By Rep. Ellie Sato

One of the most frequent questions I’ve been getting from constituents recently is how the budget passed by Republicans in Congress over the summer, also known as the “Big, Beautiful Bill,” will impact us in Maine. The legislation includes the largest cut to Medicaid in American history, along with sweeping changes to health insurance marketplace programs and food assistance. Most disappointingly, it’s paid for by tax cuts to millionaires and billionaires.

Congress decided to delay much of the law’s implementation until after the 2026 midterm elections, so the most significant impacts won’t be felt immediately. But if its provisions go into effect unchanged, it will have real consequences on our state: many Maine families could lose their health insurance or see their costs skyrocket, rural hospitals could continue to curtail services or close, and families risk losing access to food and going hungry.

The biggest cuts are to MaineCare, the state’s Medicaid program. According to the Maine Department of Health and Human Services, changes included in the law are projected to cost an estimated $5 billion over a 10-year period – a huge funding gap they know the Legislature cannot fill on its own.

In addition to reduced federal funding, there are also new, burdensome bureaucratic barriers that will make it harder for 90,000 eligible Mainers to get the health care they need by bogging down people in unnecessary red tape. This includes requiring enrollees to renew their eligibility every six months instead of annually. In year one, the state is expecting more than 31,000 disenrollments due to bureaucratic hurdles and other challenges, as well as tens of millions of dollars in increased costs for administration and verification systems.

While these policy changes will hurt Maine families, the ramifications will ripple throughout our health care system. MaineCare is one of the biggest payers to health care providers, especially in rural areas, and our hospitals and nursing homes rely on the program to stay open. Kicking eligible Mainers off their health insurance will lead to a devastating loss of revenue for these providers, who could be forced to reduce services or close altogether, which we already seen here in Maine. It will also lead to greater uncompensated care costs, which will make health care more expensive for all Mainers at a time when many are already struggling to afford it.

Additionally, the law cuts food assistance programs like SNAP, which helps nearly 180,000 Mainers – including more than 46,000 children – afford groceries every month. Benefit reductions and eligibility changes, some of which are set to go into effect this year, will exacerbate food insecurity and result in more people going hungry. Like the health care cuts, these changes will also reverberate through the economy: every dollar spent generates $1.54 in local economic activity. This will put a significant strain on local food pantries, retailers, and nonprofits.

There’s no way around it: the “Big, Beautiful Bill” creates real challenges for Maine. It will make life more expensive for working families, and it will hurt our neighbors who need support the most. But despite these challenges, I am more committed than ever to building a state where every Mainer has an opportunity to thrive, and where affordable, comprehensive, high-quality health care is within reach of every family.

As always, please don’t hesitate to reach out to me with concerns about issues you care about, for help navigating a state agency, ideas on ways to better our community, or even just to introduce yourself. You can email me at ellie.sato@legislature.maine.gov, or call the House Majority Office at 207-287-1430.

Rep. Ellie Sato, D-Gorham, is serving her first term in the Maine House of Representatives and is a member of the Legislature’s Judiciary Committee.