President Trump’s “One Big Beautiful Bill” cuts federal funding for SNAP. North Carolina would have to find $229 million per year to fill the gap.

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GREENSBORO, N.C. — There’s a lot of buzz online this week about President Donald Trump’s “One Big Beautiful Bill.” Some lawmakers claim it protects food assistance. Others argue it slashes it.

So what’s the truth? 2 Wants To Know Verified. We dug into the bill itself, crunched the numbers with the Food Research and Action Center, and checked with the North Carolina Department of Health and Human Services.

What the Bill Actually Says

Inside the 1,100+ page bill, on page 23, is a section about SNAP—the Supplemental Nutrition Assistance Program, also known as food stamps.

Currently, the federal government pays 100% of SNAP benefits. But that would change under the bill.

In 2028, the federal share would drop to 95%.

States with high error rates could see even deeper cuts.

Administrative costs paid by the federal government would also drop—from 50% to 25%

What That Means for NC and the Nation

The Food Research and Action Center estimates the changes would amount to $300 billion in federal SNAP cuts over the next 10 years.

In North Carolina alone, the state would have to come up with an extra $229 million every year to maintain current benefit levels. But state leaders say they’re not getting any extra funding from the federal government to do that.

“It is less money, and it’s not guaranteed that the state can or will fill in the reduction in federal revenue,” said Jay Ludlam, Deputy Secretary of NC Medicaid. “So to me, a cut is a cut is a cut.”

So yes—we can verify that President Donald Trump’s “One Big Beautiful Bill” does cut federal SNAP benefits.

But What About Fraud?

Republicans argue the cuts are about reducing fraud. They say putting more responsibility on states gives them a stronger incentive to prevent waste and improper payments.

Congressman Richard Hudson, who represents part of the Triad, says, “We’re here to fight for the vulnerable. We’re here to make sure Medicaid is strong now and in the future.”

But how big is the fraud problem?

A Government Accountability Office report from last year estimated North Carolina’s improper payment rate was about 9%—roughly $200 million. Again that number is an estimate by auditors. State officials say true fraud is much lower.

“I’m not aware of any specific concerns in the SNAP program about fraud, waste, or abuse,” Ludlam said. “At the department, we take the responsibility of carefully managing state and federal resources very seriously.”

Real Impact on Real People

At Second Harvest Food Bank, staff say they’re already seeing record demand for help—and shelves are sitting empty.

“The notes on fraud are inaccurate,” said Eric Aft, CEO of Second Harvest. “They’re piecemealing pieces of information that work for sound bites, but are not the reality on the ground. Having done this kind of work for over 35 years, unless people have to seek assistance, they don’t. It’s hard. It’s inconvenient. It’s embarrassing.”

And the potential SNAP cuts?

“They would only make things worse,” Aft said. “It’s important to understand that SNAP provides nine meals for every meal that food banks across the state provide. So it is an integral program for ensuring that our kids have healthy food as inflation has impacted families.”

© Philip – stock.adobe.com

The Senate could take up legislation that would counter the 2025 cut to doctors’ pay in this year’s Medicare Physician Fee Schedule.

Meanwhile, the Senate this week considered the nomination of a new deputy secretary for the U.S. Department of Health and Human Services. Maternal health also could be improved through legislative support for pregnancy programs.

Physician pay

Sen. Roger “Doc” Marshall, MD (R-Kansas)

Sen. Roger “Doc” Marshall, MD (R-Kansas), introduced S. 1640, tentatively titled the Medicare Patient Access and Practice Stabilization Act of 2025.

The two-page bill has been referred to the Senate Finance Committee. Much of its language deals with code sections of the Social Security Act, but it appears to legislate an 8.51% increase for services furnished on or after June 1 to Jan. 1, 2026.

That is “a prorated reversal of the 2.83% cut physician practices have endured since the beginning of 2025 as well as an inflation-based update,” said Anders Gilberg, senior vice president of government affairs for the Medical Group Management Association.

“MGMA strongly supports this important legislation and appreciates Sen. Marshall’s leadership in the Senate on behalf of physician group practices,” he said in a post on social networking site LinkedIn.

Rep. Greg Murphy, MD (R-North Carolina)

It appeared the bill had the same intent as legislation already pending in the U.S. House of Representatives. Earlier this year, Rep. Greg Murphy, MD (R-North Carolina) introduced similar legislation in the House, with bipartisan support.

