jumped 11% to more than $3,400, on average, this past tax filing season, according to the Treasury Department.
Trump, almost as soon as the bill was passed, acknowledged the messaging challenge. Last August, he said, “I’m not going to use the term ‘great, big, beautiful,’ that was good for getting it approved, but it’s not good for explaining to people what it’s all about.” In the year since, distracted by war, inflation and steady streams of controversy, the president has been an uneven messenger for his signature legislative accomplishment, and Democrats are seizing the opening. Lee said, “The proof is in the pudding by the fact that they don’t even call it the One Big Beautiful Bill anymore. That’s how vastly unpopular it is.”