A year ago, Congressional Republicans passed their tax and spending cut bill, widely known as “The One Big Beautiful Bill.”
The bill — President Donald Trump’s signature legislation in his second term — is shrinking the nation’s social safety net while implementing tax refunds that Republicans hope will bring relief to Americans’ pocketbooks. The bill, called H.R.1, could affect Oregon more than many states.
That’s because it specifically targets two funding mechanisms that state legislators in Oregon have used to maximize federal funding to support expanding the state’s Medicaid program and doubling the number of Oregonians with free, government-funded healthcare.
Republicans and right-leaning think tanks argue that those funding strategies made it too easy for states to qualify for federal dollars, taking away their incentive to be good fiscal stewards as Medicaid’s costs ballooned.
They say the bill is a step toward reducing federal spending and spurring business investment.
“I think Oregonians are benefiting from that right now, with the deductions for overtime and tips,” said state Rep. Ed Diehl, R-Scio, citing two of the bill’s notable tax changes. “Those are hitting the people who need it the most, who are living paycheck to paycheck.”
But critics say the legislation’s policies redistribute resources away from the nation’s poorest families and toward the highest earners, even as people pay more for groceries, healthcare, gas and utilities. They say the cuts to programs like Medicaid and the Supplemental Nutrition Assistance Program, or SNAP, will be devastating, and thousands of people are already losing food benefits.
“People in my district say this all the time to me: They are not better off than they were a year ago,” U.S. Rep. Andrea Salinas, a Tigard Democrat, told OPB. “In fact, they’re worse off. And I think everybody points to this bill as being the biggest boondoggle for billionaires and doing nothing for working-class people across my district or across Oregon.”
Cuts coming to Oregon
The Oregon Legislature will need to make major cuts to programs and services next year to balance the state’s budget with the funding cuts in the bill.
Last summer, the state Department of Human Services estimated that Oregon would need an additional $340 million annually to accommodate the bill’s changes to SNAP alone. The Oregon Health Authority has also projected a $421 million funding shortfall, due primarily to the bill’s restrictions on state-directed payments and provider taxes.
State lawmakers passed a bill during this year’s short legislative session allocating $111 million and nearly 400 positions to start implementing H.R.1.
The bill’s supporters, who view programs like SNAP and Medicaid as rife with waste and abuse, say this shift was long overdue. U.S. Rep. Cliff Bentz, Oregon’s sole Republican member of Congress, did not return a request for comment. He posted about the bill — which Republicans now call the “Working Families Tax Cuts” — on the social media platform X in April.
“Hardworking Americans are feeling the difference thanks to the Working Families Tax Cuts,” Bentz wrote. “With no tax on tips or overtime and larger deductions for seniors and working families, Americans can keep more of what they earn!”
SNAP changes ripple through state
The pandemic sparked a major increase in food insecurity throughout the country, causing more people to rely on food pantries, food banks and other nutrition assistance.
That trend has not abated.
The number of people visiting food banks in Oregon and Southwest Washington jumped 51% over the last two years, rising to a record 2.9 million visits in 2025, according to the Oregon Food Bank.
Today, about one in six Oregonians receives benefits through SNAP to help pay for their groceries, according to the state human services office. Half of them are seniors, people with disabilities and children.
Recipients now face new work requirements to keep money flowing monthly to their debit cards. They must show proof that they did some combination of 80 hours of work, volunteering or job training each month.
The rules apply to adults aged 64 or younger who aren’t sharing food with a child under 14 years old. Other exemptions also apply, such as if a recipient lives in a county that doesn’t have a Worksource Center. (In Oregon, those counties are Crook, Gilliam, Jefferson, Lake, Morrow, Sherman and Wheeler.)
Since July 2025, the number of Oregonians receiving SNAP has fallen by about 62,000 people, according to state figures. More than 25,000 people lost benefits because they didn’t meet work requirements. Sara Campos, a spokesperson for the state human services department, says officials expect this trend to continue.
There are many reasons why this growing number of people are losing their SNAP benefits, according to state officials and workers at food pantries and anti-poverty organizations.
Some are not meeting requirements around income or employment documentation. Others are deciding not to stay enrolled amid concerns about increased immigration enforcement, including how their personal information is being used.
All told, the state is passing through $13 million less to Oregon families than one year ago.
Carly Auten, the director of the food bank program at NeighborImpact, an anti-poverty organization in Central Oregon, says people are needing help who never have before. Auten says many new visitors are people who want to work but can’t due to a variety of barriers, such as a lack of transportation, childcare or jobs.
“At the end of the day, all it’s doing is driving more folks into nonprofit food assistance programs like ours,” Auten said of the cuts through H.R.1.
Work requirements coming in 2027
In a major policy shift for Oregon, H.R. 1 requires some adults on Medicaid to prove that they’re volunteering, working or in school at least 80 hours a month in order to qualify for healthcare.
