This article contains a correction.
Last month, House Republicans passed H.R. 1, the One Big Beautiful Bill Act, on a party-line vote. The bill would make historic cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) and terminate clean energy tax credits that have spurred a manufacturing boom in the United States, all to pay for tax cuts that overwhelmingly benefit the wealthiest Americans. In so doing, the bill would massively raise costs for low-income Americans, lead to 16 million fewer people with health insurance by 2034 when coupled with changes to the Affordable Care Act, put 11 million people at risk of seeing their SNAP benefits cut or eliminated, and put more than half a million jobs at risk. While the effects of this legislation will harm all Americans, people in states won by President Donald Trump in the 2024 election could bear the brunt of these devastating cuts, even though the bill’s tax breaks for billionaires would accrue predominantly for individuals living in states won by former Vice President Kamala Harris.
Medicaid cuts would hurt states and communities that voted for Donald Trump
Medicaid is a foundational pillar of the American health care system, which together with the Children’s Health Insurance Program (CHIP) provides health coverage to more than 78 million people—more than 1 in 5 Americans. Both Republican and Democratic states are reliant on Medicaid.* In places such as Alaska, Maine, and West Virginia, more than 1 in 4 residents are enrolled in the program. More than two-thirds of the nearly 300 U.S. counties that have seen the largest increases in Medicaid and CHIP enrollment since 2008 voted for Trump in the most recent election. Not only do Republican-led states have some of the highest rates of Medicaid enrollment, but the share of Medicaid enrollees in many of these states is largely in rural areas. For instance, in 2021, nearly 60 percent of all Medicaid enrollees in Wyoming lived in rural areas. In Alaska, around half of all Medicaid enrollees lived in rural communities. In West Virginia, more than one-third of all Medicaid enrollees lived in rural areas. Rural communities, notably, currently vote in greater numbers for Republican candidates.
Rural hospitals in Republican-won communities would be at risk of closure
Medicaid is a lifeline for rural hospitals, community health centers, and other providers that serve hard-to-reach communities. Nearly one-third of rural hospitals nationwide are already at risk of closure due to chronic financial instability, and more than 300 are considered at immediate risk, meaning that their financial situation is so precarious that they could close at any time. Cuts to the Medicaid program would accelerate an already-unfolding crisis—one that threatens to leave vast stretches of rural America without access to basic hospital care. Seventy-six percent of rural hospitals at immediate risk of closure—239 total—are located in states that Donald Trump won in 2024. Passing historic cuts to Medicaid is projected to dramatically increase uncompensated care costs, which could force these rural providers to shut their doors.
Medicaid’s popularity and reach extends far beyond current enrollees: Nearly all Republicans (94 percent) recognize the program is important to their local communities, including 95 percent of Trump voters and 95 percent of rural Republicans. People’s personal stakes with Medicaid run deeper than some in Congress may appreciate: Nearly two-thirds of Republicans (62 percent) report that they themselves, a family member, or a close friend have depended on Medicaid at some point in their lives. Among those who voted for President Trump in 2024, about 4 in 10 (42 percent) say that Medicaid is very important or somewhat important to them and to their family directly. These connections help explain why the program has such strong support even within constituencies whose elected representatives have historically opposed it.
Today, Republican voters by and large oppose cuts to the Medicaid program. A new poll from Quinnipiac University released on June 11, 2025, finds that only 18 percent of Republican voters believe Medicaid funding should be cut. KFF meanwhile found that more than two-thirds (67 percent) want Congress to either increase or maintain current Medicaid spending levels. The opposition is even stronger in rural areas, where almost 8 in 10 residents (77 percent) want Medicaid funding preserved or expanded; two-thirds (65 percent) of rural Republicans say funding should increase or stay the same.
Notably, when given the chance to weigh in on Medicaid directly, voters in Republican-led states have repeatedly chosen to protect and expand the program. Voters in states such as Idaho, Nebraska, Utah, Oklahoma, Missouri, and South Dakota have all passed ballot initiatives to expand Medicaid coverage. These repeated successes at the ballot box suggest that efforts to reduce or eliminate Medicaid coverage may face significant public resistance, even within conservative electorates.
Previous experience shows that states are likely to cut optional Medicaid benefits, which are primarily used by older adults and people with disabilities.
Finally, Medicaid is a crucial source of care for people living with disabilities, and disability rates tend to be higher in rural areas than in urban areas. Previous experience shows that states are likely to cut optional Medicaid benefits when federal Medicaid funding is reduced—such as home and community-based supports, dental and denture services, and medical supplies and equipment—which are primarily used by older adults and people with disabilities.
Drastic food assistance cuts would target voters that backed Trump in large numbers
SNAP is the nation’s largest food assistance program and an essential tool to combat hunger when families struggle to make ends meet. The program helps feed more than 42 million people every month, the majority of whom are older Americans and children. Proposals included in the package that would shift benefit costs and additional administrative costs to states, kick 3.2 million people off their benefits by imposing additional burdensome paperwork requirements, and freeze scheduled benefit increases, among others, would amount to the largest cut in SNAP’s history.
