The federal One Big Beautiful Bill Act does not immediately cut or end food assistance benefits for people who now receive them. People who are now getting food assistance under the Supplemental Nutrition Assistance Program (SNAP) should continue receiving their monthly benefits normally for the foreseeable future, just as they have in the past. But the law likely will harm many participants and strain state budgets in coming years.
The act includes three major types of changes to SNAP. An overview of each category is below.
1. Changes that affect state budgets
Beginning in the 2026 regular session, the Alabama Legislature will have to appropriate an estimated $35 million in new funding for SNAP administration. This is because the act will require states to cover 75% of SNAP administrative costs, up from the current 50%.
Beginning in the 2027 regular session, the Alabama Legislature will have to appropriate an estimated $172 million in new funding for SNAP benefits. This amount could be smaller or larger each year based on annual changes in the state’s SNAP “error rate,” which includes both overpayments and underpayments of SNAP benefits. The error rate is not a measurement of fraud.
The act includes a sliding scale that requires states to pay for anywhere from 0% to 15% of SNAP benefits, depending on the state’s SNAP error rate. Based on Alabama’s most recent error rate, the state would have to cover 10% of the cost of SNAP benefits, or roughly $172 million.
If Alabama lawmakers could not or would not provide the required state share of funding, the state would have to reduce the number of SNAP participants or opt out of the program entirely. Eliminating SNAP would end food assistance for more than 750,000 Alabamians who participate in the program.
Deep SNAP cuts like those would send hunger rates soaring in a state where roughly 1 in 6 people – including nearly 1 in 4 children – already struggle with food insecurity, meaning they do not always have enough to eat or know where they are going to get their next meal.
Severe SNAP cuts also could be financially devastating for many grocery stores and other retailers. If those stores responded to the revenue loss by shutting down or reducing their hours of operation, that would decrease food access in communities across our state, particularly in rural areas.
2. Changes that place new requirements and limits on more people who participate in SNAP
Beginning in 2030, many veterans, people who are experiencing homelessness and young adults who were in foster care as children may have to comply with work reporting requirements.
Adults in a household with children aged 14 or older may have to comply with work reporting requirements. We don’t know exactly when this change will happen, but people who will be affected will get notice and an opportunity to ask for an exemption.
People who are between ages 55 and 64 may have to comply with work reporting requirements. We don’t know exactly when this change will happen, but people who will be affected will get notice and an opportunity to ask for an exemption.
Some people between 60 and 65 who have received special SNAP benefits for older adults under the Alabama Elderly Simplified Application Project (AESAP) may face additional barriers to participation.
Many people who are legally in the United States as refugees or asylum seekers may no longer be eligible for SNAP. We don’t know exactly when this change will happen, but people in these categories who are participating in SNAP now should continue to get their benefits until notified of a change.
3. Changes that likely will reduce the amount of SNAP assistance over time
The law will prohibit the federal government from changing the amount of SNAP assistance by updating the USDA’s “Thrifty Food Plan,” except to keep up with inflation. The Thrifty Food Plan is used as the basis for determining SNAP benefit amounts each year. This change will reduce SNAP assistance over time but won’t affect current benefit levels.
While many Alabamians were preparing for the July 4 holiday, Congress passed the One Big Beautiful Bill Act— a sweeping federal budget law with serious consequences for families across the country, including right here in Alabama.
The Center on Budget and Policy Priorities put it plainly:
“House and Senate Republicans have now passed a bill that will raise families’ food and health care costs, increase poverty and hunger, take health coverage away from millions of people, and drive up deficits — all to give costly tax cuts to the wealthy and corporations.”
This law is a cruel tradeoff — and it hits hardest in places like Alabama, where many families are already stretched thin and our health care system is fragile.
What you need to know about the Medicaid cuts
We want to be clear: We do not expect anyone in Alabama to be immediately kicked off their health coverage because of this law. However, the long-term consequences are serious and far-reaching. This law makes it more difficult for people to access coverage, and it limits Alabama’s ability to strengthen our health care system in the future.
Here’s what we know so far:
Work reporting requirements and six-month eligibility redeterminations target adults covered through Medicaid expansion. Since Alabama hasn’t expanded Medicaid, these provisions are unlikely to affect us directly at this time.
The law eliminates key financial incentives created to encourage Alabama and other states to expand Medicaid. We no longer will be eligible for $619 million in additional funding to expand Medicaid in the future, which would have helped pay for the startup costs of Medicaid expansion.
The law also includes restrictions on provider taxes — a key tool Alabama uses to help fund its share of Medicaid. We believe the most harmful restrictions would only apply if Alabama chooses to expand Medicaid in the future. This provision will make it more difficult for Alabama to consider expansion going forward, and the cap on provider taxes for Alabama will put a long-term limit on how our state finances Medicaid as health care costs rise.
What’s changing on Healthcare.gov
The law also failed to renew enhanced subsidies that have made Marketplace plans under the Affordable Care Act (ACA) more affordable since 2021. These subsidies have helped thousands of Alabamians lower their monthly premiums — and thanks in part to this support, the size of Alabama’s coverage gap shrank from about 340,000 to 200,000 people. Now, those enhanced subsidies are going away at the end of 2025.
