As senators spent Monday debating President Donald Trump’s sweeping tax bill, Illinois Democrats, advocates and experts warned that the measure’s $1.2 trillion in cuts would cost more than 500,000 Illinoisans their health care coverage and put about 427,000 people at risk of losing food assistance.
Republican leaders are trying to pass the measure ahead of Trump’s self-imposed Fourth of July deadline, but the process has been volatile. It cleared procedurally on Saturday night, but only after holdouts were persuaded by Trump and Vice President JD Vance. Sen. Thom Tillis, R-N.C., announced he wouldn’t seek reelection after voting against advancing the measure — and a threat by Trump that he would primary the senator.
Voting on the measure is expected to be underway most of Monday. If the Senate passes the measure, it must still go back to the House.
Costly cuts to SNAP, health insurance and energy
In total, the Senate bill includes about $4 trillion in cuts and makes Trump’s 2017 tax rates permanent, while also adding new ones, including no taxes on tips. The bill would also provide $350 billion for border and national security, including for deportations.
But an analysis from the nonpartisan Congressional Budget Office found that 11.8 million more Americans would become uninsured by 2034 if the bill passes. The package would also increase the deficit by nearly $3.3 trillion over the decade, the analysis found.
The Senate package’s largest cuts include $1.2 trillion to Medicaid and food stamps — making states pay a minimum of 5% and up to 25% of Supplemental Nutrition Assistance Program [SNAP] benefit costs. That would place an astonishing budget cost onto Illinois that could force lawmakers to cut benefits, or the number of recipients.
According to the Department of Agriculture, 1,884,107 people in 1,028,197 households received SNAP benefits in Illinois for the 2022 fiscal year. The average monthly benefit was $157 per person, and 75% of SNAP recipients had income at or below the poverty line.
An overhaul of the program could cost Illinois $1.2 billion and leave 427,000 lower-income residents without food stamps, according to Gov. JB Pritzker’s office.
The potential shift in costs to the state would place “a massive strain on Illinois’ budget, threatening funding for other essential services like education and healthcare,” Pritzker said in a letter with other Democratic governors urging Congress to reject the changes.
His administration says up to a half-million Illinoisans could lose their Medicaid coverage under the federal bill, which would require most of Illinois’ 3 million-plus enrollees to prove they’ve worked, volunteered or gone to school for at least 80 hours in the month before signing up for coverage.
The Illinois Department of Healthcare and Family Services doesn’t collect work statuses of Medicaid recipients — raising more questions about the state infrastructure needed to enforce the new requirements — but about two-thirds of non-disabled customers aged 19-64 reported some income, according to state data from February.
“While most adults covered by Medicaid in Illinois work, the proposals being considered now to impose work requirements may result in [between] 270,000 and 500,000 Medicaid customers in Illinois losing coverage for mostly administrative reasons,” an IDHFS spokeswoman said in an email.
That’s in line with a June 5 estimate from the Joint Economic Committee — a bipartisan committee analyzing the state of the economy — which projects 163,674 people in Illinois would lose Affordable Health Care Act coverage and 335,000 would lose Medicaid with passage of the current measure. In total, that would mean 498,674 Illinois residents would lose health care coverage. A June 30 estimate upped that number to 535,849 losing health coverage in Illinois.
The state and federal government currently split the costs of many Medicaid programs, with the feds covering 90% of Affordable Care Act programs. That percentage is on the chopping block, which would trigger a state law backing Illinois out of ACA program matching because the cash-strapped state can’t afford billions in added costs.
The Joint Economic Committee also found that the current proposal would end home energy and efficiency tax cuts that are currently available to households, which have helped a typical family save up to $1,080 every year.
It would also cut more than $350 billion in higher education investments, including changes to Pell Grants that could result in 48,700 low and middle-class Illinois students losing federal aid and another 106,200 student losing some aid. Federal financial aid would also be taken from refugees, asylum seekers and some victims of domestic violence and sex or labor trafficking.
Illinois Democrats sound alarm
U.S. Rep. Raja Krishnamoorthi, D-Ill., started his Monday at a downtown Chicago Planned Parenthood office, with advocates warning that 40% of patients rely on Medicaid for essential healthcare services, including birth control, cancer screenings and abortions.
“Without Medicaid, almost 30,000 [Planned Parenthood of Illinois] patients would not be able to access the essential health care that they deserve,” said Tonya Tucker, interim CEO of Planned Parenthood. “Without Medicaid, PPI would need $16 million annually to continue providing current services, and this amount cannot be covered consistently by donations alone. Without Medicaid, PPI will be forced to close more health centers, leaving people without access to the essential health care that they need and deserve.”
Krishnamoorthi said the Trump bill will include upwards of $1.1 trillion in cuts to the social safety net, including $1 trillion cuts to Medicaid, which will leave almost 17 million people without health insurance.
“As a child of food stamps and public housing myself, these cuts are not just professionally repulsive, but they are personally so as well,” Krishnamorthi said.
Speaking on the Senate floor Sunday afternoon, Sen. Dick Durbin stressed the impact the bill will have on hospitals in rural communities. Durbin said hospitals in Decatur will be forced to shrink or eliminate services, or in some cases, to close.
“The Senate Republican bill, unfortunately, is going to endanger hospitals all over the United States, but if you happen to live in a small town, rural area, and I represent a lot of them in the state of Illinois, you’re the most vulnerable,” Durbin said. “You are the target. When they cut back on Medicaid programs, these are the hospitals that will close their doors….Take away a hospital and then try to attract a new business to your community. Good luck.”
Contributing: Associated Press, Anthony Vazquez