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  • These restrictions are one major reason why states and health care providers will see Medicaid funding losses that cumulatively increase over ten years — becoming increasingly devastating to services people rely on.
  • 1’s restrictions on provider taxes and SDPs will cause massive funding losses.
  • It affects funding streams, social service eligibility, and the basic structure of so many programs in so many ways that the pain of its full impact will take time to fully understand.
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These funds are used to improve healthcare quality and to fill in for low payment rates. Every state but Alaska uses provider taxes to cover some Medicaid costs, including maintaining and improving Medicaid services or funding Medicaid expansion. In Ohio, the federal match to state funding of Medicaid costs stands at 64.9% as of FY2026. The budget’s “no tax on overtime” provision allows a tax deduction of $12,500 ($25,000 for joint filers) of qualified overtime pay. The budget includes several tax benefits that apply to certain workers and senior citizens.

  • These revenue losses are particularly damaging for hospitals in rural communities, which will face an estimated $137 billion in reduced federal Medicaid spending over ten years under H.R.
  • In 2026 alone, America’s wealthiest 1% will receive $77 billion more in tax cuts than the 60% with annual income below $92,100.For the wealthiest 1%, that is an average tax cut of $66,000 next year.
  • The Supplemental Nutrition Assistance Program (SNAP) provides low-income households with nutrition assistance.
  • This continuing trend in Ohio will make covering budget shortfalls created by H.R.

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Ohio’s two-year budget for FY 2026–27 (HB 96) passed almost simultaneously with the federal budget. 1 forces their budgets to absorb higher shares of program costs with reduced available revenue. SNAP error rates combine benefits over- and under-payments that can originate from either SNAP recipient or agency errors.

More than half of workers doing gig work do not have access to employer-provided health care options. The budget also makes those who lose Medicaid coverage due to work requirements ineligible to use PTCs for purchasing ACA Marketplace coverage. In Ohio, 319,000 to 493,000 people (depending on how Ohio implements the federal work requirement) will be at risk of losing Medicaid expansion coverage as of 2034.

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Critical Minerals and the Future of the U.S. Economy

The allocation to ICE detention alone represents a staggering 308% annual increase from ICE’s detention budget in FY 2024. This amounts to $170.7 billion in federal funding that will need to be spent by September 30, 2029. 1 also committed significant additional federal funding to border enforcement.

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Congressional leaders chose to sacrifice these social programs to pay for tax cuts. 1’s energy provisions are expected to cost Ohio a cumulative $46 billion in GDP and to cause an estimated 34,000 job losses. The combination of decreased energy generation (especially lower-cost solar generation) and resulting increases in natural gas prices through H.R. 1 set the stage for less resilient energy grids, higher energy costs and clean energy job losses nationwide. By removing several federal investments in renewable energy infrastructure and energy efficiency, H.R.

Reduced health care access

This lost revenue amounts to almost half of the tax revenue collected by Ohio for its General Revenue Fund in fiscal year 2024. They include things like miscalculating a utility credit or incorrectly reporting (or recording) a household’s composition, resulting in benefits being above or below what a household should be receiving. It’s not just American household budgets that will take hits from H.R. 1.While SNAP coverage losses due to H.R. (This is often referred to as the SNAP time limit.)

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As shown above, the $50 billion fund amounts to just over a third (36.5%) of the lost funding rural areas across the U.S. are expected to face from the budget’s cuts to Medicaid over the next decade. As more people voiced how serious a threat Medicaid cuts would present to rural hospitals, Congressional budget proponents added a temporary $50 billion in funding through a Rural Health Transformation (RHT) Program. 1’s SNAP provisions will result in a major transfer of costs from federal to state funding.

President Trump’s One Big Beautiful Bill combines sweeping tax cuts with deep spending reductions, and critics say the bill could undermine long-term economic stability, weaken US global competitiveness, and accelerate fiscal strain In our baseline, we allow the Fed to respond by lowering interest rates at the time that the TCJA expires in 2026, to minimize departures from 2% inflation and full employment. Relative to FRB/US, USMM contains a more detailed modeling of the government sector, including separate treatment of the Federal and State & Local sectors; it includes a wider variety of tax rates and revenues; and more detail for government expenditures. More recently, we have constructed estimates for extending all provisions of the TCJA, including those related to individual, estate, and business taxation, as well as other provisions in the OBBBA. In 2024 we provided estimates of the dynamic impacts for extending the individual tax provisions of the Tax Cuts and Jobs Act (TCJA) through 2054. There is an important question about the extent to which the scale of the increase in debt produced in this simulation is sustainable.