Here’s what this means:
Monthly premiums will increase in 2026 for many people who buy insurance on Healthcare.gov.
Fewer people will qualify for financial help, especially those with lower or fluctuating incomes.
It will be harder to sign up and stay covered, with shorter enrollment periods and stricter paperwork rules.
These changes make health insurance less affordable and harder to access — especially in a state like Alabama, where many people already struggle to afford care.
What this means for providers and rural hospitals
The law includes a new Rural Health Transformation Program, which allocates $50 billion over five years for rural hospitals nationwide. But how that funding will be distributed is unclear, and the funding is unlikely to be enough to meet the growing financial needs of rural hospitals.
Meanwhile, the broader impact is clear:
More uninsured patients will increase uncompensated care costs for providers.
Hospitals and clinics will face more financial pressure — especially in rural areas.
Patients may face reduced access, longer wait times and fewer services as a result.
How Alabama Arise and Cover Alabama are taking action
Alabama Arise and the Cover Alabama team are taking numerous steps in response to the passage of this law. These actions include:
Analyzing the law’s long-term impact on Medicaid financing, ACA Marketplace access and Alabama’s health care infrastructure.
Creating resources for partners, community organizations and the public to explain the changes and what they mean.
Meeting with state and local leaders to discuss options and ensure they understand the financial and human stakes of these changes.
Offering presentations and briefings across the state to help Alabamians prepare and respond.
Even in the face of harmful federal policy, our commitment to the people of Alabama is strong. We are working every day to protect access to care and make sure families have the information and support they need.
We will keep moving forward — and we’ll do it together.
Alabama Arise executive director Robyn Hyden issued the following statement Thursday in response:
“It’s wrong to hurt people who are struggling to help people who are already far ahead. But Congress just passed legislation that will do exactly that. This budget bill is not only a moral failure. It’s bad policy, and it is a really bad deal for Alabama and our entire country. It also will undermine important bipartisan progress that state policymakers made this year on food affordability and maternal health care.
“This cruel budget plan will take away food assistance, health coverage and other vital services from tens of thousands of Alabama families who struggle to afford basic needs. And it will make those cuts in service of slashing taxes for billionaires and highly profitable corporations, with more than $1 trillion in tax cuts accruing to people in the top income brackets. Meanwhile, more than $1 trillion in funding cuts will impact essential services for people with low incomes.
SNAP cuts could send hunger soaring, undermine state grocery tax reduction
“Alabama likely will feel the worst effects from cuts to the Supplemental Nutrition Assistance Program. SNAP benefits have been fully federally funded for decades, but this plan will change that starting in October 2027. If this legislation were in effect now, Alabama would be on the hook for about $207 million a year in direct benefits and additional administrative costs for SNAP. That amount would be roughly the same as the state’s first-year cost to expand Medicaid to cover nearly 200,000 adults with low incomes, and it would not include the cost savings that Medicaid expansion would generate for other services.
“There is reason to worry that the Legislature would decide it can’t or wouldn’t provide the additional SNAP funding. In that case, Alabama would be forced to cut SNAP participation significantly – or even eliminate the program altogether for nearly 800,000 participants statewide. This federal cost shift would reduce our state’s ability to fund existing essential services and programs. And it could lead to deep SNAP cuts that would devastate grocery stores and other retailers in communities across Alabama.
“This bill will expand work reporting requirements to cover more SNAP participants, including veterans, people experiencing homelessness, and young adults aging out of foster care. Many of them likely will lose food assistance not because of a failure to work but because of a failure to complete complicated paperwork. These new red-tape barriers will increase hunger for struggling families while billionaires and corporations run off with a bigger slice of the pie.
“Federal SNAP cuts will leave more Alabamians unable to afford to keep food on the table. That is a step in the wrong direction, and it will undermine the benefits of the state grocery tax reduction that Alabama legislators enacted unanimously this year.
Health coverage cuts will increase human suffering, reduce health care access
“This budget plan will make health care inaccessible or less affordable for tens of thousands of Alabamians. It will allow enhanced Affordable Care Act subsidies to expire, increasing premium costs for marketplace plans. It also will remove the additional $619 million in federal incentives for the first two years of Medicaid expansion that Alabama left on the table. That increases the chances that our state will continue to refuse to expand Medicaid, leaving hundreds of thousands of our neighbors stuck in the health coverage gap with no options to afford life-saving care.
“In total, nearly 200,000 Alabamians could lose health coverage as a result of policy changes like these. Those coverage losses likely will increase hospitals’ uncompensated care costs and make health care even less accessible in rural areas. Fourteen rural hospitals in our state have closed since 2010, and more than 20 others are at risk of closing. When a hospital or clinic closes, it closes for everyone, regardless of their insurance status.
“The human toll of cutting health coverage is all too real. It might mean a later cancer diagnosis for your neighbor. Your pregnant friend might die when her preeclampsia isn’t caught or treated in time because she has to drive an hour longer to get to a doctor. Your son or daughter might experience a mental health crisis and have no way to access or pay for care. Funding for health coverage is not just a line on a spreadsheet. It is often literally a matter of life or death for people facing medical challenges.
