The Connection
A roundup of recent Fund publications, charts, multimedia, and other timely content.
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June 30, 2025
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Medicaid and SNAP Cuts Would Trigger Job Losses
Widespread job losses and weakened state economies would result from proposed cuts to Medicaid and the Supplemental Nutrition Assistance Program (SNAP), according to a report from the Commonwealth Fund and the George Washington University. The cuts are part of the House-passed budget reconciliation bill, currently being debated in the Senate. The report provides a state-by-state analysis of the potential fallout, which includes 1.2 million jobs lost in 2029 and a $154 billion drop in states’ combined gross domestic products (GDPs).
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Medicaid Cuts Would Squeeze State Budgets
If the $800 billion in proposed federal funding cuts to Medicaid make it into the final reconciliation bill, they will force states to make tough decisions. On To the Point, the former health secretaries of North Carolina and Indiana discuss the ripple effects of the cuts. Because states are required to balance their budgets, some might be forced to end or limit Medicaid benefits to fill the financial gaps, they explain. With many of their patients losing coverage, providers would be left with little option but to raise prices, and rural health services would be hit especially hard.
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FEATURED CHART
New State Scorecard Shows Coverage Gains at Risk
Every state has reduced its uninsured rate over the past decade, and today there are fewer adults who are skipping needed medical care because of the cost. This progress, largely due to the Affordable Care Act’s Medicaid expansion, marketplace plan subsidies, and consumer protections, is now at risk from looming cuts to safety-net programs, finds the Commonwealth Fund’s 2025 Scorecard on State Health System Performance. Our latest state scorecard offers a comprehensive look at how well health care systems are meeting people’s needs in all 50 states and the District of Columbia. The report also identifies some troubling trends, including falling childhood vaccination rates in nearly every state, worsening infant mortality, and persistently high rates of avoidable deaths in many parts of the country.
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QUIZ
If the current budget reconciliation bill becomes law, by how much would monthly health insurance premiums rise for a 60-year-old married couple earning $62,000 a year with a gold-level ACA marketplace plan?
- $50
- $150
- $250
- $350
Scroll down to see if you got it right.
Medicare Is Tuning In to Needs of Family Caregivers
Family caregivers work tirelessly, often without formal training or adequate support, to provide long-term care for millions of Americans. To Jason Resendez, president and CEO of the National Alliance for Caregiving, they have remained in the shadows of our health care system for too long. On To the Point, he explains how that may be changing, as the Centers for Medicare and Medicaid Services’ Innovation Center tries to move caregivers from a hidden role to “an explicitly acknowledged component of the health care landscape.” Learn what the new strategy aims to do.
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How Health Coverage Helps Norway Reduce Crime
In the United States, people leaving incarceration face some of the highest health risks but have few ways to get the care they need. Without coverage or continuity in their care, their chances of hospitalization, death, or returning to prison go up. In International Insights, the Commonwealth Fund’s Munira Gunja looks at what the U.S. can learn from Norway, where incarcerated people have full health coverage. Those released from prison, she says, experience lower rates of recidivism and better health outcomes, as well as fuller reintegration into society.
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Impact of Nonpatent Exclusivities on Drug Prices
Patents are the best-known source of market power for pharmaceutical companies. But in a new study published in Nature Biotechnology, Commonwealth Fund grantee Robin Feldman and colleagues demonstrate that certain nonpatent exclusivities — periods during which the FDA cannot approve generic or biosimilar versions of a drug, even if the drug’s patents have expired — can have an outsized impact on prices. That's because they significantly hinder the ability of generic competitors to enter the market. The researchers say that using these exclusivities as a strategy for extending monopoly protection “indicates a focus of energy for the pharmaceutical industry in recent years — a focus directed away from innovation and toward preclusion of competition.”
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Helping Rural Areas Retain Medical Graduates
North Carolina’s Mountain Area Health Education Center (MAHEC), which trains residents in the state’s rural areas, announced that close to 40 percent of the 90 residents graduating in June would remain in western North Carolina ([link removed] ) . A Commonwealth Fund feature article describes the strategies MAHEC employs to retain its graduates ([link removed] ) . These include a unique postresidency fellowship that allows students to retain the best aspects of residency while they adjust to the challenges of caring for patients often dealing with chronic illness and few financial resources.
QUIZ: Answer
The answer is D. The couple could see an increase of $350 in their monthly premium.
Republicans in Congress are considering a budget reconciliation bill that would dramatically reshape the Affordable Care Act’s health insurance marketplaces while raising consumer costs, leaving millions more people uninsured, and straining state budgets. As explained by Katie Keith and Sara Collins, the bill would end the practice of “silver loading,” a tactic insurers have used since 2017 to make marketplace premiums more affordable for millions of consumers. Find more details in our new explainer ([link removed] ) , which discussed how cost-sharing subsidies would change under the new bill, how premiums and coverage rates would be impacted, and how abortion access in marketplace plans could be disrupted.
Affordable, quality health care. For everyone.
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