Health Policy Center
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Urban Institute Update







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As Congress nears the end of a lengthy budget reconciliation process, read Urban’s latest analyses on how the House and Senate’s versions of the bill could affect Medicaid, food assistance, homelessness, and K–12 and higher education. For the full catalog of analyses, visit the web page
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Research to Inform 2025 Reconciliation: Taxes, Safety Net, and Beyond.

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How the Senate reconciliation Supplemental Nutrition Assistance Program (SNAP) proposals will affect families in every US state
Using Urban’s Analysis of Transfers, Taxes, and Income Security microsimulation model, researchers find 22.3 million families would lose some or all of their SNAP benefits and 5.3 million families would lose at least $25 a month in benefits should the Senate-passed bill be enacted into law.

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State-level estimates of health care spending and uncompensated care changes under the reconciliation bill and expiration of enhanced subsidies
Explore our data to understand how health care spending and uncompensated care costs will be affected nationwide and at the state level if the reconciliation bill passes and enhanced premium tax credits were to expire.

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The pending Senate budget bill is even more regressive than the Finance Committee’s version
The Senate’s bill would cut 2026 taxes by about $2,900, up about $250 from the Finance Committee’s version, distributing most of the additional tax cuts to the highest-income households.

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Rural hospital revenue could drop by $87 billion over 10 years because of the reconciliation bill and expiring enhanced premium tax credits (PTCs)
Provisions in the Senate-passed bill could cause rural hospitals to lose $66 billion in revenue and $22 billion from expiring enhanced PTCs between 2025 and 2034. A relief fund has been proposed to ease the revenue loss.

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How does the federal tax credit scholarship proposal stack up against other federal investments in K–12 education?
The House-passed reconciliation bill would divert up to $5 billion in tax dollars annually to support roughly 1 million students for private school or other educational costs. The Senate-passed version allows states to opt out.

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Medicaid is essential for addressing the homelessness crisis. The reconciliation bill would make it worse.
Proposed changes, like work reporting requirements, proof of address and citizenship, and frequent eligibility checks, would make it more difficult to qualify for Medicaid, threatening the health care coverage of millions of people.

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Higher education accountability in the budget reconciliation bill
The Senate-passed bill wants to cut off access to federal student loans for degree programs if students don’t meet specific earnings thresholds. This would make programs for 12 percent of associate’s degree and 1 percent of bachelor’s degree borrowers vulnerable.

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