As for Marshall’s bill, Congress.gov also lists the legislation’s working title as A Bill to Amend Title XVIII of the Social Security Act to Increase Support for Physicians and Other Practitioners in Adjusting to Medicare Payment Changes.

HHS nominees get hearings

James “Jim” O’Neill, MA, testifies during his confirmation hearing before the Senate Health, Education, Labor & Pensions Committee on May 8, 2025. This image was taken from the hearing video published by Forbes on YouTube.

The Senate this week also held hearings on the nominations of two leaders for the U.S. Department of Health and Human Services (HHS). Republicans and Democrats split over their qualifications and suitability to lead HHS, and over the direction, goals and measures of President Donald J. Trump’s Make America Healthy Again (MAHA) initiative.

The Senate Committees on Finance and Health, Education, Labor & Pensions (HELP) held separate hearings about the nomination of James “Jim” O’Neill, MA, to serve as HHS deputy secretary.

O’Neill opened his hearings with similar statements to the respective committee members. He referred to the Organisation for Economic Co-operation and Development.

“Sadly, America’s health is in crisis,” O’Neill said in testimony. “Three quarters of Americans are overweight or obese, leading to chronic diseases like diabetes, high blood pressure, and over time, heart attacks and kidney failure. Diabetes alone costs us $400 billion every year, and it has exploded in prevalence tenfold since 1960. Fentanyl ravages our cities and our countryside. Addiction and mental health are urgent unsolved problems. Since 2000, suicide has increased by 37%. Medicare hospital insurance is headed toward insolvency. Families struggle to afford individual insurance. We spend $4.1 trillion on health care — double the OECD average — yet our life expectancy is actually shorter than it was in 2010. These aren’t just numbers; they’re a call to action. Overall, what we’ve been doing is just not working.”

O’Neill drew praise from HELP Committee Chair Sen. Bill Cassidy, MD (R-Louisiana) and Finance Committee Chair Sen. Mike Crapo.

Cassidy also cited the health problems ailing America.

“The American people want solutions that make their lives easier. They want results, not excuses,” Cassidy said. “President Trump, working with Secretary Kennedy, has laid out a bold vision to make health care more affordable and to Make America Healthy Again. To do this, he needs officials with the expertise and vision to carry out his agenda, while also increasing transparency, restoring trust, and ensuring that science, not politics, drives decision-making. That is why this nomination is so important.”

Senate Finance Committee Ranking member Sen. Ron Wyden (D-Oregon) claimed the tenure so far of HHS Secretary Robert F. Kennedy Jr. “has been nothing short of a disaster.” His official testimony recounted the chronic and current health woes, including the current measles outbreak, and argued Kennedy has done nothing to help.

“Unfortunately, Mr. O’Neill, who has been nominated to serve as Mr. Kennedy’s right hand man, has been cheering him on every step of the way, including as recently as last week when he told my staff that he thought Robert Kennedy was doing a ‘good’ job on addressing the measles outbreak,” Wyden said.

Legislative liaison

Wyden also criticized Gary Andres, PhD, the president’s nominee for assistant secretary for legislation. Andres, current Republican staff director of the House Budget Committee, was part of the Senate Finance Committee hearing.

“In his current role, Mr. Andres released House Republicans’ wishlist of more than $2 trillion in proposed Medicaid cuts and hundreds of billions more from programs that help families afford food, energy bills, and child care,” Wyden said. “Mr. Andres should also answer for this anti-family grab-bag of cuts targeting our country’s most vulnerable citizens.”

In his testimony, Andres said he hopes to build a bridge between Congress and the White House.

“I’m also passionate about health care reform and eagerly anticipate working on an agenda to Make America Healthy Again,” Andres said. “Much of Washington’s debate centers on what I term the supply side of health care — tracking the number of providers, coverage levels, and health care spending. These metrics matter and warrant attention.

“Equally critical, however, is the demand side of health care,” his official statement said. “We must prioritize keeping people healthy, emphasizing preventative care and screenings, reducing chronic illness, and taking proactive steps to foster wellness. If confirmed, I would pursue these objectives with enthusiasm and vigor.”

