On July 4, 2025, President Donald Trump signed into law the One Big Beautiful Bill Act, a sweeping piece of legislation that has sent shockwaves through America’s social safety net and rural healthcare system. The law, which includes historic cuts to both the Supplemental Nutrition Assistance Program (SNAP) and Medicaid, is already having far-reaching consequences for some of the country’s most vulnerable populations—refugees, asylees, and rural communities dependent on local hospitals.
For B., a 39-year-old man from Cameroon who arrived in the United States in 2016, the new law has upended a fragile sense of security. After fleeing imprisonment and threats to his life due to his sexual orientation, B. was granted asylum in late 2024 and became eligible for SNAP, commonly known as food stamps. "I think it’s unfair. I understand that there are some people who abuse the system," B. told Stateline. "There are also people who are in need. And cutting help for families like mine—not being able to get the help—it will be very difficult."
B.’s story is not unique. SNAP serves an average of 42 million Americans each month, supplementing grocery budgets for those with lower incomes. But under the new law, most refugees and asylees who entered the country legally, like B., are no longer eligible for food stamps. Only Cubans and Haitians remain exempt from this restriction. The change comes at a time when more than 2.2 million immigrants are awaiting asylum decisions, and the country is seeing record numbers of new arrivals from unstable regions, including 60,050 refugees admitted in 2023 alone, according to the U.S. Department of Homeland Security.
Supporters of the change, such as Jessica Vaughan of the Center for Immigration Studies, argue that refugees and asylees have access to work permits and support from sponsoring organizations. "They really should be moving forward towards self-sufficiency with support right out of the starting gate. And they should be moving ahead to obtain green cards," Vaughan said. She pointed to federal grant programs that reimburse states and nonprofits for the aid they provide to refugees.
Critics, however, warn that these pathways to stability are long and uncertain. Nicolas Palazzo, policy counsel at HIAS, told Stateline, "SNAP is an incredibly fundamental program for this population that comes to the United States, really, with very little, if anything. These are people who literally had to flee—many times overnight—with nothing but, you know, a pair of clothes in a backpack." Palazzo called SNAP a "smart and moral investment" that strengthens communities and the economy, cautioning that "stripping critical food assistance forces refugees and asylees into the shadows of informal work, labor exploitation, and hunger that weakens our workforce and denigrates our moral obligations."
B. described the labyrinthine process of seeking asylum in the U.S. He applied immediately upon arrival, waited months for a work permit, and survived by cleaning homes and delivering food. When a car accident left him unable to work, SNAP was a lifeline. "While not having income, it was very helpful," he recalled. "I’m somebody who if I can work, I will work. The only reason I went over there to ask is because I had nowhere else to go." Even now, B. says, "There are people who are in need. I think ignoring that—it’s not human."
The impact of the law is already being felt in states across the country. According to Barbara Guinn, commissioner of New York’s Office of Temporary and Disability Assistance, around 41,000 people in the state who are not lawful permanent residents—including refugees and asylees—will lose SNAP eligibility. In Texas, roughly 24,600 refugees or asylees were receiving food stamps as of July 2025. Maryland’s program supported more than 10,000 such recipients last year, while California projects that 74,000 noncitizens—including refugees and asylees—will lose eligibility under the new law.
The law also shifts part of the financial burden to states, requiring them to cover between 5% and 15% of SNAP costs starting in fiscal year 2028. Robert Rector, a senior research fellow at The Heritage Foundation, noted, "If New York state doesn’t want to cut these people off, they can continue to give them something like food stamps. They just have to do it with New York state money right now." But Guinn countered that this would be difficult given already stretched resources, and food banks are in no position to fill the gap. Sherri Laigle of HIAS explained, "They’re already stretched, and now we’re going to see tens of thousands of people also needing to continue to rely on these programs. Of course, there’s limited access to them. You have to have transportation. You have to be able to get there."
While the SNAP cuts threaten food security for new Americans, the same legislation’s Medicaid reductions are putting rural healthcare on the brink. A report released in August 2025 by Protect Our Care estimates that more than 330 hospitals nationwide face imminent risk of closure due to the Medicaid cuts, including Aroostook Medical Center in Presque Isle and Maine Coast Memorial Hospital in Ellsworth. Maine hospitals alone could lose more than $66 million annually in revenue, according to analyses from Families USA and Third Way.
Nearly half of Maine’s 24 rural hospitals are now considered "at risk" of closure, according to the Center for Healthcare Quality and Payment Reform. The consequences for local economies and healthcare access are dire. Nationally, hospitals employ about 10% of all workers in rural counties with hospital employment, and the closure of a single rural hospital can eliminate 220 jobs immediately, the Protect Our Care report found.
Since 2020, five hospitals in Maine have already shut down their labor and delivery units, with four closures occurring in 2025 alone. The law’s $1 trillion-plus in Medicaid cuts represent the largest rollback in the program’s history, while the $50 billion allocated for rural health aid over six years is widely seen as insufficient. As the report starkly put it, congressional Republicans are "pulling the plug on entire communities’ access to care."
The political response has been sharply divided. U.S. Senator Susan Collins, one of just three Republicans to vote against the tax package, cited the threat to rural hospitals as her reason for opposition. Yet Maine Democratic leaders have criticized Collins for previously supporting the bill’s advancement. Devon Murphy-Anderson, executive director of the Maine Democratic Party, said, "She has cost us our health care. She has cost us freedom. She has cost us the representation that we as Mainers and as Americans deserve."
For rural Mainers, the stakes are clear: if closures accelerate, residents could face long drives to reach emergency rooms or maternity care—if those services remain available at all. Advocates warn that without further intervention, the state’s fragile hospital system may not be able to sustain the services that communities depend on.
The One Big Beautiful Bill Act has become a flashpoint in the debate over America’s social contract, pitting fiscal restraint and calls for self-sufficiency against the urgent needs of those starting anew or living on the edge. As the country grapples with the fallout, the stories of people like B. and the fate of rural hospitals stand as stark reminders of what’s at stake when the safety net is pulled back.