Republican-leaning groups of voters would suffer the consequences of drastic cuts to food assistance. SNAP participation is often higher in rural areas and thus makes up a larger portion of food sales than those in suburban and urban areas; as a result, grocery stores and the communities they serve in these areas are at greater risk if the benefit cuts are enacted. Of the roughly 300 counties that are home to more than 27,000 retailers that would be put at higher risk of financial hardship from cuts to SNAP, a disproportional 77 percent of them are in rural areas.
Older Americans in the 50 to 64 age range, who made up the most favorable age group for Trump in 2024 election exit polling, would face additional dangers from the proposal. Specifically, the bill would expand who would be subject to new paperwork requirements from SNAP recipients who are 55 to those as old as 64 for the first time. This proposal puts greater burdens on workers who could be caring for an aging parent or school-age child, or trying to reduce their working hours as they get closer to retirement.
Sixty-one percent of Republicans agree that SNAP benefits should be raised, and a majority of Republicans stated they would feel less favorable toward their representatives in Congress if they voted for cuts.
Given the critical role SNAP plays in Republican-leaning areas and that families are already feeling squeezed by the high cost of groceries, it is unsurprising that the vast majority of people oppose cuts to SNAP. Polling repeatedly shows that SNAP is popular, as 85 percent of voters say that the program is important. Substantial majorities support policies that would strengthen and expand SNAP, including nearly 8 in 10 who believe Congress should make it easier for struggling families to qualify for benefits. In fact, 61 percent of Republicans agree that SNAP benefits should be raised, and a majority of Republicans stated they would feel less favorable toward their representatives in Congress if they voted for cuts. This includes 65 percent of white men without a college degree and 64 percent of small town and rural residents—both of which are key groups of voters for the Republican base. This is clearly reflective of the fact that people recognize that SNAP can help ease the burden on household budgets, as nearly half of voters have either relied on SNAP before or know someone who has.
Putting jobs at risk in Trump-won states
Clean energy tax credits enacted through the passage of the Inflation Reduction Act are lowering Americans’ energy costs, creating hundreds of thousands of jobs, and expanding the United States’ energy supply. Trump-won states have benefited the most from the growth of the clean energy economy, receiving 77 percent of investments already spent and 78 percent of jobs created. All of this is at risk of being cut if the House Republicans’ budget bill is passed, including more than $380 billion of outstanding investment for Trump-won states. Cutting these investments translates to more than 530,000 potential jobs in Trump-won states that are at risk of being lost, which is equivalent to 78 percent of all at-risk jobs. In fact, 9 out of the 10 states with the most jobs at risk if the clean energy tax credits are eliminated are states that voted for Donald Trump in 2024. Texas alone has more than 130,000 jobs at risk, which is more than the next three states with the most jobs at risk—California, Georgia, and Michigan—combined.
By ending almost all federal clean energy investments, the House Republican budget bill will cause electricity bills to increase. The states that would see the largest increases in their residential electricity bills by 2026 are mostly Trump-won states: Of the 29 states that will see more than a 5 percent increase, 70 percent are Trump-won states. Four of the 5 states likely to suffer the largest electricity price increases (greater than $200) by 2026 are states where Trump won: Wyoming ($225), North Carolina ($215), Arizona ($203), and Tennessee ($202). Given all the benefits of the clean energy tax credits and risks if they are repealed, it is not shocking that most Americans—including Republicans—oppose cutting these clean energy tax credits. According to recent polling, only one-third of Republicans and 21 percent of all respondents are in favor of cutting funding for clean energy tax credits.
The budget plan guts basic needs for people in Trump-won states while the richest Americans get massive tax breaks
The One Big Beautiful Bill Act would issue the largest transfer of wealth from working-class Americans to the ultrawealthy in the nation’s history. To do so, House Republicans are proposing to cut programs that are essential to people, especially in states that voted for Trump in the last election, in order to pay for tax cuts for the wealthiest Americans. Under this proposal, millionaires would see a larger tax cut than the bottom half of Americans combined—with more than $1.5 trillion in tax cuts going to the top 5 percent. In total, households that make at least $1 million per year would receive roughly twice as much in tax breaks as the bottom 50 percent of the nation combined. Roughly 57 million households in the bottom 60 percent would see a tax increase or a negligible tax change ($100 in either direction) under the House Republican proposal. Not only does this proposal extend the 2017 Tax Cuts and Jobs Act’s tax breaks for the wealthy, but it also adds additional loopholes that skew the tax code even more in favor of the ultrawealthy. Polling demonstrates that Republican voters oppose the bill when they learn that the tax cuts overwhelmingly benefit those who are already rich.
Conclusion
House Republicans’ One Big Beautiful Bill Act would give the wealthiest Americans huge tax breaks while harming everyday Americans—many of whom live in states that voted for Donald Trump—by enacting massive cuts to health care and food assistance. As the Senate prepares to take up this legislation, senators should reject tax and budget proposals that pull the rug out from under working-class people to fund tax breaks that disproportionately benefit millionaires and billionaires. As the U.S. Senate considers changes to the One Big Beautiful Bill Act, the Center for American Progress encourages all Americans to contact their senators to plead with them to reject these devastating cuts that would fall especially hard on Republican-leaning constituencies, rural communities, and states Donald Trump won.
*Correction, June 26, 2025: This article has been updated to clarify the states most reliant on Medicaid.