President Donald Trump’s “big, beautiful bill” has passed the Senate and is set to pass in the House on Thursday. If it does, the bill will head to the White House for the president to sign. For many Medicaid and food stamps recipients, that will mean changes are coming their way.
The budget bill is expected to have wide effects on Medicaid and the Supplemental Nutrition Assistance Program, with billions of dollars in cuts and tweaked requirements for the programs. House Republicans say they are stripping the “waste, fraud, and abuse” in the programs to save money.
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The majority of their effects will not be felt immediately, though, by Medicaid and SNAP users.
Here’s when the changes will take effect.
Medicaid
The legislation imposes a new 80-hours-per-month work requirement on able-bodied Medicaid recipients aged 19-64 who do not have dependents, but the change will not kick in until Dec. 31, 2026.
One of the largest cuts on the legislation was originally slated to take place in 2029, but more conservative Republicans fought to move up the date to enact the cuts quicker. House Speaker Mike Johnson (R-LA) originally said the extra time was so states could “retool their systems.”
The government will also require all states to conduct eligibility redeterminations for expansion individuals every six months, instead of 12, starting in December 2026.
An immigration stipulation in the bill prevents states from covering undocumented immigrants, or else they will face federal Medicaid cuts. Several states provide state funding to undocumented immigrants, even though federal funding cannot be directed to them. The changes will take effect Oct. 1, 2027.
Increased co-pays up to $35 will begin on Oct. 1, 2028, for those who make more than the federal poverty level of just over $15,500 for single beneficiaries.
The bill also bans any Medicaid funding to Planned Parenthood as long as it provides abortions or abortion services. Other examples of changes include increased required Medicaid paperwork or income and residency verification to prevent “double-dipping” on benefits.
The nonpartisan Congressional Budget Office estimates 11.8 million people will be uninsured under Medicaid by 2034. Another estimate, from Joint Economic Committee Democrats, says around 20 million people will lose coverage. Around 71.2 million were enrolled in Medicaid and the Children’s Health Insurance Plan as of March.
Johnson said last month that many Medicaid recipients will not “lose their Medicaid unless they choose to do so.” Sen. Joni Ernst (R-IA) defended the cuts in a response to a heckler, saying, “We all are going to die,” sparking criticism of her.
The bill also reduces the retroactive Medicaid benefits from three months to one month and the open enrollment period for the Obamacare marketplace by a month. The new period is now November to December, starting in 2027.
SNAP
SNAP is a government program that helps low-income families afford groceries. People are qualified if they make at or below the poverty level set by the government. The bill will defund SNAP-ed, an education program aimed at nutrition education and obesity prevention, after the end of 2025.
Starting in 2027, the government will begin cost-sharing with states on SNAP administrative funding. The federal government will reduce its share of SNAP administrative costs from 50% to 25%, leaving states with 75% of the cost. The bill will require states to chip in at least 5% for SNAP benefits starting in 2028.
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The bill will raise the work requirement age from 54 to 64 and lower the age limit for dependent children from 18 to 7.
It will also be prohibited for undocumented immigrants to receive SNAP benefits, among other changes.