Similar to the requirements for SNAP eligibility, the work requirement is primarily targeted at single adults ages 19 to 64 and doesn’t apply to other groups, like those who qualify for Medicaid based on a disability or pregnancy.
The Oregon Health Authority has been preparing to implement the work requirement starting January of next year by training roughly 1,000 people to assist with the basic rules and encouraging Oregon Health Plan enrollees to update their contact information. The agency is also planning to send out paper and electronic notices later this year.
Unlike many states, Oregon will be implementing the work requirements more gradually.
During the Biden administration, the state launched an experiment that allows people to stay enrolled in the Oregon Health Plan with less frequent eligibility checks — taking place once every two years rather than annually, which is the standard in most other states.
The idea was to reduce the number of people who lose coverage due to red tape.
Due to Oregon’s current 24-month renewal timeline, the state will have one of the longest timeframes in the country before all current OHP members go through the renewal process. The work requirement will be assessed as part of that eligibility redetermination, on a rolling basis.
Starting in January, any new applicants to the state health plan should expect to be evaluated to see if the work requirement applies.
Oregon’s experiment with extended eligibility runs through September 2027, and is unlikely to be continued. After that, OHP members will have to prove their eligibility more frequently: every six months for most adults, and annually for children and other special groups — another policy change as a result of H.R. 1.
In a separate wrinkle, last month Oregon joined two dozen other states led by Democrats and sued the U.S. Health and Human Services agency over its interim final rule implementing the work requirement.
The lawsuit argues that the agency misled states with earlier guidance that suggested medical records and codes would be sufficient to show a person was medically frail and exempt from working or volunteering, only to establish a more stringent standard for the exemption in their final rule.
The states are seeking an injunction to delay the work requirement. HHS did not immediately respond to a request for comment on the suit.
Last year, OHA estimated that the work requirement and more frequent eligibility checks would lead to about 200,000 Oregonians losing their health coverage.
Covering fewer people would save the state an estimated $412 million in the upcoming 2027-2029 budget cycle, but could have indirect costs like greater medical debt, more unpaid bills for hospitals and health clinics and people who are sick going without treatment or skipping needed medication.
Deep cuts to Medicaid
Nationwide, H.R. 1 cuts federal funding for Medicaid by an estimated $911 billion over a 10-year period, according to KFF, a nonprofit health policy think tank.
The cuts grow larger over time, as new restrictions on what types of payments qualify for federal matching dollars grow more stringent each year until 2032.
The restrictions particularly affect an intergovernmental transfer agreement between OHA and OHSU that the state has used to draw down a significant amount of federal funding in recent years.
The governor’s office has estimated that Oregon will lose $4.7 billion in federal funding through 2031.
The state faces an immediate budget gap of $421 million in the upcoming 2027-2029 biennium. A workgroup convened by Gov. Tina Kotek has floated more than 40 different options for how the state could close that funding gap.
Those include an across-the-board budget cut, eliminating or reducing optional benefits — like physical therapy and adult dental care — and changes to prescription drug purchasing. But the budget gap will double in the following biennium, from 5% of OHA’s Medicaid budget to 10%.
Millions for new programs in rural healthcare
Out of concern that H.R.1’s cuts to Medicaid could harm rural communities and rural hospitals, which have benefited from some of the policies the bill unwinds, Congress also created a $50 billion rural health transformation fund.
Oregon’s share of that funding amounts to $172 per rural resident, according to KFF, the policy thinktank.
To date, the state health authority has awarded nearly $100 million to organizations in every county across the state. The funding is meant to help transform rural healthcare to be more efficient or innovative, and not simply to backstop the cuts in H.R.1.
One of the largest grants in Oregon, a $6 million award, expands a residency program for nurse practitioners and physician associates in the Rogue Valley. The program is run by La Clinica, a community health center.
La Clinica is using the award to grow the program to eight residents, placing people in primary care clinics in Ashland and Cave Junction, in partnership with Rogue Community Health and Siskiyou Community Health Center.
Maria Underwood, chief partnership officer for La Clinica, says the program is an effort to combat provider shortages in rural communities, as residents are more likely to stay in the places where they do their training.
“This is a way to train providers and do our very best to keep them,” she said.
In addition to the larger, competitive grants the state has awarded, OHA has given each of the state’s 35 rural hospitals the chance to qualify for one-year grants of approximately $1 million and has made $100,000 grants available to 99 rural health clinics statewide.
The amount the state is receiving through the rural health fund is small compared to the scale of the federal cuts to Medicaid in Oregon but is still welcome, said OHA Health Policy & Analytics Director Clare Pierce-Wrobel.
“These awards can make a huge difference for individual organizations that are doing much-needed work in rural Oregon,” she said in a press release announcing the latest round of grants.
