Low-income families and children would be among the most affected groups under the Republicans’ proposed One Big Beautiful Bill Act, according to the nonpartisan Congressional Budget Office (CBO). While the bill promises substantial benefits for affluent Americans, it would reduce support for some of the nation’s most vulnerable populations.
To fund the extension of the 2017 Trump-era tax cuts, Republicans in both chambers of Congress aim to scale back several essential safety net programs, including healthcare, food aid, and financial assistance. These changes would impact millions of American children.
Currently, more than 37 million children receive healthcare through Medicaid or the Children’s Health Insurance Program (CHIP). CHIP covers pregnant women and children slightly above the Medicaid poverty line. Combined, these programs provide coverage to nearly half of all children in the United States, ensuring vital prenatal care, facilitating over 40% of U.S. births and nearly half of rural births, and supporting millions of children through adolescence.
Under the Republican plan, states would be allowed to impose waiting periods before families can enroll in CHIP and penalize them for missing premium payments by locking them out of the program. Additionally, the bill proposes a nationwide Medicaid work requirement for the first time. Though the House version claims to exempt parents, Allison Orris of the Center on Budget and Policy Priorities (CBPP) notes, “What we’ve seen from past experience with work requirements is that exemptions are not always effective.”
Senate Republicans take it a step further, requiring even part-time work from parents of children over 14. Kevin Corinth of the conservative American Enterprise Institute (AEI) argues that this may benefit families: “If [parents’] earnings go up because they’re complying, that actually could be good for the kids. Because there is good research showing that, when parents work and we get more earnings coming into the household, that can improve current and future outcomes [for children].”
However, critics believe these requirements create more red tape. “When there’s more red tape, we know that it’s harder for families,” explains Joan Alker, who leads the Center for Children and Families at Georgetown University. “To see these kinds of cuts is very, very scary.”
Despite these criticisms, House Speaker Mike Johnson’s office defended the proposals, stating, “Republicans are protecting and strengthening Medicaid for American citizens who need and deserve it by rooting out waste, fraud, and abuse.” On NBC’s Meet the Press, Johnson also declared, “There are no Medicaid cuts in the Big, Beautiful Bill. We’re not cutting Medicaid.”
However, the CBO estimates that the House bill would reduce federal Medicaid spending by approximately $800 billion over the next decade. The Commonwealth Fund suggests that one in five children could lose Medicaid coverage under this plan. Alker warns that the proposed changes would push states into making tough choices between reducing services or raising taxes. “Governors are gonna have to do the dirty work,” she says, adding that the Senate’s version would likely impose even greater burdens on states.
CBO research indicates that childhood Medicaid coverage correlates with increased adult earnings and higher tax contributions, potentially offsetting the cost of the program. “Increasing children’s enrollment in Medicaid would reduce the future federal deficit by between roughly $800 and $3,400 per child per year of enrollment,” the CBO found.
Beyond healthcare, Republicans are targeting food assistance. The House bill proposes substantial changes to the Supplemental Nutrition Assistance Program (SNAP), or food stamps, which currently helps over 15 million U.S. children afford groceries. Katie Bergh, a senior policy analyst at CBPP, said the House proposal represents “the deepest cut to food assistance in history.”
The bill would expand existing work requirements under SNAP. “Research has repeatedly shown that this doesn’t increase people’s employment. It doesn’t increase their earnings. It just cuts people off of SNAP and leaves them hungry,” Bergh argues.
In total, the House plan would cut over $290 billion from SNAP over the next 10 years. Bergh estimates this would “eliminate or substantially reduce” food support for more than 2 million children. The plan would also require states to fund between 5% and 25% of SNAP costs, a shift Bergh and others worry could prompt some states to reduce benefits, limit eligibility, or exit the program entirely. CBO notes that as a result, children could also lose access to free school meals, which are automatically tied to SNAP enrollment.
Overall, CBO estimates the poorest households would lose about $1,600 annually under the GOP proposal—mainly due to reductions in programs like Medicaid and SNAP. In contrast, the wealthiest Americans would gain an average of $12,000 per year. Disputing the analysis, House Republicans insist that “the biggest beneficiaries of this [bill] will be low- and middle-income Americans,” according to Speaker Johnson.
The Senate’s plan closely aligns with the House’s in imposing work requirements and shifting costs to states.
On the tax side, Senate Republicans propose modest improvements to tax benefits for families, including the Child and Dependent Care Tax Credit. Sarah Rittling, executive director of First Five Years Fund, welcomed this move, saying, “Expanding child care tax credits in the Senate bill is a step in the right direction toward making care more affordable and accessible for families nationwide.”
However, proposed changes to the Earned Income Tax Credit (EITC) and Child Tax Credit (CTC) have raised concerns among researchers. The EITC, a critical anti-poverty measure for low-income working families, would require parents to undergo a burdensome precertification process before claiming the credit. Kevin Corinth of AEI notes that this added requirement could create barriers for families and place further strain on the IRS, which has already suffered staffing reductions.
The current Child Tax Credit allows families to deduct up to $2,000 per child from their tax bill. The House bill would raise this to $2,500 but maintains income requirements that limit access for low-income households. Megan Curran, policy director at Columbia University’s Center on Poverty and Social Policy, points out that the proposal would make it even harder for families to qualify. The House plan would disqualify an estimated 4.5 million children by requiring both parents to have Social Security numbers. The Senate version, by contrast, would require only one parent to have a Social Security number, though it’s unclear how many children that would still exclude.
The bill would also preserve the existing rule that blocks the lowest-income families from receiving the full credit. “Under current policy, a two-adult, two-child family needs at least $36,000 [in income] in order to get the full [credit],” Curran explains. “That’s 1 in 4 kids nationwide who are left out of the full credit.” If the credit is raised, that same family would need $48,000 in income to qualify. “As a result, under the House Reconciliation Bill, 1 out of every 3 children would be left out of the full credit nationwide,” Curran adds.
While many countries provide child benefits to all families, Curran emphasizes that “we exclude the families with lower and moderate incomes. And those are children who arguably could really benefit from this type of investment the most.”
In 2021, Congress briefly expanded the CTC to cover the lowest-income families, cutting child poverty nearly in half during its six-month duration. Curran argues such investments pay for themselves. “Every dollar that you spend on the child tax credit in an expanded form that reaches all kids would return at least $10 a year,” she says. The return comes in the form of better health, improved academic outcomes, higher lifetime earnings, and increased tax contributions.