June 3, 2025

As the Senate begins its work on budget reconciliation, local leaders are facing significant potential fallout from Congress’ plan to shift massive costs onto states in order to pay for more tax breaks for billionaires. And they're not ready.

From expensive new cost-sharing requirements in SNAP, to new limits on how states can raise funds to pay for their portion of Medicaid, to the imposition of costly red tape through work requirements – local leaders are at a loss for how to address the coming blows from Congressional leadership's misplaced priorities.

But one thing is certain: The house-passed bill is not only full of steep cuts that are harmful to people and the economy, it is also completely unworkable for states.

Here some of what state and local leaders are worried about, in their own words:

VIEW FROM THE STATES

Alabama: “‘We know things are going to get tough, OK, but we don’t know how tough they’re going to be’… Albritton said lawmakers had trouble finding an increase of about $220 million for Medicaid this past legislative session and he expects another significant increase next year. ‘Between the changes of SNAP and other changes, that’s going to put more pressure on us.’” - Sen. Greg Albritton, R-Atmore, chair of the Senate Finance and Taxation General Fund committee. [Alabama Reflector]

Alaska: “Given our current fiscal situation, I don’t think that’s going to be realistic, in terms of delivering health care services for people who need it.” - Rep. Genevieve Mina, D-Anchorage, who successfully led the AK legislature to pass a bipartisan resolution to urge the state’s congressional delegation to oppose cuts to Medicaid in the budget reconciliation. [Alaska Beacon]

Arizona: “It will devastate these communities. Some of these health centers or hospitals are the largest employer in these communities and it will cause the loss of jobs, if these places have to close,” - Governor Katie Hobbs on federal cuts to Medicaid. [KTAR]

Illinois: “The Trump slump is affecting every state, and the chaos and uncertainty of the Republicans’ proposed cuts to health care and education and jobs have made budgeting, well, harder than ever before….“Of course, we do not know the full extent of the cuts Washington is preparing. But we do anticipate that health care access and infrastructure will be most directly impacted.” - Governor JB Pritzker [Chicago Tribune]

Massachusetts: “A quarter of a million people losing coverage, where are they gonna go? Some will end up in the street. Many will end in emergency rooms. Who do you think pays for it when people end up in emergency rooms? Hospitals can’t absorb that. Insurance companies can’t absorb that. We’re going to all be absorbing that. Businesses here, residents here, people are going to see their premiums go up. People are going to see a whole lot of harm.” - Governor Maura Healey [GBH News]

Michigan: “At the end of the day, there's no way for us to backfill a cut of that magnitude. That would devastate the state budget, so you'd have to lower benefits. It would force some really tough conversations that would lower benefits and also impact public safety, education, health care access.” - Jen Flood, State Budget Director [The Detroit News]

Missouri: “The effects will be felt well beyond hospitals and the patients they serve. ‘This ripples through the entire economy.’” - Cindy Samuelson, Kansas Hospital Association [Kansas City Beacon]

New York: “The proposed federal cuts represent a triple threat—to county budgets, to the vulnerable people we serve, and to the stability of New York’s healthcare system. Counties simply cannot absorb the loss of billions in federal funding without massive service reductions or local tax increases.” - NYSAC Executive Director Stephen Acquario [Ithaca Times]

North Carolina: “Cuts to Medicaid alone could leave the state in a $2.5 billion hole. ‘Until we have a better feel for federal funding, I don’t see how we are really going to truly know what our funding looks like here in North Carolina.’” - State Senator Natalie Murdoch [WRAL]

North Dakota: “If there are cuts to SNAP that would have a huge impact on us. For every meal we provide (through the food bank), SNAP provides nine.” - Susie Boelter, Executive Director of North Country Food Bank on the proposed federal cuts to SNAP as agencies are already facing lost revenue and increased need. [North Dakota Monitor]

Pennsylvania: “There is little room to make up for potential federal cuts with state funding. ‘Knowing the state budget the way I know it, we know that we have no capacity to backfill any of those cuts.’” - Sen. Vincent Hughes (D-Philadelphia), the minority chair of the Senate Appropriations Committee [Pennsylvania Capital Star]

“We’ve got 25 rural hospitals that right now are operating on a deficit that likely would have to shutter if these Medicaid cuts go into effect.” - Governor Josh Shapiro [Pennsylvania Capital Star]

South Dakota: “It would be unfeasible for us to maintain our core responsibilities like education, community support providers and others while simultaneously subsidizing every federal grant.” - Brandy Miesner, chief budget analyst for the state Bureau of Finance and Management. [SD Public Broadcasting]

Utah: The federal proposal has a “pretty big dollar figure tied to work requirements as it’s proposed.” -- Utah Medicaid Director Jennifer Strohecker [Utah News Dispatch]

West Virginia: “This is a brand new problem for the state,” said Sean O’Leary, a budget analyst for the West Virginia Center on Budget and Policy. A federal cost-sharing proposal for food stamps could cost West Virginia from $60 to $100 million… state elected officials so far have no plan to reduce the harm. [Mountain State Tribune]

Oklahoma: “These types of cost burdens and shifts on the state of Oklahoma will be detrimental to taxpayers in Oklahoma and to the state budget. If those costs are then shifted on Oklahoma's budget and we can't pay for it, they'll either be cut or reduced on who can access those programs.” - Rep. Cyndi Munson (D), House Minority Leader [News on 6]

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Contact: Kristin Sosanie (kristin@fairshareusa.org) or Ashley Woolheater (ashley@fairshareusa.org)