A Shrinking Safety Net
The Host
Enrollment in the federal food stamp program — the Supplemental Nutrition Assistance Program, known as SNAP — is down by more than 10% nationally, according to a new report, and in some states by as much as half. Those numbers are falling as states enact changes ordered by the GOP budget bill passed in 2025. The drop is much steeper than was predicted and could portend a similar fate for those on Medicaid, as states prepare to implement many of the same changes ordered for SNAP.
Meanwhile, amid a rise in reported cases of the gastrointestinal ailment caused by the parasite cyclospora, federal public health officials once again struggle to explain to a confused populace how to stay safe.
This week’s panelists are Julie Rovner of KFF Health News, Joanne Kenen of the Johns Hopkins Bloomberg School of Public Health and Politico Magazine, Alice Miranda Ollstein of Politico, and Margot Sanger-Katz of The New York Times.
Panelists
Among the takeaways from this week’s episode:
- Participation in the nation’s food stamp program is down, with children representing nearly half of those losing benefits, according to a recent analysis. Some states are showing much larger drops than others. The GOP-passed budget law imposes penalties for errors, leaving states spooked about the possibility of losing funding — and suggesting problems ahead for the full rollout of Medicaid work requirements next year.
- President Donald Trump’s immigration crackdown is increasing pressure on the health system, in particular on the availability of home-based and long-term care workers — including those who fill critical roles such as serving food and driving patients to medical appointments. Research has shown that the presence of immigrant workers has a protective effect on the health of their charges.
- Responding to revelations that doctors are reaping large payouts from the surprise-billing arbitration process, the Trump administration this week released information showing a spike in such payments and noted the need for changes to the law — without specifying what kind of changes. That law, the No Surprises Act, took effect in 2022 with the primary intention of shielding patients from big bills when they unknowingly receive out-of-network medical care.
- In other news, the Pentagon is imposing testosterone tests for many service members. The cyclospora outbreak continues. And the Trump administration announced plans to withhold Medicaid funding from California and Minnesota over accusations of fraud.
Also this week, Rovner interviews Sen. Bill Cassidy (R-La.), chairman of the Senate Health, Education, Labor, and Pensions Committee, as part of the “How Would You Fix It?” series.
Plus, for “extra credit,” the panelists suggest health policy stories they read this week that they think you should read, too:
Julie Rovner: The New York Times’ “The Fake Influencers Selling Wellness on Your Feed,” by Arijeta Lajka, Isabelle Niu, Mark Boyer, James Surdam and Dan T. Peters.
Joanne Kenen: Stat’s “A Most-Wanted Fugitive Appears To Have Been Secretly Working as a Biotech Executive,” by Adam Feuerstein.
Margot Sanger-Katz: NPR’s “Amid Nurse Shortage, a University Rolls Out the Welcome Mat for Men,” by Andrea Hsu.
Alice Miranda Ollstein: Roll Call’s “Trump Administration Puts Kibosh on HIV Prevention Funding,” by Ariel Cohen.
Also mentioned in this week’s podcast:
- KFF Health News’ “Doctors ‘Cringe’ at Possibility of Documenting Which Medicaid Enrollees Too Sick To Work,” by Sam Whitehead.
- KFF Health News’ “A Deloitte-Run System Denied Medicaid Benefits for Michigan’s Disabled. Now Trump’s Law Piles On,” by Rachana Pradhan, Samantha Liss, and Kate Wells.
- The New York Times’ “Senior Living Facility in Distress as Immigrant Caregivers Are Forced Out,” by Miriam Jordan.
- The Wall Street Journal’s “Medical Billing Arbitration Paid Out $15 Billion to Providers in Surprise Bill Disputes,” by Anna Wilde Mathews and Tom McGinty.
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