July 4 will mark the first anniversary of H.R. 1, President Trump’s signature megabill (the inaptly named “One Big Beautiful Bill”). Marylanders are already feeling its harms, and those harms will only grow in coming years. Ultimately, the only solution is for Congress to repeal the law. However, state policymakers have some options to cushion the blow.
Here are some of the law’s biggest impacts:
- The number of Marylanders receiving food assistance through the Supplemental Nutrition Assistance Program (SNAP) has fallen by 39,500 since July, including 17,300 children.
- Under the law, up to 80,000 Marylanders could ultimately face more red tape in order to access food assistance, according to the Maryland Department of Human Services.
- 130,000 Marylanders are expected to lose Medicaid health insurance, beginning when new restrictions take effect in 2027. Including other harmful provisions, the law could take health insurance away from up to 205,000 Marylanders.
- The law shifts about $262 million in costs from the federal government onto the state in the next budget year, fiscal year 2028 (July 2027 to June 2028), with the cumulative cost shift exceeding $1.3 billion by FY 2031.
- The law hands more than $1.8 billion per year in federal tax cuts to the wealthiest 1% of Maryland households (with annual income over $881,000), an average tax break of $57,000.
Food Assistance
H.R. 1 made multiple major changes to SNAP, the largest federal-state food assistance program:
- Red tape: The law expands work documentation requirements to include parents of children ages 14 to 17, people over age 54 without dependent children or a documented qualifying disability, veterans, people experiencing homelessness, and adults aging out of foster care. The law also complicates the process for many families to deduct utility costs from their income, meaning lower benefits. Thousands of Marylanders could lose access to food assistance or see their benefits reduced simply due to paperwork errors, even if they have a job or qualify for an exemption.
- Cost shifts: The law increases the state share of SNAP administrative costs from 50% to 75%, and shifts a portion of benefit costs to states, with the amount depending on each state’s payment error rate. Together, these shifts are expected to cost the state $262 million in FY 2028, with a cumulative cost of more than $1.3 billion by FY 2031. Other provisions of the bill could reduce state spending – at the expense of struggling families.
- Locking out new Americans: Historically, refugees and people granted asylum – all of whom are in the country legally – were eligible for SNAP, helping them put food on the table amid some of the most difficult circumstances a human being can face. H.R. 1 takes this eligibility away except for green card holders. Up to 643,000 people nationwide could lose food assistance under this provision.
Since President Trump signed the law in July of last year, Maryland’s SNAP enrollment has fallen by 39,500 people, a 6% decline. This includes 17,300 children, or 44% of all Marylanders losing food assistance. SNAP enrollment fell slightly more sharply among children than adults.
While social and economic trends are always complicated, it is doubtful that SNAP enrollment would have fallen as steeply without the law. Maryland’s economy has not improved since last summer – quite the opposite, due to drastic federal layoffs – and the enrollment decline since July is nearly twice as large as during the same period a year ago.
Maryland has so far fared better than most other states. In percentage terms, the nationwide drop in SNAP enrollment was nearly five times as severe as Maryland’s as of March, and the Mid-Atlantic region’s loss was nearly three times as severe as ours. While multiple factors are likely at work, Maryland’s Department of Human Services deserves credit for concerted efforts to help families navigate and satisfy the new paperwork requirements.
Health Insurance
Likewise, H.R. 1 includes multiple provisions restricting access to health insurance, primarily through Medicaid. As these measures have a slightly delayed implementation schedule, the resulting harms largely lie in the future:
- Red tape: The law creates new work documentation and other administrative requirements for adults insured under the Affordable Care Act’s Medicaid expansion, beginning next year. Medicaid expansion was the largest driver of Maryland’s 40% reduction in uninsured residents between 2013 and 2018 and covered 332,000 Marylanders as of mid-2025. As with SNAP, the new Medicaid paperwork requirements will likely cost many employed Marylanders their health insurance simply due to convoluted administrative burdens.
