As House Republicans worked Wednesday to win over holdouts on the Senate’s version of President Donald Trump’s budget bill, Utah advocates worried about the consequences. They warned that tens of thousands in the state could lose Medicaid or food assistance if the House approves the bill.
Republicans are racing to get the “big beautiful bill” done by July 4.
Under the House-passed version, Utah would see a $698 million decline in federal Medicaid spending in rural areas by 2034, according to health policy organization KFF. It estimates 10,000 rural Utahns would lose coverage. The Senate version of the bill calls for greater cuts to Medicaid.
“I had a call yesterday from a concerned citizen in rural Utah wanting to know where they're going to go to receive care if their hospital closes in their community,” said Matt McCullough, rural hospital improvement director with the Utah Hospital Association. “And the bill hasn't even passed yet, and that's the kind of anxiety that it's causing folks in rural Utah.”
Many rural hospitals nationwide operate at or near a budget deficit, he said. Emergency rooms will still treat patients without Medicaid, but they’ll get less help paying for it. That could force hospitals to cut services.
As for food assistance, Glenn Bailey, executive director of Crossroads Urban Center, said their two food banks are already serving more and more people. The GOP budget bill would reduce funding for the Supplemental Nutrition Assistance Program. And extra paperwork to comply with expanded work requirements for SNAP would be a barrier to hard workers who are already busy, he said.
“This is absolutely the wrong time to make cuts in the safety net, particularly in food resources,” he said.
Utah Sens. Mike Lee and John Curtis both voted for the bill.
In a statement, a spokesperson for Curtis said changes to Medicaid will protect health care for those who really need it — and keep it safe for future generations.
The bill also has the support of Rep. Burgess Owens. In a statement from his office, he said “From reining in over $700 billion in wasteful Medicaid spending, including benefits going to illegal immigrants, to enforcing work requirements and eliminating fraud, the One Big Beautiful Bill protects and strengthens Medicaid for those in Utah and across the nation who truly need it.”
While Emergency Medicaid reimburses hospitals for emergency care for immigrants without legal status, federal Medicaid coverage is already not available to people in the country illegally.
In terms of Medicaid and SNAP in Utah, former Republican state Rep. Marsha Judkins, who served on the Social Services Appropriations Subcommittee, said there’s “very little fraud, misuse or waste.”
“The application process is very rigorous, and the clients on these programs are often reviewed to make sure that they still qualify,” she said.
State lawmakers could let federal budget cuts stand, she said, or step in with state funds — but that would pull from other programs.
“It's going to be real people who are going to be cut, and they're going to be cut from programs that they truly need,” she said.
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Macy Lipkin is a Report for America corps member who reports for KUER in northern Utah.
