By Sheeva Azma

The legacy of this Congress will be all of the things they took away from the American people while they, themselves, benefited more and more.

It’s the day before this blog is to be published and I’ve let my responsibility of blogging each week come down to the wire. Oh well. At least we made it through the government shutdown just for more rigamarole come January 30.

Congrats to the United States for making it through its longest government shutdown in history!

SNAP benefits ran out towards the end of the shutdown, which meant that people literally went hungry. Yikes! Never seen that happen here in the good ol’ US of A before.

Here in Oklahoma, one out of six people are on SNAP, which you probably know is a social safety net — basically government’s way of helping people who cannot afford groceries to be able to eat. As of writing this on Friday, November 14, 2025, I don’t think everyone has gotten their food benefits back fully yet, and while government workers are finally receiving their back pay, I have read around the different corners of the internet that it was not the full pay they were expecting.

We can do so much better if we inform ourselves about everything our government is doing. It’s easy to feel like there’s too much to care, but we should pay attention when things get complicated and handwavey (if that can be a word).

If, like me, you flew during the government shutdown when TSA and air traffic control were not getting paid, you probably have a different view of its impacts than if you were a member of Congress who got paid for 7 weeks. Me, personally, I worked long 12-hour days while being so bitterly resentful and angry that our lawmakers get to skip town (and vacation when the people helping them get from point A to point B were not getting paid). It feels so unfair to the federal workers who went without pay, the people who did not have food assistance during that time, and basically everyone in the US who had to put up with our lawmakers not being able to work together. It is embarrassing for the US to be run this way when we could do so much better (but that’s probably a good subject for another blog post, or series, or even another blog…hmm!).

One central part of this shutdown, besides this idea that we need to “balance the budget” – is it really making ends meet with the federal budget or another way of saying that the people in power want to shift national funding priorities? – is the Affordable Care Act. That not only happens to be my healthcare, but also the members of Congress’ healthcare, since their healthcare is on the exchanges!

Well, the One Big, Beautiful Bill Act (H.R. 1) sure accomplished something big. The biggest legislative accomplishment of H.R. 1 is that it’s the largest cut to essential health programs including Medicare in US history.

The bill takes away essential health care from the people who need it the most to give a tax cut to millionaires and billionaires, who aren’t the ones agonizing over food prices at the grocery store or wondering if they will be able to afford their health insurance next month.

The bill’s cuts to Medicaid, which covers costs for low-income people, are the largest cuts in the program’s history.

It all really makes you wonder if Congress is working for the people or their dark-money donors. Why did we elect these people?

Thanks, but No Thanks

The fight to save the Affordable Care Act almost makes no sense in the context of what Congress has already gutted. For the Congress to act like renewing ACA subsidies is some grand humanitarian act is incredibly disingenuous. (I can sense my blood pressure rising as I try to make sense of Congress’s actions. Can you tell?)

“No health care for illegals” is the battle cry of House and Senate Republicans, but they already took away healthcare for lawful immigrants in H.R. 1. I’m pretty tired of it, and pretty tired of seeing my tax dollars go to advertisements about illegal immigration that are clearly meant to make people feel like they do not belong in the United States.

Quite honestly, I’m shocked that more people are not talking about what happened in H.R. 1. So, here is a quick explainer I put together that can help you understand why Congress should be held accountable for what they did here. We can’t let them get back to “business as usual” and act like nothing happened, especially after this as well as working for seven weeks while getting paid (I thought we did not have any money? Shouldn’t they all be volunteering their time at this point if that’s the case?).

The bill cuts over $1 trillion dollars from health care while also tacking on $3.4 trillion to the national debt and helping Medicare become insolvent sooner, triggering an automatic $500 billion cut to it over the next decade. Double yikes! 

The Congress’s reopening bill included a promise to vote on extending Marketplace health insurance subsidies. If the vote fails, premiums are estimated to go up by 75% starting in January 2026; 10,000,000 Americans will lose their health insurance, and 4 million people a month will be losing SNAP food assistance each month at a time when grocery prices are at record levels. There’s nothing beautiful about any of that, especially at a time when high prices and economic uncertainty is occurring due to rampant inflation and large-scale tariffs.

Healthcare Provisions Gutted in H.R. 1 (A Non-Exhaustive List)

The healthcare provisions I detail below describe a bill that, in my opinion as someone who has worked in health policy and cost-reduction in the healthcare system, is kind of heartless and awful. 

But wait … there’s more! 

The inhumanity does not stop there. Keep reading for my Oklahoma-specific breakdown of how H.R. 1 gutted healthcare as we know it. Amazingly, I have heard very little about any of these things, except maybe on CSPAN from House Democrats in the recent government shutdown sessions they had.