Where we go from here
“It will be a few years before many of the federal budget bill’s worst provisions will take effect in full. Alabama Arise’s members and supporters will continue urging our state’s congressional delegation to reverse this bill’s harmful provisions. We also will continue working at the state level to advance public policies to improve the lives of Alabamians marginalized by poverty. That includes advocacy to close our state’s health coverage gap, to right the wrongs of our state’s upside-down tax system and to ensure that all Alabamians have the resources they need to survive and thrive.
“Alabama Arise believes in building an economy that works for everyone and a society where everyone has the opportunity to reach their potential. We will continue working in the years and decades ahead to make that vision a reality for our state.”
More resources
June 27: A news release on the Hands Off SNAP and Medicaid news conference at the State House in Montgomery.
June 5: A letter from 52 Cover Alabama coalition partners, including Alabama Arise, urging Ivey and legislators to oppose harmful cuts to Medicaid and health coverage under the Affordable Care Act.
May 23: A statement from Alabama Arise on numerous ways that the U.S. House budget bill would harm struggling Alabama families,
Alabama’s congressional delegation should oppose a harmful budget bill that would reduce or remove food assistance, health coverage and other vital services for hundreds of thousands of Alabamians who struggle to afford basic needs, Alabama Arise and other advocates said Thursday during a Hands Off SNAP and Medicaid news conference at the State House in Montgomery.
The U.S. Senate could vote on the bill, HR 1, as soon as this weekend. The U.S. House passed its version of the legislation by a narrow 215-214 vote in May. Both versions include deep cuts to the Supplemental Nutrition Assistance Program (SNAP) and to health coverage under Medicaid and the Affordable Care Act. And both versions also include large tax cuts for wealthy households and highly profitable corporations.
“It’s wrong to hurt people who are struggling just to help people who are already far ahead. That’s exactly what the Senate is debating right now,” Alabama Arise executive director Robyn Hyden said during the news conference. “The budget moving through Congress is not only a moral failure. It’s bad policy, and it is a really bad deal for our state.”
Photos from the news conference are available here. A video of the news conference is available here. (Remarks start at the 2:00 mark.)
SNAP cuts would send hunger soaring, imperil local retailers
For every meal that food banks provide in Alabama, SNAP provides nine. But if state lawmakers could not or would not provide new SNAP funding required under the bill, Alabama could be forced to cut SNAP benefits significantly – or even eliminate the program altogether for nearly 800,000 participants statewide.
Deep SNAP cuts could leave food banks with a “perhaps insurmountable” challenge, said Michael Ledger, president and CEO of Feeding the Gulf Coast, a food bank serving southwestern Alabama, southern Mississippi and western Florida.
“We’re worried that SNAP reductions are going to have a dramatic impact on our ability to help our neighbors,” Ledger said. “We’ve seen so many people who would have never dreamed they’d be in that position, in that position. I think as a community, it’s our responsibility to make sure we help these people through those struggles. If we don’t, where do they go?”
Michael Ledger, president and CEO of Feeding the Gulf Coast, speaks at a news conference at the State House in Montgomery on June 26, 2025. (Photo by Matt Okarmus)
Rhonda Mann, executive director of VOICES for Alabama’s Children, said nearly 5,000 retailers statewide redeemed more than $2 billion in SNAP benefits in 2023. She said the wreckage of harmful SNAP cuts would reach far beyond program participants.
“SNAP is incredibly important to the economy of our state. So when you don’t think this affects you because you don’t receive SNAP benefits, think again,” Mann said. “What you’re going to see are the closings of food retailers, and that will hurt everybody. Access to food in some areas of our state is already a problem, and it could become a problem in every area of our state.”
SNAP cost shift would strain state budgets
The federal budget bill could add severe strain to Alabama’s General Fund budget. Under the House-passed bill, states would have to pay for a portion of SNAP benefits, which have been 100% federally funded for decades, according to a sliding scale. The bill also would require states to pay for 75% of SNAP administrative costs, up from the current 50%.
Those cost shifts could leave Alabama on the hook for more than $120 million a year in direct benefits and additional administrative costs. For a sense of scale, that amount would be almost identical to the state’s Education Trust Fund (ETF) budget appropriations next year for both Jacksonville State University and the University of North Alabama combined. In a worst-case scenario, the state could be forced to find nearly $300 million a year for SNAP. That would be more than the 2026 ETF appropriation for either the University of Alabama or Auburn University.
Alabama Arise executive director Robyn Hyden speaks at a news conference at the State House in Montgomery on June 26, 2025. (Photo by Matt Okarmus)
While increasing Alabama’s cost to administer SNAP, the bill also would expand work reporting requirements to cover many more participants. Hyden said these changes would harm many veterans, people experiencing homelessness, and young adults aging out of foster care. She also warned that many families could lose food assistance not because of a failure to work but because of a failure to complete complicated paperwork.
“These cuts will see hunger skyrocket while our state government, churches and charities and everyday working families are struggling to get by, and we’re all going to pay for that,” Hyden said. “It’s going to reduce our ability to fund existing essential services and programs. And we are going to be left on the hook to pick up the slack while billionaires and corporations run off with a bigger slice of the pie.”
