One Year After Trump’s One Big Beautiful Bill Act, Millions Have Lost Health Coverage and Food Assistance

By Center For American Progress Photos: Wikimedia Commons Washington, D.C. — One year after President Donald Trump signed the One Big Beautiful Bill Act (OBBBA) into law, Affordable Care Act (ACA) plan selections have fallen by 1.2 million people and participation in the Supplemental Nutrition Assistance Program (SNAP) has dropped by more than 4 million people, according to a new Center for American Progress analysis. The article finds that families are paying more for health care and groceries while the law delivers roughly $1 trillion in tax cuts to the top 1 percent of households. Many of the law’s largest cuts have yet to take full effect. Over the coming years, new Medicaid work requirements, SNAP restrictions, and other provisions are expected to push millions more Americans off health coverage and food assistance programs. The Congressional Budget Office estimates that the law’s health care provisions alone will leave 10 million more Americans uninsured by 2034. “The consequences of the One Big Beautiful Bill Act are only beginning to take hold,” said Natasha Murphy, director of Health Policy at the Center for American Progress and co-author of the analysis. “Just one year after its enactment, millions of Americans are losing health coverage and food assistance while families face the economic pressures of higher health care, grocery, and energy costs. As the law delivers massive tax breaks to wealthy households, working families are struggling to make ends meet.” Key findings from the analysis include: ACA plan selections have fallen by 1.2 million people. Marketplace sign-ups declined 5 percent between 2025 and 2026, the largest drop since the marketplaces opened in 2014. Marketplace coverage has become significantly more expensive. Average monthly ACA net premium costs among enrollees increased 58 percent, from $113 in 2025 to $178 in 2026, while average deductibles rose 37 percent to a record high of $3,786. The law’s health care provisions are expected to leave 10 million more Americans uninsured by 2034. New Medicaid work requirements and other coverage restrictions are projected to cause millions of Americans to lose health insurance over the next decade. SNAP participation has dropped by more than 4 million people. SNAP participation fell by 10 percent nationwide between July 2025 and March 2026, with participation declining in every state during this period. More than 700,000 children have lost SNAP benefits in 12 states alone. Participation has fallen by at least 5 percent in 42 states and by at least 10 percent in 21 states. The top 1 percent receive roughly $1 trillion in tax cuts. Meanwhile, the law cuts more than $900 billion from Medicaid and more than $1.2 trillion from programs that help families meet basic needs. Families are facing higher utility bills. The law’s repeal of clean energy incentives is projected to raise household electricity costs by more than $110 in 2026, with electricity rates expected to increase nearly 18 percent by the end of President Trump’s term. Read the analysis: “On the First Anniversary of the OBBBA, Millions of Americans Have Been Left Behind” by Amina Khalique and Natasha Murphy