A bill for mothers

Marshall, who made his career as an obstetrician-gynecologist, also was a leading co-sponsor of the bill, the More Opportunities for Moms to Succeed (MOMS) Act. His legislative summary said the bill “would improve access to critical resources during the toughest phases of motherhood, including the prenatal, postpartum, and early childhood development stages.”

In 2023, the number of U.S. births was the lowest since 1979, and the total fertility rate in America hit an all-time low. Last year, fertility and birth rates remained near record lows, reflecting a continued, concerning trend in America, according to Marshall’s office.

“As a former OB-GYN who spent over 25 years caring for thousands of women and delivering over 5,000 babies, I understand firsthand the importance of supporting mothers throughout their pregnancy and into motherhood,” Marshall said in a news release. “The MOMS Act is critical legislation to ensure we are providing countless women in America the resources they need.”

Co-sponsors include Sen. Katie Britt (R-Alabama), Sen. Kevin Cramer (R-North Dakota), and Sen. Eric Schmitt (R-Missouri).

It is important for Congress to revise the reconciliation budget bill passed by the House last month. Republicans appear ready and willing to reduce spending by cutting programs vital to the health of the nation, including the Supplemental Nutrition Assistance Program and Medicaid. This is a grave mistake, especially at a time when prices are inflated.

Medicaid is a pathway to eligibility for families to receive free school meals. Many low-income children are reliant on schools to fill their nutritional needs and combat hunger. Nutritious meals are essential for student success, but for people facing poverty, access to healthful food is often challenging. Free school meals boost academic achievement, improve student behavior and promote equity.

Medicaid and SNAP impose costs on taxpayers, yes, but the benefits — better nationwide health and nutrition — are worth it. Access to SNAP reportedly helps people develop better long-term health. The optimal policy would be increasing funding for benefits, not decreasing it, especially as families struggle with higher-than-normal grocery costs.

Having assistance for food and medical needs helps our most vulnerable families succeed, which enables a better future for everyone. That’s how you “Make America Great Again,” not by cutting vital programs.

Gail B. Landy, Gaithersburg

Republicans said it out loud

Regarding the April 27 online article “Democrats seize on a new issue to use against the GOP: Social Security”:

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Nowhere did the article mention that in March 2024, barely a year ago, the Republican Study Committee — which includes about two-thirds of the Republican members of the House — loudly advocated for a budget that would cut Social Security benefits by raising the retirement age from 67 to 69 as well as privatize Medicare (the “premium support model”), turning our Medicare money over to private insurers that could delay or deny our claims.

The Trump-Musk model of cutting phone-call takers, closing offices and making it difficult to access benefits seems like a precursor to actually cutting the program itself. Republicans can say whatever they like about retaining Medicare funding, but the reality is that only Republicans have proposed cutting the program — both recently and with an overwhelming majority of support from their House lawmakers.

The best predictor of future behavior is past behavior.

Linda Falcão, North Wales, Pennsylvania

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Bad for the economy

Cutting funding for Social Security, Medicare and/or Medicaid would be a major blow to seniors who rely on these programs to support their health-care needs. But in addition to hurting our older citizens, any significant change in these programs could result in drastic effects on the economy.

Cutting these programs would result in fewer seniors being able to afford senior-care facilities. Some would have to be taken in by relatives (or face homelessness). Those relatives would then probably be less able to work and would have less disposable income to spend in our consumer economy.

The loss of clients might also result in many senior-care facilities closing. If that happens, workers who lose their jobs might find it hard to market their skills in an economy with a sudden excess of specialized assisted-living workers. Closed facilities and newly unemployed workers would pay no taxes. These facilities and unemployed workers will buy fewer products.

Even individuals with the financial means to pay their own health-care costs will have less cash available. And if consumers, especially the wealthy, stop spending as much to pay medical bills, this could have ripple effects on the stock market.

Whether you appreciate these programs or not, they now support a significant part of our economic fabric. Addressing the shortcomings of these programs cannot be accomplished by significant cuts in funding without much grander, perhaps unintended, consequences.

Vincent C. Stone, Martinsville, Virginia

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You call this waste?

Medicare Advantage delivers more value for seniors and taxpayers, with better care and better health outcomes at lower costs to beneficiaries, than traditional fee-for-service Medicare. Unfortunately, one wouldn’t know it from reading the April 22 online editorial, “To cut ‘waste and fraud,’ reform Medicare Advantage.”