Medicaid, ACA cuts would increase health care costs across Alabama
The Senate bill also would make health coverage more expensive or less accessible for tens of thousands of Alabamians. The legislation would allow the expiration of extra financial help for health coverage through HealthCare.gov and would block Alabama from receiving an additional $619 million in federal incentives to expand Medicaid to cover adults with low incomes. In total, nearly 200,000 Alabamians could lose health coverage as a result of the bill’s changes.
Rhonda Mann, executive director of VOICES for Alabama’s Children, speaks at a news conference at the State House in Montgomery on June 26, 2025. (Photo by Matt Okarmus)
These coverage losses could make health care even less accessible in rural areas of Alabama, Mann said. Fourteen rural hospitals in the state have closed since 2010, and more than 20 others are at risk of closing.
“Medicaid dollars are for services and resources we all use, and cuts to Medicaid are going to result in increased health care costs for all of us,” Mann said.
Hyden underscored the human toll that losing health coverage could take on families and communities across Alabama.
“Cutting Medicaid and cutting the enhanced HealthCare.gov tax credits is going to mean one less early cancer diagnosis for your neighbor,” she said. “Your pregnant friend might die when her preeclampsia isn’t caught or treated in time because she has to drive over an hour to get to her doctor. Your daughter might experience a mental health crisis and have no way to access and pay for care.”
Rev. Valtoria Jackson, the Montgomery lead organizer for the Alabama Poor People’s Campaign, speaks at a news conference at the State House in Montgomery on June 26, 2025. (Photo by Matt Okarmus)
Rev. Valtoria Jackson, the Montgomery lead organizer for the Alabama Poor People’s Campaign, called the bill’s proposed cuts to food assistance and health care “a war on the poor.”
“This is not just bad policy. It is a moral sin,” Jackson said. “We know that when people lose access to health care, they die. When food stamps are cut, hunger rises.”
‘Do something better for our state’
State Sen. Kirk Hatcher, D-Montgomery, said he sees up close the struggles that people living in poverty face, both as a legislator and in his role as Head Start director in Montgomery County. Passing legislation to make life even harder for struggling families would be “an absolute moral abomination,” he said.
“I do know what this particular bill and many of the things in it will do to damage the lives of so many,” Hatcher said. “Every life – and I do mean every life – has value. … We can do better.”
State Sen. Kirk Hatcher, D-Montgomery, speaks at a news conference at the State House in Montgomery on June 26, 2025. (Photo by Matt Okarmus)
Jackson said the federal budget bill would cause significant harm to “the least of these” and urged Congress to reject it.
“Budgets are moral documents, not just numbers. And this budget is morally bankrupt,” Jackson said. “The budget will not reduce poverty at all; it will increase it. It will not help seniors live with dignity; it will push them deeper into despair. It will not uphold Alabama’s moral values; it will betray them.”
Hyden closed by urging U.S. Sens. Katie Britt and Tommy Tuberville to oppose cuts to food assistance and health care and to focus instead on policies that would improve the well-being of every Alabamian.
“We have time to ask Congress to do something better for our state,” Hyden said. “We ask you to protect essential services like SNAP and Medicaid to help us build strong, healthy communities. For the future of our state, for our children and families, for all of us who struggle and anyone who might struggle, please vote no on HR 1.”
More resources
Thursday: A photo gallery and a video livestream from the Hands Off SNAP and Medicaid news conference at the State House in Montgomery.
June 5: A letter from 52 Cover Alabama coalition partners, including Alabama Arise, urging Ivey and legislators to oppose harmful cuts to Medicaid and health coverage under the Affordable Care Act.
May 23: A statement from Alabama Arise on numerous ways that the U.S. House budget bill would harm struggling Alabama families.
Virginia found a good job and health insurance that meets her needs after moving back to Alabama last year. But Congress is considering legislation that could send health care costs soaring for her and tens of thousands of other Alabamians. (Photo by Whit Sides)
Virginia would say things have been going well since moving back home to Birmingham a year ago – steady even. She said consistency has been key in staying healthy when life takes on unexpected changes.
And Virginia has had to navigate some unexpected changes recently.
After graduating from Mountain Brook High School and attending the University of Montevallo, she got married and followed her military spouse out of state. Virginia became a federal employee on the base where they were stationed, working in health care administration.
One of the benefits of being in a military family was having health coverage through TRICARE. That allowed her to stay on top of her mental and physical health.
“I’ve been treated for depression, anxiety and ADHD since I was very young, about 14, so it’s important that I regularly go to counseling. It’s important to find medication that works and stick with it,” Virginia said. “The reason I’ve done so well with my mental health is because I’ve had access to great health coverage throughout my life.”
When she and her spouse decided to separate, Virginia moved home. Then she learned she had lost her TRICARE health coverage in November 2024.
“I knew I had to be in Birmingham. It’s where I know people. It’s where my family is,” she said. “I wasn’t in the best space emotionally, but I knew if I could make it home, I could deal with whatever was next once I got there.”
Reconnecting with the community
Virginia began her job search the day she arrived back in Alabama. She soon started working at a grocery store. The work was brutal, with long hours on her feet and only 10-minute breaks. But she said she was grateful for the support system that helped her earn money and become plugged into her community again.