- Locking out new Americans: The law eliminates federal Medicaid funding for several categories of lawfully present immigrants, including some with humanitarian protections. While states can and should continue to cover these individuals, they must do so entirely with state dollars. The Congressional Budget Office expects 100,000 people nationwide to lose coverage due to this provision by 2034. Another 100,000 nationwide will lose coverage under new Medicare restrictions, despite paying into the system for years or decades. Finally, new restrictions on premium tax credits used to buy coverage on Affordable Care Act marketplaces (such as the Maryland Health Connection) are expected to cost 1.2 million Americans their health insurance. People losing premium assistance include refugees, asylees, and victims of crimes, including children – all of whom are lawfully present in the United States.
- Less help getting private insurance: Marylanders who purchase private insurance through the Maryland Health Connection marketplace are now facing drastically higher costs because Congress allowed enhanced premium assistance to expire. More than 4 million Americans will likely lose health coverage because of this failure, and many more will face skyrocketing premiums. Insurers recently announced plans to hike marketplace premiums by 13% in 2027, for a two-year increase exceeding 27%. The Maryland Insurance Administration is now reviewing the proposal. As insurance becomes less affordable, people with the fewest medical needs are the first to drop coverage, leading to spiraling costs as people with higher medical costs increasingly dominate the market. Maryland policymakers are using state dollars to supplement premium assistance, protecting families from even steeper price hikes.
State officials project that 130,000 Marylanders will ultimately lose Medicaid coverage under the law, and an independent estimate predicts that all provisions combined will cost 205,000 Marylanders their health insurance.
(Paper)work Requirements Based on Myths
The law’s new work documentation requirements are rooted in myths about who relies on SNAP and Medicaid to meet their basic needs. The fact is, the majority of participants in both programs are either children, seniors, or employed adults, and most of the remainder are looking for work, caring for children, attending school, or living with a disability. Even within the tiny sliver not in any of these categories, an unknown number are likely caring for elderly or disabled family members.
Lopsided Tax Cuts
While most Marylanders are worse off under H.R. 1, big corporations and wealthy individuals are getting a windfall. The wealthiest 1% in Maryland (with annual income over $881,000) received federal tax cuts averaging $57,000 per year, nearly half of which are above and beyond what they would have received from a simple extension of the 2017 tax cut law. Just the wealthiest 5% of Maryland households (those with annual income over $395,000) receive 43% of the law’s tax cuts. Meanwhile, tariffs have resulted in net tax increases for many low- and middle-income families.
What Can Be Done?
There is only one way to undo the harm wrought by H.R. 1: Congress must repeal it, root and branch. The best time to do so is now. Of course, this is unlikely while the same Congress that passed the law remains seated and the same president who signed it remains in office. In the meantime, there are some steps Maryland policymakers can take – and in some cases have already taken – to cushion the blow:
- Support Marylanders in satisfying paperwork requirements. Thanks in part to recent staffing increases, the Department of Human Services has limited the damage from SNAP cuts by proactively helping families meet complicated new paperwork requirements. The Department of Health plans to take a similar approach to protect Marylanders insured through Medicaid. To succeed, these efforts must be sufficiently staffed and funded, and must be sustained over the course of the law’s multiyear implementation.
- Use state funds to patch the holes. Policymakers should consider using state dollars to support families who lose access to federal assistance. This could include continuing Medicaid coverage for new Americans whose federal funding was cut, providing alternatives for families who run afoul of Medicaid and SNAP paperwork requirements, and strengthening state enhancements to marketplace premium assistance. Many of these measures would require major fiscal commitments.
- Avoid further state-level cuts. Due in part to federal layoffs and funding cuts, Maryland currently faces substantial fiscal challenges. Cutting state services would in many cases harm the same families who are hit hardest by H.R. 1. To prevent this, policymakers must raise new revenue by asking the large corporations and wealthy individuals who are benefiting from H.R. 1 to pay their fair share.