A Republican budget bill that would slash more than $1 trillion from federal health care and food-assistance programs, cut taxes primarily for wealthy Americans and add almost $4 trillion to the national debt is raising alarms among experts and advocates across South Carolina.
The legislation, officially dubbed the “Big Beautiful Bill Act,” passed the Republican-controlled House on May 22 in a 215-214 vote, overwhelmingly along party lines. Under the bill, about 14 million Americans would lose health care coverage and at least 5 million would lose food aid, according to the nonpartisan Congressional Budget Office and independent estimates.
Sixth District Democratic U.S. Rep. James Clyburn, the only South Carolina member who voted no, highlighted the potential impact of the cuts at a May 29 town hall in North Charleston.
“They call it the Big Beautiful Bill,” he said in remarks prepared for the event. “I call it the Huge Ugly Bill. Republicans are taking food and
health care from the poorest to pay for a massive tax cut for the richest.”
Clyburn went on to note that five out of eight nursing home patients in the state are covered by Medicaid, and that another 600,000 residents — mostly families with children — rely on the Supplemental Nutrition Assistance Program (SNAP) for food aid.
“The Huge Ugly [Bill] is so big and so bad that it can be hard to keep it all straight,” Clyburn said. “[But] here’s the bottom line: it would take food and health care away from working people to pay for tax cuts for the wealthy.”
South Carolina GOP U.S. Reps. Nancy Mace, and Ralph Norman — who both voted for the bill and have said they’re considering gubernatorial runs next year — did not respond to requests for comment.
But the White House and many GOP members argue that official estimates of the bill’s effects fail to account for positive impacts from economic growth they say it would create.
‘Cruel’ Medicaid and food cuts
S.C. Appleseed Center Director of Policy Sue Berkowitz called the cuts “cruel” in a May 29 interview.
“These Medicaid and nutrition cuts would devastate low-income people,” she told Statehouse Report. “Hundreds of thousands of South Carolinians would lose health care, and the SNAP cuts would take food out of the mouths of hungry people who need it.”
What’s worse, she argues, are the larger impacts that cuts of that magnitude would have on systems that all South Carolinians rely on.
“What we’re going to see, particularly in the rural areas, are hospitals and medical providers that rely on Medicaid closing down,” she said. “And that becomes a health crisis for all of us.”
Similarly, she warns that new unfunded SNAP mandates could force state lawmakers to consider deep cuts to beneficiaries or even eliminate the program entirely.
“This turned out to be an easy budget year, but we’re going to see huge cuts and a lot of pain if this bill passes,” she said. “And our [state] legislators should be really angry that this shift has been pushed onto the states to cut income taxes for the wealthiest Americans.”
More health care cuts under the ACA
Long a lightning rod among politicians, the Affordable Care Act — or Obamacare as it was first known — has proven increasingly popular with South Carolinians, with about 600,000 now purchasing subsidized health insurance through the program.
And while Medicaid cuts are getting most of the attention, Palmetto Project President and CEO Aaron Polkey says tens of thousands more South Carolinians stand to lose coverage under the ACA if the Big Beautiful Bill becomes law. The Palmetto Project operates the state’s only nonprofit insurance agency, specializing in subsidized ACA plans.
Of particular concern, Polkey says, are provisions that would lower current income eligibility thresholds and raise premiums for those who still qualify.
“It would just make health insurance much more expensive for folks who don’t qualify for Medicaid but are working people who need coverage,” he told Statehouse Report on May 29. “And that’s the whole point of the Affordable Care Act.”
The budget bill, which President Donald Trump has called “arguably the most significant piece of legislation that will ever be signed in the history of our country,” is now in the U.S. Senate, where at least three Republican members have publicly expressed concerns about the cuts.
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