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In Some States, Strapped Counties Must Impose Trump’s Medicaid Cuts

September 30, 2025
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In Some States, Strapped Counties Must Impose Trump’s Medicaid Cuts
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For more than a decade, residents of the sparsely populated San Juan Mountains of southwestern Colorado have applied for government assistance by dealing with the San Juan County Department of Social Services’ staff of one: Krissy Rhoades.

In the coming months, because of President Trump’s new domestic policy law, Ms. Rhoades’s responsibilities will take on considerably more weight. It will fall to her to ensure Medicaid and food stamps applicants comply with the law’s complex new eligibility rules, which require adults to work in order to receive benefits, unless they have children under 13.

“It’s just me up here,” Ms. Rhoades said in her office inside the historical county courthouse in tiny Silverton, Colo. “It’s a little stressful.”

Because Medicaid and food stamps do not require annual appropriations from Congress, neither should be significantly affected by the looming government shutdown. Republicans say Mr. Trump’s sprawling domestic policy bill doesn’t cut benefits for Medicaid and food assistance at all: It simply makes sure that those who can work, do work.

But the restrictions and new requirements are designed to disqualify recipients and cut $317 billion in anticipating spending on Medicaid over the next 10 years. Food assistance is expected to be reduced by $69 billion. And with dozens of changes to dates, deadlines, document requirements and rules embedded in the new law, longer wait times and more confusion are all but assured.

When Congress passed its One Big Beautiful Bill Act this summer, it didn’t just impose those requirements. It punted the implementation to states. And in a handful of states like Colorado, busy county governments already handle eligibility requirements, enrollment and renewals.


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The post In Some States, Strapped Counties Must Impose Trump’s Medicaid Cuts appeared first on New York Times.

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