In the closing weeks of 2025, the shadow of sweeping federal cuts is looming large over American cities and states, with Philadelphia and Montana emerging as stark examples of the turbulence wrought by recent policy changes. As the Trump administration and a Republican-led Congress push through a series of budget slashes targeting health care, social services, and scientific research, the cascading effects are being felt by families, hospitals, universities, and entire communities—often in ways that threaten to unravel years of progress.
In Montana, the story begins with a rare note of bipartisan cooperation. According to Townsquare Media, both Republican and Democratic legislators joined forces during the 2025 legislative session to permanently reauthorize the Affordable Care Act’s (ACA) Medicaid expansion. Governor Greg Gianforte signed the bill on March 27, a move that was hailed as a lifeline for tens of thousands of Montanans. Over 77,000 residents—ranchers, gig workers, small business owners, and early retirees—rely on the ACA’s insurance marketplaces for their health coverage, part of the more than 24 million Americans benefiting from these reforms since the ACA’s passage in 2009.
But that sense of security is proving fragile. As reported by Representative Tom France, a Democrat from Missoula, Republicans in Congress, including Montana’s entire delegation, have voted to slash the very ACA subsidies that keep insurance premiums affordable for middle- and lower-income Americans. With these cuts set to take effect at the end of 2025, insurance carriers are already sounding alarms. Blue Cross Blue Shield of Montana projects premium increases between 23% and 33% for marketplace plans, a jump that could cost some families hundreds of additional dollars each month. For many, that means the impossible choice between paying more for basic coverage or dropping insurance altogether.
France, who worked with 93 other legislators to pass Medicaid reauthorization, didn’t mince words in his assessment: "Working Montanans will now either pay more for basic health coverage or go uninsured so that high-income households and large corporations can enjoy new tax advantages." The silence of Montana’s congressional Republicans in the face of these looming hikes, he argued, was striking—especially given the clear, bipartisan support for affordable health care within the state.
Meanwhile, in Philadelphia, the impact of federal retrenchment is even more sprawling and immediate. As detailed in Philadelphia Magazine, the Trump administration’s budget cuts are hitting the city on multiple fronts, from social safety nets to the lifeblood of its local economy: higher education and health care. These sectors, known collectively as “eds and meds,” account for roughly one in three jobs in Philadelphia and have long been a buffer against the city’s persistent poverty and economic volatility.
But the buffer is thinning. At the end of May, Penn researcher Aaron Richterman received a ten-page letter from the National Institutes of Health (NIH) terminating his multimillion-dollar grant, which was funding a study on the health impact of stabilizing housing for people with HIV—a group numbering about 4,000 in Philadelphia. The justification? The administration cited Diversity, Equity, and Inclusion (DEI) grounds, calling the research “antithetical to science inquiry.” Richterman, frustrated and concerned for his own career and those of younger researchers, called the decision "a gut punch—a betrayal of the underlying scientific process we’ve all committed to." The city managed to scrape together enough money to keep one of his project coordinators employed through May 2026, but the future of the research remains uncertain.
The reverberations of these cuts extend far beyond the lab. Philadelphia’s vulnerability is rooted in its demographics: nearly 475,000 residents—almost one in three—are enrolled in SNAP (the Supplemental Nutrition Assistance Program), with more than half being children, seniors, or disabled adults. Earlier this year, two federal food initiatives, the Emergency Food Assistance Program (TEFAP) and the Local Food Purchasing Assistance Program, were abruptly ended by the administration. George Matysik, executive director of Share Food (a major local food bank), described the loss as "about $7 million worth of TEFAP expenses we were looking at for this upcoming year," and another $1.5 million from the shuttered LFPA. The result: food pantries like Men Who Care of Germantown are serving hundreds of families each week but are often unable to provide meat or dairy, and the lines are only getting longer as more Philadelphians lose eligibility for SNAP.
The city’s housing and health care landscapes are equally precarious. The Trump administration has proposed consolidating and cutting most federal rental assistance programs by 40%, threatening the stability of the 80,000 Philadelphians who rely on such aid. The Low Income Home Energy Assistance Program (LIHEAP) and Community Block Grants—key supports for Mayor Cherelle Parker’s plan to build or rehabilitate 30,000 housing units—are also on the chopping block. In health care, tightened Medicaid eligibility and increased paperwork are expected to push 70,000 Philadelphia residents off the rolls by 2027, while federal grants that fund public health and behavioral health programs are being slashed or frozen.
Local leaders are sounding the alarm. U.S. Representative Mary Gay Scanlon warned, "I think the alarm should be blinking red," while her colleague Brendan Boyle emphasized that the impact in Philadelphia is "disproportionately high." Sam Katz, a veteran city finance expert, called the consequences "mind-boggling," pointing to the "cascading effect" as cuts in one area trigger larger problems elsewhere—from job losses in grocery stores as SNAP dollars disappear, to mounting pressure on hospitals required by law to treat uninsured patients.
These disruptions are not just economic or institutional; they are deeply personal. Bill McKinney, executive director of the New Kensington Community Development Corporation, noted, "Anyone who’s eligible for one of these programs—SNAP, Medicaid, housing assistance—is basically going to be eligible for all of them. It starts stacking." In neighborhoods like Kensington, where the median income is $29,000 a year, the withdrawal of federal support threatens to push already vulnerable residents into deeper instability, with potential increases in homelessness, addiction, and violence.
Philadelphia’s reliance on federal funding has deep historical roots. After decades of industrial decline, the city rebuilt itself around education and health care, buoyed by government grants and subsidies. Yet, as Penn’s Dan Kessler observed, the current cuts threaten not just immediate research but the city’s long-term economic prospects. "The less research Penn does, the less well-off Philadelphia and the state of Pennsylvania are," he said, warning that the loss of momentum comes at a critical time as the city tries to compete with places like Boston in the life sciences sector.
As the city and state grapple with these challenges, the debate about how to respond is intensifying. Some urge raising the minimum wage or lowering business taxes to broaden the economic base, while others call for stronger cross-sector collaboration and leadership. But as Bill McKinney observed, "The scarcity mindset does not encourage collaboration. It encourages the belief that there’s not enough, and so we all have to just look out for ourselves." The question now, for both Philadelphia and Montana, is whether they can break free from that mindset—and find new ways to support their most vulnerable residents as federal support recedes.
For now, the stakes are clear: The choices made in Washington are echoing across America, reshaping lives, communities, and the very fabric of the nation’s safety net.
