People hold up signs protesting against cuts to the Supplemental Nutrition Assistance Program (SNAP) during a press conference on Capitol Hill in Washington May 7, 2018. (OSV News/Reuters/Joshua Roberts)
Kimberley Heatherington
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Provisions in President Donald Trump's "One Big Beautiful Bill Act" that aim to cut Medicaid funds from clinics that provide abortions are drawing praise from anti-abortion advocates.
But additional proposed Medicaid cuts now contained in the bill — projected at $1 trillion over a decade, $200 billion more than the House's original cuts — are raising alarms about the future for poor mothers and their families, even if pregnant women are exempt from Medicaid work requirements.
"Because roughly 40% of births in the United States are covered by Medicaid, it's natural to associate Medicaid cuts with harm to pregnant people," said Stella Dantas, president of the American College of Obstetricians and Gynecologists, which opposes Medicaid cuts to Planned Parenthood.
The bill narrowly passed the House of Representatives May 22 and was released as a legislative text June 16 by the Senate Finance Committee.
"ACOG is particularly concerned about the impact on our pregnant patients, some of whom will lose Medicaid coverage because the policies added together will financially stress states," Dantas said in a May 13 public statement. "Pregnant patients who keep their coverage under Medicaid will still face challenges accessing care as labor and delivery unit closures escalate as a result of Medicaid cuts, leaving patients to travel longer distances to give birth."
Dantas also said Medicaid cuts could threaten postpartum coverage, noting two-thirds of maternal deaths occur the year after delivery.
Patrick Brown, a fellow at the Washington-based Ethics and Public Policy Center, which applies Judeo-Christian values to law, culture and politics, also has concerns about the bill's potential ramifications.
"If you're specifically concerned about pregnant women and newborn babies, the good news is that nothing in the bill directly takes aim at them," he said. "But that's not to say there aren't some meaningful changes that are included in the One Big Bill that could end up impacting families with young kids indirectly — and certainly could make it a lot harder for low-income families trying to put food on the table."
The Senate's version of the bill includes a $211 billion cut to the Supplemental Nutrition Assistance Program, or SNAP, which provides food benefits to 41 million Americans in need.
Although the Senate's proposed cuts are $80 billion less than the House's, they are still predicted to pose difficulties for benefit access.
The bill's supporters have insisted no one will lose Medicaid coverage and have characterized reductions in coverage not as "cuts" but rule changes designed to purge those taking advantage of the system.
Elisabeth Wright Burak and Nancy Kaneb — a senior fellow and policy associate, respectively, at Georgetown University's Center for Children and Families at the McCourt School of Public Policy — strongly disagreed, urging the public to question congressional Republicans' claims.
"Lawmakers have forcefully asserted that these cuts would not hurt pregnant women and children, but the evidence paints a different picture," said Burak and Kaneb in a June 6 statement.
"Don't believe any suggestion that the largest cuts in Medicaid history, an overhaul of SNAP, loss of child tax credits and other rollbacks in family support won't hurt pregnant women, children or families," they said. "No person, no family, no community, no state will be spared."
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The Center on Budget and Policy Priorities, a nonpartisan research institute in Washington, estimates about 2 million children could be impacted by that particular change.
"I think people may be surprised at just how many people this is going to affect," said Tina Tuley-Lampke, executive director of the nondenominational pregnancy resource center Hannah Center in Bloomington, Indiana. "Not only what the bill does to limit services for people who are in lower income brackets, but also just the effect of fewer and fewer health and disability services, are going to end up costing us more later."
She has been here before.
In 2010, Tuley-Lampke said she "saw a lot of parents taking their children to the ER when they didn't need to — because the doctor's office can refuse to see you if you have a large bill; the emergency room can't."
Women listen as U.S. Sen. Mark Kelly, Democrat of Arizona, holds a town hall to discuss the impact of proposed Republican cuts to Medicaid and food assistance benefits at Chiricahua Community Health Center in Sierra Vista, Arizona May 29. (OSV News/Reuters/Rebecca Noble)
Julie Bodnar, a policy adviser in the U.S. Conference of Catholic Bishops' office of Justice, Peace and Human Development, said the proposed SNAP changes are "so major that they really can threaten the viability of the program in some states. They threaten the future of SNAP as we know it."
She predicted people will go hungry.
"This is going to affect the whole family," said Bodnar. "You're still shopping with the same grocery cart; one grocery cart for the whole family. So, if you're cutting back that family's SNAP, one person's benefits, it's cutting back the whole family's SNAP benefits. That's the practical effect of it."
In a column published June 12, Archbishop Borys Gudziak of the Ukrainian Catholic Archeparchy of Philadelphia, chairman of the USCCB's Committee on Domestic Justice and Human Development, stressed that "Congress has the power to improve the lives of families and vulnerable individuals, but in many ways, this bill does the opposite."
"I think the bishops are just emphasizing the need to be consistent, and for Congress to fix any of these harmful provisions that are going to hurt families," Bodnar said. "This is a complicated bill — there's hundreds and hundreds of pages of text. There's so much going on. There's so many provisions; they all interact with each other."
"But at the end of the day, families need to be better off, not worse," she said.
Brown of the EPPC said he believes Republican lawmakers when they say they are not attempting to harm poor, pregnant women.
"But the way that they're setting up this bill will inevitably lead to low-income families having a hard time accessing health coverage," he said. "And it's very possible that some of them will have young kids and babies."
However, it is not too late for lawmakers to modify their course, he said.
"They don't have to follow that path. It's not too late for them to rebalance this bill, if they want to," he said. "The question is, is that something that they prioritize?"