“When I told my friends I was looking for a job, so many people were incredibly helpful, and that’s how I heard about the navigators at Enroll Alabama,” she said.
Virginia mentioned to her roommate that she was living without insurance. Her roommate then suggested visiting healthcare.gov to explore the Marketplace created under the Affordable Care Act (ACA).
An enrollment navigator walked Virginia through the process. With her recent income and household changes, together they discovered that she was eligible for premium tax credits that reduced the cost of her monthly health insurance premiums.
“I did a lot of research to make sure the plan I chose covered most of what I needed to cover my regular medications and doctors and everything,” she said. “And honestly, it wasn’t the cheapest plan, but I could afford it now with the help.”
Shortly after Virginia enrolled in her new plan, she received more good news: She was offered a job working at a family-owned office downtown.
“I work at a small local office now, and the reason I could accept that job is because I already had insurance,” she said.
The budget debate becomes personal
Since moving back, Virginia said, she feels like starting over in Birmingham was the right decision. She has plugged into several social organizations and is making an effort to become involved in causes she was passionate about locally.
That’s when Virginia found out the U.S. House recently passed a budget reconciliation bill (HR 1) with proposed health care cuts that might affect her directly.
“I follow the news, and I’ve seen everything to do with the budget bill for a while now,” she said. “And understandably, a lot of the discussion focuses on Medicaid and Medicare, which is a really big issue. But sometimes navigating health policy is hard when I’m like, ‘OK, if Medicaid’s getting cut and Medicare is getting cut, does that include funding for the Affordable Care Act?”
Virginia became more engaged in health care advocacy after attending a town hall that Alabama Arise co-hosted in Birmingham. She urges Alabamians to contact their lawmakers and tell them how proposed health care cuts would harm their families and communities. (Photo by Whit Sides)
Alabama Arise and Birmingham Indivisible co-hosted a community town hall at East Lake United Methodist Church on May 31 in Birmingham. Panelists discussed proposed federal cuts to food assistance and health coverage.
Virginia was one of the nearly 100 people in attendance that day. She heard Debbie Smith, Arise’s Cover Alabama campaign director, break down what HR 1 could mean for Alabamians who receive subsidies to help pay for their ACA plans. For people like Virginia.
“Someone on the panel said that there would be up to 75% cut of the premium tax credits,” Virginia said. “My heart sank, you know? I put my head in my head in my hands and may have literally gasped, ‘Oh, no!’”
How federal cuts would undermine health care across Alabama
The budget plan now moving through Congress would make health care more expensive and less accessible for people across Alabama and nationwide. One way it would do that is to allow enhanced tax credits for ACA Marketplace coverage to expire.
This expiration would cause out-of-pocket premium payments to increase by more than 75% on average for people enrolled in Marketplace plans, according to KFF. In Alabama, that increase would be 93% on average. And in a dozen other states, people would see their premium payments more than double on average. Most of them, like Alabama, have not expanded Medicaid to cover adults with low incomes.
The most significant Marketplace premium increases likely would hit older adults and enrollees with lower incomes, according to KFF. And those higher costs would play a huge role in driving up Alabama’s uninsured rate.
About 190,000 Alabamians would lose health coverage under the proposed new cuts and barriers to Medicaid and ACA coverage. The cuts also would increase the financial strain on many rural hospitals and clinics and ultimately would drive up health care costs for everyone, no matter what type of coverage they have. And all of the cuts would help finance tax breaks for wealthy households and highly profitable corporations.
For Virginia, the health care cuts would be personal. She said she receives close to $300 a month from the tax credits toward her health coverage costs.
“It’s only $3,100 a year, which is not a lot to these people working on the bill, but like, come on, man,” she said. “You’re going to take that from us, when it’s a 75% difference? That’s such a huge deal.”
Speaking out for herself and others
Virginia said she understands that our country needs a budget from year to year. But she said she hopes Alabama’s elected officials reject health care cuts that would harm so many people, including her.
“I’ve been making calls to lawmakers about other issues since before I even knew I was impacted,” Virginia said. “And so now I just start my day by calling [Sen.] Katie Britt and calling [Sen. Tommy] Tuberville. If I leave a voicemail, I call him ‘Coach,’ but sometimes, people actually answer and I have to work through my social anxiety.”
Virginia encourages anyone who might feel overwhelmed by advocacy to take it one step at a time, and to reach out to their lawmakers with their own story.
“I fundamentally disagree with everyone right now who says that it doesn’t matter if you make a call or show up at a town hall,” she said. “Because if we all say, ‘Nothing I do matters’ and we all sit here and do nothing, then we’re really going to be in trouble.”
About Alabama Arise and Cover Alabama
Whit Sides is the storyteller for Alabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.
Arise is a founding member of the Cover Alabama coalition. Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.
A bill passed by the U.S. House would put the health of thousands of Alabamians — and the state’s fragile health care system — at serious risk.
Here is what’s at stake for Alabama:
190,000 Alabamians could lose coverage
The bill would make cuts to Medicaid and would raise premiums through the Health Insurance Marketplace. As a result, thousands of Alabamians may lose their health insurance, and many would be forced to skip medications, delay care or go to the ER in crisis.
