Updates August 4, 2025

Big BS Bill…belatedy.

(I had most of the items listed and then the post got lost to the Squarespace ether. Call it a blog rescission.)

There have been many articles and summaries published about bill impacts- my goal here is to highlight items that will negatively impact DEI in education and healthcare. Where I can, I will note when provisions go into effect at different times.

Education

Several changes will make it more difficult for students and immigraants from low-income backgrounds to pursue health professions education; one or two may make it easier.

• Financial aid

  • Student loans

    • (July 1 2026): Graduate student loans capped $20,050/year & lifetime max $100,00; Professional graduate degrees loans capped $50,000/year & lifetime $200,000; Combined undergraduate and graduate lifetime cap: $257,700; Parent PLUS loans capped $20K/year & max $65K (Average debt in 2024: MSN $49K, PharmD $170K DDS $296K, MD $212K)

    • Repayment

      • (July 1, 2027) No longer able to defer payments due to economic hardship

      • (July 1, 2028) New simplified repayment plans go into place

  • Grants

    • Despite earlier proposed limits, Pell grants remain in place with current eligibility and fully funded.

    • (July 1 20260 New Workforce Pell Grants: now students of short-term training programs can also get Pell Grants; this could include training and additional certifications for healthcare jobs

  • Institutional Accountability: even if you personally can receive federal loans, you many not be able to use them for your school or program within the school doesn’t meet new requirements on their alumni earnings. (this one could be a big unknown).

Food Insecurity

• Fewer people will be able to get SNAP (July 4 2025): (1) New work requirements for SNAP: adults 55-64 (previously set at 54), parents of children 14 & above (previously age 18); (2) new time limits on veterans, unhoused persons, and former foster children; (3) Only legal permanent residents may receive SNAP: other immigrants with various (legal) documentation statuses, including refugees, asylees, and Temporary Protected Status, will no longer be eligible (despite July 4 timeline, states will take longer to implement); (4) people who receive Low Income Home Energy Assistance will no longer automatically qualify for SNAP unless they have an elderly or disabled member of the household;

• SNAP benefits will shrink: (1) benefits have updated via the Thrifty Food plan- now this will be adjusted fewer times and pinned to inflation, rather than the cost of food; (2) Costs will be shifted to states; (3) recipients can no longer deduct internet payments (cuts benefits on average by $10/month); (4) SNAP-Ed eliminated: ends community grants for improving nutrition and physical activity

Health Insurance (KFF timeline; Details)

• Fewer people will be covered under Medicaid:

  • (January 1 2026) The federal government will no longer provide enhanced matching for states that choose to expand Medicaid, making it even less likely they will expand (10 states have not expanded Medicaid, including Texas and Florida)

  • (December 31,2026; January 1, 2027) Increases paperwork burdens by requiring 6 month or more frequent eligibility determinations; requires verification of meeting new work requirements; eligible people will lose coverage due to new administrative burdens (note that these policies apply to undergraduate and graduate students, who will be stuck between fewer SNAP benefits, tighter loan limits)

  • (October 1, 2026) Cuts off lawfully present immigrants other than legal permanent residents (green card holders), some Cuban and Haitian immigrants, citizens of Micronesia and the Marshall Islands

  • (October 1, 2034) Delays two rules that would have improved enrollment for low income, disabled and older people with Medicare coverage and raise their costs as those will no longer be covered by Medicaid

• Medicaid benefits will shrink

  • (July 4, 2025) Eliminates payments to specific Medicaid providers who also provide abortions (not covered by Medicaid); primary target is Planned Parenthood and other larger clinics (currently on hold due to litigation)

  • (October 1, 2026) Federal government will no longer provide matching benefits for services provided under Emergency Medicaid to expansion beneficiaries who are immigrants and not under the eligible categories listed above.

  • (October 1, 2028) People with Medicaid coverage will have to pay cost-sharing, e.g. copayments and deductibles, for non-primary care/mental health services

  • *Overall, multiple provisions lead to major cuts in the ways Medicaid is financed, so expect longer term changes that may include both fewer people eligible and fewer benefits.

• Fewer people will be able to get Marketplace coverage:

  • (December 31, 2025) Low income individuals who enroll outside of open enrollment, or do not experience a major life event, will be barred from receiving premium subsidies or cost-sharing supprt

  • (January 1, 2026) Elimination of enhanced premium subsidies (which had made up for some of the cost differences in more expensive states); expected average premium will rise 75%

  • (January 1, 2026) Eliminates premium subsidies for lawfully present immigrants other than those described above for Medicaid

  • (January 1, 2027) Medicaid enrollees who fail to meet the paperwork requirements will also be blocked from Marketplace subsidies

  • (January 1, 2028) Eligibility for premium subsidies must be complete before enrollment (more paperwork, likely delays) rather than verified afterwards

• Fewer immigrants will be able to get Medicare coverage:

  • (July 4, 2025): Restricts eligibility to lawfully permanent residents, other groups described above; other lawfully present immigrants currently covered will be terminated after 18 months

Financial Assistance

• (January 1, 2025) The Child Tax Credit goes up $200 and new babies born before December 31, 2028, get a $1000 deposit