The Promise Was a Lie: The Cuts Are Already Here, and the Worst Is Still Coming
Millions of children have already lost food and health coverage. Congress and the Trump Administration promised no real kids would be harmed. The data says otherwise. And Congress still has choices.
When Congress debated H.R. 1 — the so-called “One Big Beautiful Bill” (OBBB) — reassurances echoed from leadership again and again: don’t worry about the kids. Children are protected. The Medicaid cuts only targeted able-bodied adults.
Secretary Robert F. Kennedy Jr. insisted, repeatedly, that there were no real cuts at all because overall Medicaid spending would still grow over time.
The data is in. And the data proves these assurances were false.
We now have a mounting body of evidence from respected nonpartisan research institutions showing that millions of children have already lost food assistance and health coverage. Worst of all, the most sweeping cuts haven’t even fully taken effect yet.
A Baseline Reality: The Spending Numbers Before the Harm
Start with the context that makes everything else legible: children have always been dramatically underinvested in relative to their share of the population. Children are approximately 23% of the U.S. population, but in 2024 received less than 9% of federal spending.
That chronic underinvestment has already contributed to child poverty more than doubling, rising from 5.2% in 2021 to 13.4% in 2024, after the expanded Child Tax Credit and other provisions from the American Rescue Plan Act (ARPA) expired at the end of 2021.
Against that backdrop, Congress subsequently chose to leave children even worse off.
The Congressional Budget Office (CBO) estimates that OBBB cuts federal Medicaid and CHIP spending by nearly $1.2 trillion through 2036 — the largest cuts to the program in its 60-year history. The law adds an estimated $2.8 trillion to the national debt while handing the wealthiest Americans a massive tax windfall.
And at the bottom of that pyramid, as always, are children — who didn’t vote for any of this, who have no lobbyists of their own, and who will be living with these consequences long after today’s elected officials have left office.
The False Promise of “No Cuts to Children”
President Trump, Dr. Mehmet Oz, and Secretary Robert F. Kennedy, Jr. have all tried to wave away the CBO numbers by arguing that, since overall Medicaid spending grows over time, nothing has really been cut.
Health policy experts across the ideological spectrum have called this what it is: smoke and mirrors. Everything in health care gets more expensive over time. Spending less than you would have spent is a cut. By definition, 9 million people losing Medicaid coverage — including nearly 3 million children — is a cut.
Congressional Republicans echoed the same talking points. One member, Rep. Julie Fedorchak (R-SD), explained her vote by declaring that the cuts had no impact on children and other populations. She added that claims of coverage loss “have been debunked.”
What has actually been debunked are her answers.
The children being swept up in this aren’t violating work requirements — they don’t have work requirements. They are losing coverage because they don’t exist in isolation from their families. When a parent loses Medicaid because of increased bureaucratic burdens and red tape, because a state’s system isn’t properly automated, because they work gig jobs and can’t document 80 hours a month, their children often fall off the rolls with them. Researchers call it the “unwelcome mat” effect: even when children remain technically eligible, the family doesn’t know, or can’t navigate the bureaucracy, or simply gives up. The result is the same: a child who qualifies for coverage goes without it.
2 Million Children Have Already Lost Medicaid
Even before the bulk of the Medicaid cuts take effect, Georgetown University’s Center for Children and Families (CCF) reports that 2 million fewer children were enrolled in Medicaid and CHIP as of April 2026 compared to January 2025, when President Trump took office (see chart above).
Income eligibility levels for children have not changed. The unemployment rate has been rising. Federal officials should be scrambling to understand what is driving this coverage loss, yet we have heard nothing from them other than issuing more regulations and bureaucratic barriers to coverage and funding for states.
When child enrollment in Medicaid and CHIP goes down, the child uninsured rate goes up — and the child uninsured rate was already rising when President Trump took office. The decline in child Medicaid enrollment is occurring more rapidly during this second term, which is ominous given that Medicaid cuts from H.R. 1 have largely not even kicked in yet. CBO projects the number of children covered by Medicaid will decline by 3 million from 2026 to 2036.
Health insurance is not merely a card in a wallet. Research consistently shows that children with health coverage are more likely to receive preventive care, vaccinations, developmental screenings, and treatment for chronic conditions such as asthma. Coverage losses often lead to delayed care, missed diagnoses, and increased use of emergency rooms when conditions become more severe.
700,000 Children Already Dropped from SNAP — In Just 12 States
Turning to food assistance, the early data is equally alarming.
