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Long federal road ahead for SNAP, health care


By Carol Gundlach, senior policy analyst, and Debbie Smith, Cover Alabama campaign director

Alabama Arise believes that society should care for the most vulnerable in our nation—children, the elderly, those who are disabled and those who have fallen on temporary hard times. Since the Great Depression, Americans have been assured that, no matter how hard times get, our basic nutritional needs would be met by our government.

But 2025 has been a head-spinning and traumatic year for the 750,000 Alabama recipients of SNAP food assistance (commonly called Food Stamps), a stable pillar in America’s response to poverty and hunger. For 60 years, through multiple federal shutdowns, budget crises and wars, SNAP assistance has reliably fed hungry Americans. 2025 was different. 

Bill doesn’t help those who need it

HR1, the budget reconciliation bill (or “One Big Beautiful Bill”) passed by Congress in July, made it harder for people to receive food assistance and reduced the amount of assistance available, even as grocery costs rose. Existing time limits and burdensome paperwork requirements for some SNAP recipients were expanded to include unhoused people, veterans, children aging out of foster care and elderly recipients. 

Non-citizens and refugees legally in the U.S. were denied food assistance. And states, for the first time, will have to pay for some SNAP benefit costs. By mid-2027, Alabama will have to come up with approximately $175M to pay for our existing SNAP program.

Shutdown deepened impact

The October federal government shutdown only made the food crisis worse. The United States Department of Agriculture (USDA) refused to use its emergency funds and instead cut off food assistance to 42 million Americans, including all SNAP recipients in Alabama. 

Food banks and pantries, bolstered by small state grants, tried to fill the gap but many of our neighbors faced hunger as the holidays approached. The ending of the shutdown allowed the Department of Human Resources to get SNAP benefits out in record time, but legal immigrants face immediate termination of SNAP benefits. And many more people face new, draconian time limits that began in December. 

And many of the same people face huge increases in the cost of their health care.

Health costs will soar

As of this writing, Congress has not extended enhanced premium tax credits (ePTCs), which lower monthly premiums for nearly 500,000 Alabamians who get their coverage through the ACA Marketplace. As a result, 130,000 Alabamians are expected to lose coverage. This decision threatens to roll back the significant progress Alabama has made in reducing its uninsured rate.

The enhanced tax credits have played a central role in that progress. Lowering premiums opened Healthcare.gov plans to workers who had long been locked out of affordable coverage. Nearly half of Alabama’s Healthcare.gov enrollees fall into income ranges that would qualify them for Medicaid expansion if they lived in the 40 states that have expanded. Without the credits, many will face premiums they simply cannot pay, increasing the number of uninsured at a time when families are already navigating high costs of living.

This shift will place additional pressure on Alabama’s health care system, especially rural hospitals and clinics that already struggle with staffing shortages, rising uncompensated care, and service reductions. 

HR 1 complicates health care access

Federal changes under HR 1 create additional challenges. The law eliminates financial incentives meant to help states like Alabama adopt Medicaid expansion, including extra federal funding that would have supported expansion startup costs for the first two years. It also places new restrictions on increasing provider taxes, which Alabama uses to help fund its share of Medicaid. These limits would become more restrictive if Alabama chose to expand Medicaid in the future, and even now, they place a long-term cap on our state’s flexibility to finance Medicaid as health care costs continue to rise.

HR 1 also shifts new SNAP funding responsibilities to states. This will strain the state budget at a time when food insecurity is rising and families are struggling to meet basic needs.

Taken together, these issues ensure that health care and food access will be unavoidable priorities in the 2025 legislative session. The coming year will bring real challenges, but it also offers Alabama lawmakers an opportunity and a responsibility to strengthen the state’s health and nutrition safety nets at a moment when Alabamians need them most.