The Republican’s harmful megabill, signed into law this past summer, makes significant cuts to health care, nutrition assistance, and other programs that help families meet basic needs. The legislation includes some of the largest proposed cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP) in history.

These changes would reshape health care and nutrition assistance across Pennsylvania. An estimated 450,000 residents could lose health coverage due to cuts and the expiration of enhanced ACA premium tax credits. Another 340,000 people are expected to lose Medicaid coverage. About 143,000 residents may lose all or part of their SNAP benefits. The bill would also shift costs to the state, with Pennsylvania potentially responsible for up to $636 million per year in new SNAP expenses tied to federal cost-sharing requirements.

Sara Stone, a 34-year-old Pennsylvania mother of three, knows exactly where the cuts will hit her family. Relying on $200 a month in SNAP benefits while working part-time as her severely autistic son’s home health aide, Stone has already mapped out which bills won’t get paid so she can keep food on the table. The family has started rationing snacks, stocking up on ramen noodles and canned soup, and visiting local food banks—though those options don’t work for her son, who requires specific foods. As Stone prepares to start nursing school in January, she’s bracing for an uncertain future. Learn more about how Pennsylvania families are navigating these challenges.

“We have to figure out where we’re pulling money from to cover the $200 that we do get a month because there’s just no extra funding,” said Stone. “So, we’re going through what bill is not getting paid for November so we can put food on the table.”

The bill’s provisions would affect working families like the Stones who rely on the ACA marketplace, Medicaid recipients who depend on stable coverage, and households that use SNAP benefits to meet basic needs. These policy changes would reach an estimated 790,000 Pennsylvania residents losing health coverage and 143,000 losing nutrition assistance, affecting household budgets, access to medical care, and family stability across the state.

Put simply, the bill reduces health care and food assistance while providing tax breaks to higher-income households. Additionally, the House Republicans bills propose further cuts, including reductions to housing assistance funding that could affect families’ ability to maintain stable housing. We urge Members of Congress to protect the millions who rely on these essential services by extending enhanced premium tax credits to prevent over 20 million Americans with Affordable Care Act health plans from seeing their premium costs skyrocket and opposing funding bills that further cut basic needs programs.