Medicare Cuts

H.R. 1 blocks the implementation of rules that would have helped low-income Medicare enrollees to cover premiums and cost-sharing for their Medicare benefits. According to the Center for American Progress, this will “disproportionately affect disabled people, as they are more likely to have lower incomes than nondisabled people.” Lastly, the bill eliminates Medicare eligibility for people with lawful immigration status even if they have paid into the program (more about that later). The Congressional Budget Office estimates that, without future action by Congress, the bill will trigger the Statutory Pay-As-You-Go Act of 2010, which automatically enacts $490 billion in Medicare cuts from 2027 through 2034.

The Biggest Medicaid Cuts in History

Here in Oklahoma, H.R. 1 creates drastic cuts to SoonerCare amidst its voter-approved expansion, with little chance to recoup funds. Perhaps it is the same for other states who opted to expand Medicaid in the pandemic.

Prior to H.R. 1, the federal government paid for 68.5% of Oklahoma’s Medicaid program, SoonerCare. However, now, the law restricts states’ ability to generate money to fund Medicaid, a program jointly run by states and the federal government to help people with limited income gain access to health care coverage.

1 million people in Oklahoma participate in Soonercare; that number is higher because in 2020, Oklahomans voted to expand Medicaid.

H.R. 1 forces SoonerCare recipients to verify eligibility twice a year, rather than once a year as before. It also adds strict 80 hours-a-month work eligibility requirement, which poses a challenge for families with young children and people who cannot work due to disabilities. The cuts are also estimated to lead to a loss of $8.7 billion dollars for Oklahoma hospitals.

For a bill that was supposed to make government more streamlined and less wasteful, H.R. 1 adds more paperwork and bureaucracy to Medicaid and makes it more insolvent rather than helping it. Despite that, I see lawmakers talk about how great H.R. 1 is all the time and how it delivers on the president’s promises.

More expensive Marketplace healthcare

The bill increases healthcare premiums by 75% for the 300,000 Oklahomans reliant upon the Affordable Care Act to obtain Marketplace health insurance. It also takes away the ability for many different categories of lawful immigrants to access Marketplace healthcare (more about that later in this post). This was a focus of the government shutdown and the premiums could be extended, but watching CSPAN, I saw many lawmakers and commentators comment on how insurance is so expensive instead of talking about the fact that we all need health care and that it’s the government’s role to ensure the general welfare. That’s, perhaps shockingly, in Article I, giving Congress the power to tax and spend for “the common defense and general welfare of the United States.”

Closing rural hospitals and lost health benefits for many rural Oklahomans

This one is Oklahoma-specific, again, but I can imagine that other states with sizeable rural areas might be similarly affected by the actions of our lawmakers.

51,100 rural Oklahomans can expect to lose their healthcare coverage, and rural hospitals stand to lose $2.4 billion.

While the Senate version of the One Big, Beautiful Bill, which is now law, restored some of the rural health funding in the form of a one-time $50 billion addition to the bill, these cuts will lead to the closure of rural hospitals, which are already struggling, according to the Oklahoma Hospital Association. This translates to cuts to important services as well as tens of thousands of job cuts in rural Oklahoma.

The worst part about all of this is that people simply just do not know these facts. When you hear lawmakers touting a one-time $50 billion injection to rural hospitals, it’s actually just giving the funding back that they took away. This type of messaging on what Congress is funding and not funding is one of the reasons that increasingly, I don’t think that we can take our lawmakers at their word anymore on what they are doing for the people.

No more food assistance for people who need it the most

H.R. 1 forces states to foot the bill for Supplemental Nutrition Assistance Program, a federal- and state-run food assistance program. In 2024, Oklahoma was ranked 5th highest population for SNAP benefit recipients among the 50 states and Washington, DC, with 16.8% of Oklahomans participating.

Under the bill, an estimated 131,000 Oklahomans – one-sixth of current SNAP recipients – will lose their SNAP benefits. That includes 25,000 people in our district, according to Oklahoma Watch.

No Medicare, Medicaid, SNAP, or other assistance for lawful immigrants

According to The National Immigration Law Center, H.R.1 made lawfully present immigrants ineligible for Affordable Care Act (ACA) subsidies, SNAP, Medicare, Medicaid, and the Children’s Health Insurance Program. Refugees, asylum recipients, survivors of human trafficking, survivors of domestic violence, and others are no longer eligible for these programs under H.R. 1. This includes lawful immigrants eligible for Medicare that have already paid into the system. The Congressional Budget Office has noted that 1.2 million people will lose health insurance nationally as a result and between 120,000 and 250,000 lawful immigrants would lose SNAP benefits.

But wait … says your wannabe infomercial announcer … there’s more! We didn’t even get into health insurance for children (known as CHIP), which H.R. 1 also defunded, for instance.

We must hold our lawmakers accountable for the decisions they make that are not in our interest. You can read all of H.R. 1 at Congress.gov. If it’s too much sadness for you, feel free to Google around and ask your favorite AI tool to summarize different parts.