$1.14 billion hit to Alabama’s economy
Raising premiums by letting enhanced Affordable Care Act (ACA) premium subsidies expire would shrink Alabama’s economy by $1.14 billion and cost the state 10,000 jobs in 2026.
Blocks Medicaid expansion funding
The bill would eliminate $619 million in federal funds set aside to help Alabama expand Medicaid. This would deny Alabama the chance to cover at least 200,000 more residents – including veterans, college students, caregivers and more.
Pushes Alabama’s health care system closer to collapse
Alabama’s health care infrastructure is already stretched thin – with at least 20 rural hospitals already at risk of closing. This bill would put more than $400 million per year in state Medicaid provider taxes at risk. As a result, our state lawmakers could be forced to cut coverage or raise new taxes to fill the gap.
Raises health care costs for everyone
When people lose coverage, hospitals and providers still deliver care — but with no reimbursement. That means higher health care costs for everyone — no matter what type of coverage you have.
Alabama Arise executive director Robyn Hyden speaks in support of untaxing groceries during Arise’s annual Legislative Day on March 20, 2025, in Montgomery. (Photo by Julie Bennett)
The 2025 legislative session is officially over, and it was busy and productive. Alabama Arise staff, partners and members worked hard to improve the lives of folks living paycheck to paycheck while also protecting the rights of Alabamians under attack by people with regressive policy agendas.
We successfully advocated for new laws that will improve lives. These policies will:
● Make groceries more affordable for all Alabamians by reducing the state grocery tax (again)!
● Increase access to food in schools by securing more funding in our education budget for no-cost school breakfast programs in public schools.
● Make it easier for pregnant Alabamians to get prenatal screenings by removing red tape around Medicaid’s “presumptive eligibility” rule.
● Ensure more parents can care for their new families by securing a new paid parental leave policy for teachers, two-year college workers and state employees.
● Decrease the cost of living for families by ending the state sales tax on essential items like diapers, baby supplies, menstrual hygiene products and maternity clothing.
The fight doesn’t stop here. We must build on this momentum as we head toward the 2026 session. Become an Arise member today to join the fight and make your voice be heard!
Irondale resident Angelica McCain plays with her daughters near the Cahaba River in fall 2024. Years of living in Alabama’s health coverage gap and advocating for her children’s health care needs motivated her to become an advocate for affordable health coverage for every Alabamian. (Photo courtesy of Angelica McCain)
By the time Angelica McCain was 17, she had moved out of her family’s home in St. Clair County, east of Birmingham. Since then, she has worked full time in the service industry, where health coverage never comes easily.
Now a single mother of two living in Irondale in eastern Jefferson County, McCain finds herself in a familiar struggle. She is fighting to ensure her children have access to the same Medicaid coverage that helped her growing up.
“I was on Medicaid with my brothers,” McCain said. “My mom worked three jobs, my dad didn’t work much, and that was the only way we could have health care.”
That early experience shaped her perspective and fueled her advocacy today. Working in the service industry for much of her adult life – where health insurance is rarely offered – Angelica often falls into Alabama’s health coverage gap. People in the gap have incomes too high to qualify for Alabama Medicaid, but too low to afford private coverage.
Angelica had coverage during her pregnancies, only to lose it shortly after giving birth.
“Medicaid would cover me while I was pregnant, then drop me afterward,” she said. “It’d be great if our country cared about parents after the babies are born.”
Alabama lawmakers in 2022 extended the postpartum Medicaid coverage period to one year after childbirth, up from the previous cutoff of just 60 days. It was a step in the right direction – but it wasn’t enough to ensure families can get the health care they need.
The life-saving importance of Medicaid coverage
Irondale resident Angelica McCain smiles for a photo with her children near the Cahaba River in fall 2024. Medicaid coverage paid for live-saving cancer treatment for her older daughter last year. (Photo courtesy of Angelica McCain)
In February, Angelica was able to obtain health insurance for herself for the first time in her adult life through the Marketplace created under the Affordable Care Act. She said it’s not cheap, but she’s got to take care of herself to be around for her daughters.
A recent health scare demonstrated just how important health insurance is for families like Angelica’s. Medicaid coverage proved life-saving when Angelica’s daughter needed major cancer surgery last year.
“First of all, I thought, ‘Oh my God, is Medicaid even gonna cover this because of how big it is?’” she said. “But it covered everything. They did it all. That saved me from being like $200,000 in debt from five days in the hospital.”
Her daughter, now 10, fully recovered. But Angelica said the experience reaffirmed the critical role that Medicaid plays for Alabama families, especially in rural communities.
Tired of the status quo
Angelica is outspoken about the misconceptions and stigmas that often surround federal programs serving Alabama families. She said that in the past, more than half of her paycheck would be spent on private insurance. She said her sister is still in the same situation, facing the choice between paying for groceries or health care.
“I get very, very tired of the status quo,” Angelica said. “I’ve worked in this state for 17 years, and I still didn’t have health care to show for it. It’s not about laziness. It’s about survival.”
