The “Big Beautiful Bill” currently under consideration in Congress proposes substantial changes to Medicaid and the Supplemental Nutrition Assistance Program (SNAP, formerly “food stamps”). Below, I take a closer look at these proposed changes and examine their implications for Ohio, including both direct impacts and spillovers into the broader economy. The numbers cited here reflect the House version of the bill; some changes occurred in the Senate version.
The bill proposes a range of provisions to limit Medicaid and SNAP spending. Some of these provisions would directly cut spending through decreased program participation, while others would likely prompt states to scale back eligibility and benefits. The Medicaid provisions include new work requirements, additional out-of-pocket costs for recipients, reductions in funding for states that serve unauthorized immigrants, a cap on Medicaid provider taxes, and limits on Medicaid state-directed payments, among others. The SNAP provisions include state matching requirements and an expansion of work requirements, among others.
To understand how these federal changes might affect Ohio, I examine projections for state and congressional district-level impacts. According to an analysis from George Washington University, the combined impact of the provisions mentioned above would reduce Ohio’s annual Medicaid funding by $3.4 billion (a 12% reduction) once the changes have been fully phased in in 2029, and would reduce Ohio’s annual SNAP funding by $1 billion (a 30% reduction) by 2029.
The nonpartisan research organization KFF estimates that the proposed Medicaid cuts would cause 270,000 Ohioans to lose their health insurance, while the Center on Budget and Policy Priorities estimates that the proposed SNAP cuts put 316,000 Ohioans at risk of losing some or all of their current food assistance benefits. Figures 1 and 2 show the estimated number of Ohioans at risk of losing health insurance and SNAP benefits by congressional district.
Figure 1: Ohio Residents Who Would Lose Health Insurance Due to Medicaid Cuts Proposed in the “Big Beautiful Bill,” by Congressional District: Link to interactive map
Map generated with data from Seeberger, Colin, Andrea Ducas, Lily Roberts, Shannon Baker-Branstetter, Kennedy Andara, and Kyle Ross. 2025. The Devastating Harms of House Republicans’ Big, ‘Beautiful’ Bill by State and Congressional District. Center for American Progress.
Figure 2: Ohio Residents at Risk of Losing SNAP Benefits due to Cuts Proposed in the “Big Beautiful Bill,” by Congressional District: Link to interactive map
Map generated with data from the Center on Budget and Policy Priorities. Estimated number of SNAP participants in households at risk from two provisions of Johnson proposal.
Beyond the individuals directly affected, reductions in Medicaid and SNAP spending may have broader economic impacts through spillovers into other parts of Ohio’s economy. Funding from these programs flows into local economies through healthcare facilities, grocery stores, and other retailers. If the benefits are reduced, those local businesses would lose revenue, which may lead to job losses and further spillovers. The report from George Washington University estimates that across all states, the proposed cuts to Medicaid and SNAP would reduce states’ GDP by $154 billion in 2029 when the cuts have been fully phased in, which is more than the $131 billion the cuts would save in federal spending. The loss to Ohio’s GDP would be $5.2 billion. Furthermore, the report estimates that the cuts would cause 44,700 lost jobs in Ohio (0.8% of Ohio’s employment), and a $366 million reduction in Ohio’s annual state and local tax revenue.
An analysis by the Washington Center for Equitable Growth underscores the impact of Medicaid and SNAP on state and local economies. The analysis finds that income transfers from Medicaid (measured as Medicaid payments to medical care providers) and SNAP jointly make up 5.6% of Ohioans’ personal incomes. Figure 3 shows the percent of residents’ personal income that comes from Medicaid and SNAP, by congressional district.
Figure 3: Medicaid and SNAP as a Percent of Personal Income, by Congressional District: Link to interactive map
Map generated with data from Manduca, Robert. 2025. Medicaid and SNAP cuts in congressional Republicans’ budget bill will negatively impact local economies. Washington Center for Equitable Growth.
Studies also suggest that spending on social safety net programs like Medicaid and SNAP for families with children has economic impacts decades into the future, because childhood poverty is associated with worsened long-term health outcomes and reduced future earnings. A cost-benefit analysis by Columbia University’s Center on Poverty and Social Policy found that for every $1 in cuts to SNAP for families with children, there is a $14 to $20 economic loss to society in the long term.
Medicaid and SNAP play an important role in Ohio’s health, food security, and economy. Changes to these programs would affect not only their recipients, but also the healthcare and retail sectors, with ripple effects into other parts of the state’s economy. Similar impacts are projected for other states. As policymakers consider reducing spending on these programs to shrink the federal deficit, it is important to consider not only the effects on public health, but also the broader economic implications.
For more on Medicaid and SNAP, see our articles on Medicaid work requirements, Medicaid expansion, Medicaid’s impact on poverty, SNAP benefits in Ohio, the SNAP benefits cliff, Ohio’s safety net, and ending hunger in America.