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U-M specialists examine the health—and financial—ramifications of modifying, reducing Medicaid, Medicare, SNAP, Affordable Care Act
As the U.S. Senate discusses the One Big Beautiful Bill Act of 2025, experts from the University of Michigan are poised to address facets of the proposed financial plan that could impact health, medical care, and public wellbeing.
The legislation proposes significant budget reductions or new stipulations for Medicaid, Medicare, the Supplemental Nutrition Assistance Program, or SNAP, the Affordable Care Act, and various other health-associated and safety net initiatives that millions depend on nationwide.
Kate Bauer, associate professor of nutritional sciences at the School of Public Health, has investigated and collaborated extensively with both urban and rural communities to comprehend hunger and the initiatives designed to mitigate it.
“The severe federal reductions to SNAP will adversely affect our children, our community members, and the economy,” she stated. “Every dollar a SNAP recipient utilizes for food purchases uplifts local enterprises and food growers. The budget slate diverts billions from our neighborhoods, merely enriching the wealthiest individuals in our nation.”
“SNAP remains one of the most efficient methods we possess in the U.S. to assist families in escaping poverty and ensuring children have adequate nutrition. Numerous studies consistently demonstrate that this program is not wasteful, and the levels of waste or fraud are exceedingly low. Families utilizing SNAP strive diligently to balance their budget, particularly with current elevated food expenses. Clearly, children will bear the consequences when SNAP funding is reduced.”
Bauer’s Feeding Michigan Families initiative and video.
Contact: [email protected]
Renuka Tipirneni serves as an associate professor of internal medicine at the Medical School and of health management and policy at the School of Public Health.
“Reductions of this magnitude to Medicaid will result in millions losing their coverage, particularly those eligible but struggling to manage frequent and burdensome paperwork requirements,” she explained. “Our findings reveal that Medicaid correlates with enhanced health outcomes and decreased mortality, along with improvements in individuals’ financial situations and the broader state economy. Loss of Medicaid will likely reverse these favorable health and economic gains.”
Regarding work stipulations, “our research indicates that the majority of Medicaid recipients are already employed or enrolled in education, and those who aren’t often face significant health challenges and caregiving obligations. Past state work mandates did not raise employment figures, but they did increase the uninsured rates,” Tipirneni noted.
Moreover, assertions of Medicaid waste are unfounded, she remarked.
“Medicaid operates with the lowest administrative expenses of any health insurance program nationwide, at under 5%. Policies intended to eradicate waste will encounter a program that is already efficiently run, with little room for reduction except in eligibility and benefits to vulnerable demographics. I am concerned about how funding cuts will impact older individuals and those with disabilities who depend on Medicaid for essential services like mobility aids and home health care, which keep individuals healthy and residing in their own homes.”
Contact: Kara Gavin, [email protected]
Minal Patel, a professor specializing in health behavior and health equity at the School of Public Health, researches how the economic pressures of chronic diseases impede individuals’ capabilities to manage diabetes. In a recent study, she identified a notable trend.
“Almost 25% of individuals spend over $300 monthly merely to manage their diabetes. That’s akin to what many households pay for heating and electricity or for maintaining a vehicle,” she pointed out. “These aren’t luxuries; they’re fundamental requirements competing with essential medical care.”
Prescription drugs, specialized foods, doctor appointments, and glucose supplies form the highest costs for the 30 million Americans diagnosed with diabetes, a figure projected to double in the forthcoming years, Patel mentioned. Approximately 10% of Medicaid beneficiaries have diabetes, and millions rely on SNAP for survival, she noted. Additionally, managing diabetes incurs a fiscal burden exceeding $400 billion annually for the U.S.
The suggested cuts to Medicaid and SNAP could dismantle the support systems that prevent individuals from falling into crises, Patel warned.
“Medicaid enables individuals to afford insulin. SNAP assists them in procuring nutritious options. Removing these supports won’t merely lead to poorer health outcomes; individuals will likely resort to emergency rooms, or worse,” she asserted. “Medicaid is one of the few mechanisms that helps keep taxpayer costs in check by providing preventive care, stabilizing conditions, and reducing emergency visits. Cutting it is like sending households across America a recurring $3,000 medical bill each year. It functions as a levee preventing a surge of medical debt and strain on hospitals. If we breach that levee, the flood will overwhelm hospitals, taxpayers, and families alike.”
“Slashing Medicaid doesn’t reduce costs—it merely redistributes them. And it drives patients closer to the brink,” Patel concluded. “Our research determined that fewer than half of participants were aware of available assistance options. If we uproot existing support now, we’re setting the stage for a health emergency that will be significantly more costly—and profoundly damaging—down the road.”