Irondale resident Angelica McCain plays with her children near the Cahaba River in fall 2024. Angelica works full time in the service industry and spent many years living in the health coverage gap, earning too much to qualify for Alabama Medicaid but not enough to afford private insurance. (Photo courtesy of Angelica McCain)
Angelica said she often feels like leaders in Washington, D.C., and Montgomery can’t relate to folks like her. When House Speaker Mike Johnson recently claimed to reporters that many young Americans on Medicaid are just “playing video games all day,” it struck a nerve with Angelica.
“He must be out of his mind,” she said bluntly. “They have no idea what’s happening to working-class folks underneath them.”
‘That emotional weight is crushing’
For Alabamians like Angelica, Medicaid is not just a lifeline. It’s a matter of dignity for working families. But the program faces numerous threats at the federal level.
The U.S. Housevoted 215-214 in May for a budget bill that would cut $800 billion from Medicaid and Marketplace coverage over the next decade. The bill now awaits Senate consideration. If these cuts are enacted, health coverage could become more expensive or inaccessible for tens of thousands of Alabamians.
The bill also would remove additional federal incentives for states to expand Medicaid to cover adults with low incomes. Alabama is one of 10 states yet to expand Medicaid, leaving nearly 200,000 people in the state’s health coverage gap.
Medicaid is an essential part of Alabama’s health care infrastructure. More than 1 million Alabamians – almost all of whom are children, older adults, or people with disabilities – receive their health coverage through Medicaid.
“Children… that’s my heart,” Angelica said. “And it breaks my heart to think there are kids out there who will potentially die, and then families will go under. That emotional weight is crushing.”
If Medicaid were to face cuts or further restrictions, Angelica said her family’s most basic needs could be jeopardized. When times are already tough, she said she doesn’t know if families like hers can take another hit.
“I’d fear their teeth falling out. I’d fear not being able to get my daughter glasses. And I’d fear going into debt just trying to keep them healthy,” she said.
An empowered advocate gets results
In February, Angelica accepted an invitation to share her story at an advocacy day that Cover Alabama and the American Cancer Society Cancer Action Network co-hosted at the State House in Montgomery. There, she met other Alabamians living in the coverage gap. She also spoke at a news conference, where her message to legislators was simple: Expand Medicaid and stop targeting vulnerable communities who are just trying to get by.
Irondale resident Angelica McCain (center, standing behind the lectern) speaks about her experience in Alabama’s health coverage gap during a news conference co-hosted by Cover Alabama and the American Cancer Society Cancer Action Network on Feb. 27 at the State House in Montgomery. Speaking at the event and meeting with lawmakers inspired Angelica to deepen her advocacy for affordable health coverage for every Alabamian. (Photo by Whit Sides)
Ever since, Angelica said, she has felt more empowered to share her story and help make a difference for working families and people with low incomes across Alabama.
“There are so many people that benefit from Medicaid who don’t fit the stereotype,” she said. “We live in rural Alabama, and we live in cities. We’re white, Black, it doesn’t matter. They’re people like me, just trying to do our best for our kids.”
About Alabama Arise and Cover Alabama
Whit Sides is the Cover Alabama storyteller forAlabama Arise, a statewide, member-led organization advancing public policies to improve the lives of Alabamians who are marginalized by poverty. Arise’s membership includes faith-based, community, nonprofit and civic groups, grassroots leaders and individuals from across Alabama. Email: whit@alarise.org.
Arise is a founding member of the Cover Alabama coalition.Cover Alabama is a nonpartisan alliance of advocacy groups, businesses, community organizations, consumer groups, health care providers and religious congregations advocating for Alabama to provide quality, affordable health coverage to its residents and implement a sustainable health care system.
Congress is advancing a cruel proposal to take away food assistance, health coverage and other vital services from millions of Americans who struggle to afford basic needs.
Why? To give huge tax cuts to the wealthiest people in the country. The bill’s proposed $1.1 trillion of cuts to food assistance and health care over the next decade would be equal to the amount of tax cuts it would provide for the wealthiest 2% of households, according to the Center on Budget and Policy Priorities.
Congressional leaders are pushing the bill through budget reconciliation, a process that bypasses the Senate filibuster and allows legislation to pass with a simple majority vote. That process is ongoing and fluid. The U.S. House voted 215-214 for the bill in late May. By the time you read this, the Senate may have made many changes, some for the better and others for the worse.
The specifics may change, but the bill’s brutal core will remain the same. It will increase suffering for millions of Americans with low incomes to finance tax breaks for wealthy households and highly profitable corporations.
An existential threat to SNAP in Alabama
Alabama likely would feel the worst effects from proposed cuts to food assistance under the Supplemental Nutrition Assistance Program (SNAP). SNAP helps more than 42 million people nationwide and nearly 800,000 Alabamians put food on the table.
Now, Congress and the White House are threatening those families’ meals in an effort to reduce taxes for billionaires. Three major proposed SNAP changes would have devastating effects on Alabama.
(1) The bill likely would require Alabama to pay hundreds of millions of dollars more for SNAP benefits and administrative costs. The federal government has funded 100% of SNAP benefits for decades. Under the new cost shift, Alabama would become responsible for a projected $258 million or more in direct benefit costs annually, plus an additional $35 million a year in administrative costs.
