Today, Congress passed H.R. 1, a reconciliation package that is projected to increase the national debt by $3.9 trillion. This package includes some of the most significant health policy provisions to be made into law since the Affordable Care Act (ACA) and has the potential to significantly threaten the health of millions, including maternal and child health (MCH) populations and those already facing the greatest risks. The bill is estimated to: 

• Increase the number of people without health insurance by about 17 million, bringing the country back to pre-ACA levels;  
• Cut $930 billion from Medicaid, the safety net program that covers more than 40% of births in the U.S. and provides over 1.5 million low-income women with prenatal and postpartum care; and  
• Cut $186 billion from the Supplemental Nutrition Assistance Program (SNAP), the largest cut to SNAP in history.  

Select provisions include: 

• New Medicaid eligibility verification and work requirements; 
• Coverage termination for adults who do not fulfill regular paperwork requirements; 
• Increased cost-sharing requirement for people enrolled in Medicaid expansion;  
• Cuts to states’ ability to use provider taxes to finance Medicaid; 
• Prohibition of Medicaid funds from being used for gender-affirming care; 
• Reduction of federal Medicaid funds for states that use state dollars to cover residents who are not eligible for federally-funded Medicaid due to their immigration status; 
• An increase to the Child Tax Credit (CTC) to $2,200 beginning in 2026; and 
• A requirement for states with high SNAP error rates to contribute a share of the program’s cost. 

The text of the legislation is available for review. 

AMCHP is deeply concerned by the impact these policies could have on MCH populations. These policy changes come at a time when the country continues to battle unacceptable infant and maternal mortality and morbidity rates. Further, these policies would place significant financial strain on states, forcing states to make difficult decisions about what services they can continue to offer, such as the life-saving postpartum Medicaid extension that, as of February 2025, 48 states and the District of Columbia have adopted.  

To hear more on the bill’s passage, please register for the AMCHP Policy & Partnership Town Hall Series occurring next Thursday, July 10, at 2 PM ET. Please don’t hesitate to reach out to our Government Affairs Team with questions: Sherie Lou Santos (ssantos@amchp.org), Gabrielle Galusha (ggalusha@amchp.org), and Karina Collins (kcollins@amchp.org).