In fact, interest payments alone now constitute up to 20% of all federal spending, and the pressure on future budgets will only increase. More worrisome, Moody’s Investors Service already downgraded the US credit rating in May, citing runaway deficits; and the OBBBA may pave the way for further credit rating downgrades, especially as interest rates weigh heavier on the federal budget. Of course, the argument here is that the economic benefits of these tax cuts will trickle down through the rest of the country, boosting prosperity for everyone and strengthening the overall economy. In the baseline beyond the short run, we allow increases in the ratio of debt/GDP to be reflected in moderately higher interest rates as the Fed continues to target 2% inflation and unemployment at NAIRU. The importance of macroeconomic feedback on the budgetary impacts of the passage of the OBBBA increases substantially over time.

The upward pressure on interest rates is manifested in growing interest payments to holders of federal government debt, which boosts personal disposable income and consumer spending even with a substantial increase in the personal saving rate. The Budget Bill under consideration on the Hill would substantially add to the debt and deficit at the same time that it contains relatively few investment-incentivizing provisions (as opposed to direct tax cuts for individuals). The budget also allocates funding to defense spending and border enforcement, but the lion’s share of spending is related to making tax cuts first enacted in 2017 permanent. Importantly, given how sharply cuts to provider tax revenues will impact health care providers, states must cap their use of RHT funds for provider payments at 15%.

H.R. 1 reverses course on investments in clean energy infrastructure and jobs.

1 also restricts another, more recently-established funding mechanism, state directed payments (SDPs). They make up the largest portion of Ohio’s state support for Medicaid and leverage $20 billion in federal match funds per year. Provider taxes in Ohio bring in several billion dollars annually. These revenues draw down federal matching funds without pulling directly from the state’s general revenue fund. Of the remaining 35.1% Ohio covers, only a small share is directly covered through state tax revenues. (See this section for more details on the timing of these cuts.)

A minimum of 25% of approved states will receive a portion of this $25 billion in workload funding, and states will learn of award decisions (and award amounts) by December 31, 2025. This is being referred to as “baseline funding.” The other $25 billion (referred to as “workload funding”) will be awarded according to how a state scores across a range of measures. Guidelines on how states can apply for (and what states can expect from) RHT funding were released on September 15, 2025, through CMS’s newly created Office of Rural Health Transformation. The other half would be distributed using an approach determined by the Centers for Medicare and Medicaid Services (CMS) Administrator. Eligible Ohioans, like Medicaid expansion enrollees across the nation, face a real risk of losing coverage simply because of administrative churn that happens more frequently.

A second table summarizes debt, deficits, and net interest as percentages of nominal GDP, by decade reflecting all effects, i.e., direct-mechanical and macro-dynamic, and take into account that the path of GDP is different than in the baseline, as noted elsewhere. Averaged over the full 30 years, the increase in deficits/GDP is split about 55% due to mechanical effects and 45% to macro-dynamic effects. A higher effective interest rate accounts for three-fifths of the increase in net interest outlays in the third decade. In the third decade, macro-dynamic effects account for slightly more than one-half of the average increase in total deficits/GDP, with most of the remainder accounted for by mechanical effects.

These cuts were designed to expire at the end of 2025. The basic math behind this budget would be familiar to any American household that’s had to find other expenses to cut back on when purchasing a big-ticket item. 1’s provisions unfold over the next several years, this overview is a tool for helping Ohioans better understand its sweeping consequences. This budget is far-reaching. Americans will experience fallout from this expansive, unpopular budget for years to come. Critical Questions is produced by the Center for Strategic and International Studies (CSIS), a private, tax-exempt institution focusing on international public policy issues.

More than 130,000 Ohio households to see an $1,150 annual reduction in SNAP benefits, and rural counties are hit hardest. This estimated tax cut range includes income brackets for Ohioans making up to $84,500 a year, the bottom 60% of earners. How Americans view the GOP’s budget and tax bill.

Boosting consumer incomes, for a time at least — The Act avoids a large tax hike on US consumers by making permanent provisions of the expiring 2017 Tax Cuts and Jobs Act (TCJA), while also making many of them more attractive with adjustments to various limits and phaseouts. With nearly $1 trillion in Medicaid cuts planned for over the next 10 years, millions of Americans are predicted to lose healthcare coverage. In addition, the healthcare industry, especially hospitals and clinics that serve low-income or rural populations, will face strain.

When all is said and done, this budget increases the national deficit by $3.4 trillion over the next decade. 1’s tax provisions in 2026 in Ohio Americans in the middle income range (between $53,300 and $92,100), will see an average tax cut of $1,510. In exchange, Congress gave the largest share of tax cuts to a tiny share of households. In this case, Congressional leaders decided that its big splurge should be extending 2017 tax cuts that overwhelmingly benefit the richest Americans. It affects funding streams, social service eligibility, and the basic structure of so many programs in so many ways that the pain of its full impact will take time to fully understand.