The General Fund is already facing increasing costs and often stagnant revenues. There is real reason to be concerned that the Legislature can’t, or wouldn’t, commit this money. In that case, Alabama would be forced to cut SNAP benefits significantly – or even eliminate the program altogether.
(2) Congress also is considering expanding SNAP current time limits and work verification red tapefor an additional 165,000 Alabamians, including parents with children over age 7. A change of this magnitude would create additional burdens for Alabama’s already stretched child care and child welfare systems. And it could leave thousands of Alabama children and families without food.
(3) Congress is considering limiting future growth in the value of SNAP benefits. Over time, this would reduce benefits for nearly 800,000 SNAP participants in Alabama, including more than 300,000 children, even as food costs continue to grow.
The economic devastation of SNAP cuts
SNAP cuts not only would hurt Alabama’s people. They also would damage Alabama’s economy. More than 5,000 Alabama stores are authorized to accept SNAP payments, and for many, it’s a large part of their business. This is particularly true in small towns and rural communities where retail is a major source of jobs and tax revenue.
Every $1 in SNAP benefits can generate $1.50 in economic activity in local communities, the USDA estimates. Deep SNAP cuts could force layoffs or closures at grocery stores and other retailers across our state. A reduction or loss of SNAP benefits is a threat to our economy and the local communities where we all live and shop.
Threats to Medicaid and ACA coverage
The bill also would make health care inaccessible or less affordable for tens of millions of Americans, including tens of thousands of Alabamians. It would allow enhanced Affordable Care Act (ACA) subsidies to expire, increasing premium costs for marketplace plans.
In addition, the bill would create new barriers that would limit Alabama’s ability to manage its own Medicaid program in the future. For example, the legislation would eliminate the federal incentives set aside to help states like Alabama cover the first two years of Medicaid expansion.
Alabama is one of 10 states yet to expand Medicaid to cover adults with low incomes. As a result, nearly 200,000 Alabamians are in the health coverage gap, earning too much to qualify for Medicaid but too little to afford private insurance.
The bill also would freeze provider taxes at current levels. This would ban Alabama from increasing fees on nursing homes, ambulance providers and others to fund Medicaid costs – even if legislators find that move necessary to sustain the program or expand coverage later.
Now is the time to speak out
It is not too late for us, as Alabamians and Alabama Arise members, to raise our voices against this dreadful bill. Congress is hearing the opposition from people back home, and that pressure continues to grow. The bill’s margin for passage is tight, and only a few votes can make a difference.
Please call on your U.S. representative and senators to say “no” to deep cuts to food assistance and health care. Ask them to focus instead on legislation that advances tax equity and meets essential health and nutrition needs in our communities.
Alabama Arise successfully leaped into action this year to defend health coverage for thousands of children. In February 2025, Rep. Ben Robbins, R-Sylacauga, introduced HB 177, which would have required that a child covered by Medicaid be placed on a non-custodial parent’s employer-provided health insurance when available, regardless of whether the parent could afford it. The bill also would have required Alabama Medicaid to sue parents who did not do so for payments made on the child’s behalf. Arise went into action.
Policy analysis: Looking for the devil in the details
After reading HB 177’s worrisome language, Arise senior policy analyst Carol Gundlach and other staff got to work on assessing its repercussions. As written, HB 177 would have:
Required Alabama Medicaid to sue many parents.
Put many parents who were already struggling into medical debt.
Forced some victims of domestic violence into contact with their abusers.
Lawmakers turn to Arise for answers
On Feb. 19, the House Ways and Means General Fund Committee debated HB 177. Arise’s Robyn Hyden spoke in opposition.
“One example … is a friend [whose] take-home pay is $600 a week. … So she could opt in to pay for health insurance through her employer, [but] it would take more than one-third of her paycheck,” she said.
Many committee members raised questions about the bill’s potential harms. Acting committee chair Rep. Chris Blackshear, R-Phenix City, urged the sponsor to collaborate with Arise regarding our concerns.
Our members take action
At Cover Alabama’s advocacy day, Irondale resident Angelica McCain – equipped and encouraged by Arise – shared her story of being a single mother in the health coverage gap.
“There are so many people that benefit from Medicaid who don’t fit the stereotype,” McCain said. “We live in rural Alabama, and we live in cities. We’re white, Black, it doesn’t matter. They’re people like me, just trying to do our best for our kids.”
Later that day, she spoke directly to Robbins to explain how HB 177 would harm her family. In all, nearly 100 of our advocates visited their lawmakers that day.
Harm mitigation: Advocating for amendments
Arise continued speaking with legislators about HB 177. Robbins ultimately proposed a substitute version that removed some of the bill’s most harmful impacts. The substitute added an affordability test and clarified that the insurance requirements would not apply to custodial parents.
A quiet but mighty win
Sometimes a legislative win is obvious: A good bill is enacted into law. Other times, it looks more like stopping a bad bill or mitigating the harm it would cause. In the case of HB 177, Arise identified a bill that would have hurt vulnerable Alabamians. Then we successfully advocated to make it less harmful – and ultimately, the bill died.
This is just one example of the kind of critical legislative victories that Arise regularly secures for families across Alabama. Your advocacy and support of our work makes it all possible!
