Miller-Meeks, Nunn vote to cut Medicaid and SNAP

House Republicans passed a tax bill that includes major cuts to Medicaid and SNAP food aid. While the cuts will be experienced by the poorest Iowans, the package funds tax breaks for billionaires.

House Republicans passed a massive budget bill early Thursday morning that would slash federal funding for Medicaid and food assistance programs while extending tax cuts for the wealthy and corporations, potentially affecting hundreds of thousands of Iowans who rely on these safety net programs.

The legislation — dubbed the “One Big Beautiful Bill Act” — passed the House 215-214  after a week of intense negotiations. The sweeping legislation runs more than 1,000 pages long and calls for roughly $3.8 trillion in tax cuts while scaling back safety net programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP).

Iowa’s Congressional delegation supported the cuts. US Reps. Mariannette Miller-Meeks, Zach Nunn, Ashley Hinson, and Randy Feenstra all approved the bill. Miller-Meeks, Nunn, and Feenstra even served on committees that approved portions of the budget legislation. 

In an appearance at the American Hospital Association’s Annual Membership meeting this month, Miller-Meeks claimed the bill would not cause significant harm to Medicaid.

In reality, the impacts could be severe for Iowa. As of this month, 603,000 Iowans are enrolled in Iowa Medicaid. 40% are children. 42% live in a rural area. And 15% have three or more chronic conditions. More than 75% work a job.

The bill would impose new work requirements on Medicaid recipients and restructure how the program is funded, shifting much of its costs to the states. State Sen. Zach Wahls, a Democrat from Coralville, warned during a Thursday press conference that the changes would blow a $713 million hole in Iowa’s state budget and potentially cause 86,000 Iowans to lose their healthcare coverage.

“This Republican budget plan cuts healthcare funding that 700,000 Iowans rely on – people who have worked their whole lives, raised families and deserve better  than being ripped off by big corporations and being abandoned by the federal government,” Wahls said. “They’re doing it to give more tax breaks to billionaires who don’t need them. These aren’t Iowa values.”

The legislation also targets food assistance programs. The Supplemental Nutritional Assistance Program supported about 260,000 Iowans in 2024, helping them afford groceries. The bill would cut benefits and impose new work requirements that advocates say could affect Iowans who rely on food assistance programs, including school meals and Meals on Wheels.

The cuts come as Iowa’s rural healthcare system is already under strain. Rural hospitals could face additional pressure as the budget strains could prompt some hospitals and nursing homes to curtail services, increase rates for other patients or, in the worst case scenario, shut down.

During a press conference Thursday morning, former federal healthcare administrator Chiquita Brooks-LaSure warned that “over 14 million people will lose their healthcare coverage as a result of Republicans’ proposals that recklessly cut nearly a trillion dollars in healthcare spending, the largest in our nation’s history.”

The bill now heads to the Senate, where Iowa Sens. Joni Ernst and Chuck Grassley will face pressure to vote for the legislation. The Senate is expected to make significant changes before any final version reaches President Trump’s desk.