Contact: [email protected]
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Michelle Meade serves as co-director of the Center for Disability Health and Wellness, holding the position of professor of physical medicine and rehabilitation at the Medical School. She has been a dedicated researcher focusing on the treatment of individuals with disabilities and the regulations influencing their care and coverage.
“As a practitioner and researcher working with individuals who have spinal cord injuries and other severe physical impairments, I recognize that Medicaid is essential for accessing vital healthcare and community services,” she stated. “It distinguishes between being confined in a hospital and having the ability to rise from bed and engage with the community; it is a matter of life and death.”
“Research has revealed substantial innovations and fostered programs aimed at averting secondary conditions, reducing hospital admissions, and facilitating community involvement and employment opportunities for individuals with disabilities and their families. Now is the moment to pinpoint these exemplary practices and invest in—rather than cut—these effective and life-preserving services and programs.”
Contact: [email protected]
Donald Moynihan and Pamela Herd, professors at the Ford School of Public Policy, can provide their perspectives on work mandates for Medicaid. They assert that the legislation employs administrative obstacles to achieve an unpopular policy objective.
“Lawmakers and officials from the Trump administration claim that work requirements are effective for Medicaid. They are unequivocally mistaken. They are effective—but solely if the objective is to decrease access to services, while largely overlooking any increase in labor market participation. These requirements are particularly harmful to vulnerable groups, such as those already in poor health,” they remarked.
“If you take into account Medicaid beneficiaries who are already employed—and those exempt from work requirements due to disabilities or caregiving duties—nearly no one should experience coverage loss. However, when Arkansas implemented work requirements in 2018, most of the individuals who lost coverage had actually met the criteria. They simply struggled with the paperwork necessary to validate it. In addition to work requirements, there are other administrative hurdles, like copayments and more frequent renewals, that we know will disqualify eligible beneficiaries from the program. In summary: This vision would lead to a dysfunctional government to finance tax reductions.”
Contact: [email protected]
Contact: [email protected]
Michael Shepherd is an assistant professor of health management and policy at the School of Public Health. His research primarily deals with the political aspects and policies surrounding disparities in rural health, including hospital closures and Medicaid regulations. He can discuss the disproportionate effects proposed Medicaid cuts would have on rural communities, where inhabitants depend on program coverage more than the national average.
“When considering the implications of Medicaid cuts for rural areas, it’s not just about individuals losing their benefits—it could mean that everyone loses access to healthcare, and numerous individuals may end up losing their jobs,” he explained. “Rural hospitals operate with tight budgets, and many stay afloat due to reimbursements from Medicaid. Hospitals in rural regions are frequently the largest employers, so when a hospital shuts down, the result is heightened unemployment, reduced incomes, and an exodus from the community.”
Contact: [email protected]
Scott Greer, a professor of health management and policy, investigates how health and healthcare influence political ideologies.
“What we’ve observed over the past three decades is a growing correlation between poor health or a decline in self-reported health and an increased likelihood of disengagement from the political realm or voting for extremist parties,” he noted. “When diagnosed with a chronic condition or experiencing a substantial, lasting decline in self-reported health, individuals encounter extensive exposure to the healthcare system.
“They interact significantly with their employer’s HR. They may engage with the government’s benefits framework. Possibly, they will come into contact with the home healthcare sector. A bit of exposure can have a profound impact because many of these systems are not structured to make you feel like an empowered patient or a respected human being.
“These systems can be disempowering. They are not always reliable, and some are explicitly designed to impose administrative burdens, complicating your experience. So what happens when you spend considerable time dealing with entities that don’t genuinely consider your interests? You become less trusting. And as your trust diminishes, a political party willing to embrace your vote and manipulate your fears often rises to the occasion.”
Contact: [email protected]
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John Ayanian, the director of the Institute for Healthcare Policy and Innovation and the head of the evaluation that IHPI is conducting on Michigan’s Medicaid expansion, has spearheaded multiple studies examining access to care, quality of care, and health care inequities. Additionally, he holds a position as a professor of internal medicine at the Medical School, a professor of health management and policy at the School of Public Health, and a professor of public policy at the Ford School of Public Policy.
Contact: Kara Gavin, [email protected]
A. Mark Fendrick serves as the director of the Center for Value Based Insurance Design as well as a professor of internal medicine at the Medical School and a professor of health management and policy at the School of Public Health. His research concentrates on the effects of clinician reimbursement and consumer engagement strategies on access to care, quality of care, and healthcare expenses.
Contact: Kara Gavin, [email protected]
Nora Becker is a health economist and serves as an assistant professor of internal medicine at the Medical School. Her clinical and research focus lies in the effects of modifications in health policy and health insurance frameworks on health and financial outcomes for women and economically marginalized groups.
Contact: Kara Gavin, [email protected]