A letter by First Focus on Children, the American Academy of Pediatrics, Children’s Defense Fund, Save the Children, ZERO TO THREE, and MomsRising to Senate leaders cited new analysis from the Center on Budget and Policy Priorities (CBPP) showing that over 700,000 children have already lost SNAP in just 12 states that report participation changes by age: Arizona, Kansas, Louisiana, Maine, Maryland, Massachusetts, Michigan, New Jersey, New Mexico, Ohio, South Dakota, and Texas.
That 700,000 accounts for nearly half of the total 1.6 million SNAP participation decline in those states, even though H.R. 1 did not cut children’s eligibility directly.
In Arizona, the number of participants in March 2026 was less than half of what it was last July. The administrative chaos driving these numbers is staggering.
As First Focus on Children and other national partners explained:
These SNAP cost shifts threaten to exacerbate the unacceptable levels of hunger among children and their families, with long-term consequences including poor health and worse educational and economic outcomes. Children living in food insecure households are more likely to be hospitalized, to have low birthweight, to develop asthma and anemia, and to fall behind in school. Moreover, household food insecurity is consistently linked with parental depression, anxiety, and increased stress, which in turn impacts child behavior and development. Infants and toddlers, who are experiencing a rapid period of brain development, are particularly vulnerable to malnutrition and household-level stress.
KFF puts the intersection of SNAP and Medicaid in stark relief: Medicaid was the primary source of coverage for children receiving SNAP, covering 88% of kids with SNAP — approximately 13 million children. Cut one program and you destabilize the other. Cut both simultaneously, as H.R. 1 does, and you are doing something without modern precedent.
School Meals: The Hidden Casualty
There is a downstream impact that rarely gets adequate attention. Because children enrolled in SNAP are automatically eligible for free school meals through direct certification, when SNAP shrinks, school meal access shrinks with it.
The Urban Institute has put a specific figure on this: changes to SNAP could put 7.5 million students at risk of losing individual access to free meals.
Even worse, despite research showing universal free school meals improve student achievement and child health, Urban finds:
Sixteen million students in sampled states are enrolled at schools that would be at risk of losing the ability to offer universal free meals if the proposed SNAP changes take full effect.
Compounding the harm even further, children who lose SNAP may also lose WIC eligibility — the nutrition program designed specifically to protect infants, toddlers, and pregnant women during the most critical window of child development.
The Goal Should Be More Coverage, Not Less
It is not enough to simply halt the damage.
The goal should be what it has always been: ensuring that every child in America has access to quality health care and adequate nutrition. Not fewer children — all children.
Congress still has choices. It can:
Repeal or significantly modify the Medicaid cuts before they take full effect in 2027.
Restore the enhanced premium tax credits in the Affordable Care Act (ACA) that are expiring, which will otherwise cause premiums to skyrocket and coverage losses to cascade.
Repeal the SNAP cuts, or at the very least, extend the SNAP cost-shift delay to all 50 states, giving every state the same runway to lower error rates without resorting to administrative practices that cut off eligible families.
The National Governors’ Association (NGA), the American Public Health Services Association (APHSA), the National Association of Counties (NACo), the National Conference of State Legislatures (NCSL), the National League of Cities, the U.S. Conference of Mayors, and others have forewarned that the SNAP cost shift cuts threaten the future of the program.
As they explain:
These impacts cut across states of all sizes and political affiliations and, if applied based on disrupted data, risk undermining ongoing investments in program integrity and ultimately the viability of the program.
None of the harm currently being documented was inevitable. If Congress had listened, many of us repeatedly warned that these cuts would have devastating consequences (for example, see HERE, HERE, HERE, HERE, HERE, and HERE).
These are policy choices, and policymakers cannot claim they did not know.
Fortunately, these decisions are reversible.
But what is not reversible is the harm that will be done to children who go without health care, miss a diagnosis, have unmanaged asthma, or skip meals because adults in Washington decided their needs mattered less than tax cuts for the wealthy and then refused to fix the harm caused by their own actions.
At a time when federal investment in children is already near historic lows — when federal spending has dropped from 11.98% of the federal budget in 2021 to just 8.57% in 2025— the answer should not be to further shortchange and harm our children and grandchildren.
To children, it does not matter whether a coverage loss results from a work requirement, a paperwork barrier, a state error rate, or a congressional budget score. They experience only the outcome: a missed doctor’s appointment, an empty refrigerator, a prescription left unfilled, or a cancer diagnosis delayed.
The question before Congress is no longer whether these cuts will harm children. The evidence increasingly shows that they already are.
Things You Can Do:
Call your member of Congress and your senators and demand that they reverse or, at the very least, delay the Medicaid and SNAP cuts.
Share this newsletter with others to spread the word about the harm being inflicted on children.
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