Montgomery County government officials are raising concerns that President Donald Trump’s informally named “One Big Beautiful Bill Act” could lead to more than 300,000 Maryland residents losing health insurance and other negative impacts for county residents, according to a Wednesday afternoon press briefing.
“This bill doesn’t solve problems. It creates problems, many problems,” Montgomery County Chief Administrative Officer Rich Madaleno said during the virtual briefing. “It will force local governments like ours to do [more with less], while millions of Americans, our neighbors, our friends, our colleagues, people all over the country will suffer.”
According to CBS News, the U.S. Senate narrowly passed its version of the spending and tax bill on Tuesday, by a vote of 51-50 with Vice President JD Vance casting the tie-breaking vote. The bill is an extension of Trump’s 2017 Tax Cuts and Jobs Act and will make tax cuts in the 2017 bill permanent and increase spending for border security, defense and energy production, according to CBS News.
On Thursday, Republicans in the House of Representatives overcame a procedural hurdle that set the House up for a final vote to pass the bill, according to The Washington Post. House Representative Hakeem Jeffries passed the six-hour mark in a speech Thursday morning in an attempt to delay a vote on the bill, according to the New York Times.
The bill also shifts eligibility and spending on programs such as the Affordable Care Act (ACA), Medicaid and Supplemental Nutrition Assistance Program (SNAP), which the Congressional Budget Office estimates could add $3.3 trillion to federal deficits over the next decade and leave millions without health insurance – estimates Trump and other Republicans dispute, according to CBS News.
Local officials aren’t the only ones raising concerns about the bill. Maryland Gov. Wes Moore (D) said Tuesday during an appearance at the Leisure World community in Silver Spring that the bill was the “the most heartless piece of legislation that I have seen in my lifetime.”
At Wednesday’s briefing, Madaleno, who is responsible for overseeing operations and services for more than 30 executive branch departments, said watching the bill develop over the past few days was “remarkable, frightening” and “shocking.”
“Trump’s big, terrible, horrible, not good, very bad bill … will impact all of us, including the state of Maryland, the Montgomery County government,” Madaleno said.
Madaleno said the bill’s cuts to Medicaid could result in people losing insurance, people being evicted from nursing homes and rural hospitals closing. Sean O’Donnell, program administrator for Public Health Emergency Preparedness and Response at the Montgomery County Department of Health and Human Services (DHHS), echoed the concerns, saying that almost 300,000 patients in Maryland could lose Medicaid or other benefits.
According to NPR, the bill would make it so people would have to work to stay on Medicaid and coverage under the ACA will be harder to obtain and maintain. It also would end the practice of provider taxes, which states have used to increase Medicaid payments to hospitals.
“Even if you haven’t lost your insurance, it means hospitals are receiving less payment for services at the emergency department,” O’Donnell said. “It means that they have fewer staff. There are longer lines. People show up with more acute illnesses because there’s no preventative health, and that impacts every single person in our state, in our country. So we’re very concerned with the outcomes of this.”
The bill, which is expected to pass in the House by Friday according to NPR, would ban Medicaid payments to health care nonprofits that provide abortions, which could prevent Planned Parenthood health centers from receiving federal funding. Federal law already prohibits federal Medicaid funds from being used for abortions, but the bill would impact federal funding Planned Parenthood receives for the variety of other services it provides, according to the New York Times.
State Del. Bonnie Cullison (D-Dist.19), who represents Montgomery County in the Maryland General Assembly and also attended Wednesday’s briefing, said the provision was a “travesty.”
“Planned Parenthood would essentially, under this bill, would be defunded across the country,” Cullison said. “Millions of Marylanders take advantage of Planned Parenthood. The abortion services are just one service that they provide. They provide a whole range of reproductive health [services] for both men and women.”
According to the New York Times, the bill would also make it more difficult for people to qualify for SNAP, reduce benefits for those who are eligible and require state governments to take on some of the costs of providing the benefits, which the federal government has previously paid.