The editorial asserts that it costs the government more to insure beneficiaries via Medicare Advantage. However, it ignores the fact that the fee-for-service Medicare model is volume-based, which can incentivize more health visits and procedures. Medicare Advantage prioritizes preventive care and wellness benefits that keep seniors healthier and out of the hospital. Over time, that approach cuts down on total medical expenses and saves taxpayers money.

Medicare Advantage is designed to understand seniors’ health better than traditional fee-for-service Medicare. The editorial argues against overdiagnosing, but the system works only if beneficiaries are diagnosed completely and accurately every year. This not only encourages more efficient spending; it also promotes better care management. Diagnoses in Medicare Advantage are made by licensed clinical professionals and subject to rigorous checks.

Mistakes can happen, but plans cannot simply pull a diagnosis out of thin air. Medicare Advantage boasts robust accountability measures, including regular audits, to ensure that Medicare dollars are being spent correctly. It’s one reason Medicare Advantage has a higher payment accuracy rate than traditional Medicare.

That doesn’t mean there isn’t room to strengthen Medicare Advantage. Our group, Better Medicare Alliance, continues to advocate for policy solutions that would improve the program for taxpayers and beneficiaries, including more plan audits and stricter guidelines around in-home health assessments.

But these policy changes shouldn’t be made on the backs of beneficiaries. After two years of cuts during the previous administration, reforms that would further reduce Medicare Advantage funding would be a serious mistake and hurt seniors.

Mary Beth Donahue, Washington

The writer is chief executive of Better Medicare Alliance.

The wrong part to reform

The Post’s editorial ignores the compelling value of Medicare Advantage and paints a distorted picture of the part of Medicare that most seniors prefer. Nearly 35 million Americans have chosen Medicare Advantage because it provides them with better care at lower costs than fee-for-service Medicare.

The editorial ignores that beneficiaries of Medicare Advantage save, on average, more than $2,500 per year compared with those in fee-for-service. Medicare Advantage also provides more benefits, including vision, dental and hearing coverage, and prescription drugs. Seniors in Medicare Advantage have better access to preventive care and more support managing their chronic conditions — which is why Medicare Advantage delivers superior health outcomes.

Enrollment data also shows that Medicare Advantage serves a population that is more clinically complex and more diverse than fee-for-service enrollees, including a majority of beneficiaries who are eligible for both Medicare and Medicaid. These are vulnerable, low-income seniors who count on the superior value, support and services Medicare Advantage provides.

All parts of Medicare can be improved through rigorous scrutiny. A good place to start would be addressing the incentives in fee-for-service that continue to reward volume over value. Federal government data also show fee-for-service Medicare experiences higher rates of improper payments than Medicare Advantage.

But the facts show Medicare Advantage decisively outperforms fee-for-service in affordability, benefits and outcomes. Health plans welcome data-driven, beneficiary-centric discussions about how to build on this track record.

Michael Tuffin, Washington

The writer is chief executive of AHIP.

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Not ‘great,’ but …

Considering actions taken by the Trump administration in the past few months, I was wondering which words will define the future of the United States. “Great” is not one of them. So these are the five other words I fear may best describe our nation.

Sicker. Access to health care is on the chopping block for millions. The Department of Health and Human Services is planning a major downsizing. Health and safety agencies are being curtailed. University medical research funding is being cut. Vaccine misinformation is already spreading like a virus, and facts about the covid-19 pandemic are being distorted by the White House.

Weaker. With constraints placed on innovation combined with a lack of upgrades to military training and equipment, we will have a weakened military. This will be made even worse with the discontinuation of joint military training with other national forces. Senior military personnel have been ousted, and current top defense officials, such as Pete Hegseth, are proving to be poor leaders.

Poorer. Our economy’s outlook is bleak. Add to that housing limitations as well as retirement and investment accounts hit hard by the plunging stock market. Plus, financial regulatory agencies that protect consumers have been targeted. Common items, along with food, will take a bigger part of people’s earnings. The Trump administration has even ordered cuts in support programs for small banks in red districts.

Alone. This is the saddest. We have declared economic war with our tariffs on international trading partners. NATO and the European Union now distrust us. Foreign aid is frozen. We have offended most other nations, except maybe Russia. This makes the United States very unsupported — and vulnerable.

If we feel that these five words will best describe our future, isn’t it our obligation to do whatever we can to see that this does not happen?