The House of Representatives’ passage of the One Big Beautiful Bill Act (OBBBA) on May 22, 2025, marked a bold step toward reining in the rampant waste, fraud, and abuse plaguing federal entitlement programs like Medicaid and the Supplemental Nutrition Assistance Program (SNAP). Championed by President Donald Trump and House Republicans, this sprawling legislation, coupled with ongoing hearings and potential future reforms, signals a commonsense commitment to fiscal responsibility while preserving safety nets for the truly needy. From tightening eligibility to cracking down on state-level loopholes, the OBBBA and related efforts aim to restore accountability to programs that have ballooned under decades of mismanagement, saving taxpayers billions while ensuring benefits reach their intended recipients.
The OBBBA, a 1,000-plus-page reconciliation package, delivers what Republicans call the largest spending reduction in nearly three decades, with $1.6 trillion in mandatory savings over a decade. Its health care provisions alone are projected to slash federal outlays on Medicaid and Affordable Care Act (ACA) subsidies by $1.15 trillion by 2035, with an additional $100 billion from codifying Trump-era proposed rules. A cornerstone of these savings is a crackdown on improper payments, which the Government Accountability Office pegged at $31 billion for Medicaid alone in 2024. The bill targets fraudulent enrollments, estimating that 4 to 5 million people were improperly enrolled in ACA plans last year, costing taxpayers $15–$26 billion. By requiring stricter income verification through third-party payroll and consumption datasets, the OBBBA aims to curb such abuses, ensuring subsidies flow only to eligible Americans.
Medicaid reforms in the bill are particularly aggressive. One provision codifies a Trump administration rule to tighten criteria for state provider taxes, a tactic used to inflate federal reimbursements through what critics call “Medicaid money laundering schemes.” By limiting these taxes to 6% and requiring non-compliant states to correct waivers or face penalties, the bill could save billions while forcing states to fund Medicaid more transparently. Another measure excludes an estimated 1.4 million undocumented immigrants from Medicaid benefits, redirecting resources to legal residents, pregnant women, children, seniors, and the disabled. The bill also imposes work requirements on able-bodied adults without dependents, mandating 80 hours per month of work, volunteering, or training to maintain eligibility—a move projected to save $300 billion without cutting benefits for those unable to work.
SNAP, too, faces a long-overdue overhaul. The OBBBA closes loopholes that allowed states like California, Illinois, and Nevada to waive work requirements entirely, encouraging self-sufficiency among the 4.8 million able-bodied adults not working. It also introduces enhanced eligibility checks to prevent fraud, such as the $16 million SNAP trafficking scheme in Baltimore or the $1.8 million energy drink scam in New York. By requiring states to verify citizenship, income, and identity, the bill aims to ensure benefits reach the hungry, not fraudsters. These reforms, Republicans argue, protect the program’s integrity for vulnerable populations while ending the exploitation that has siphoned funds from taxpayers.
The House Budget Committee, under Chairman Jodey Arrington, has amplified these efforts through hearings, including a June 25, 2025, session titled “Rooting Out Waste and Fraud.” Experts testified that improper payments and lax oversight have driven Medicaid’s $1.1 trillion in erroneous outlays over the past decade. The committee highlighted cases like a Florida couple using 700 stolen identities to obtain SNAP cards, underscoring the need for systemic change. Arrington emphasized that both parties have historically paid lip service to tackling waste but failed to act, leaving taxpayers to foot the bill for a “bloated bureaucracy.” The hearing reinforced the OBBBA’s reforms as a starting point, with calls for further legislation to expand automated databases for real-time eligibility verification and impose stiffer penalties for state non-compliance.
Looking ahead, the House is poised to pursue additional measures. Proposals under discussion include integrating horizontal verification systems to cross-check federal and state data, reducing improper payments in real time. There’s also talk of expanding SNAP fraud investigations, potentially through a dedicated task force modeled on the Department of Justice’s efforts against pandemic-related fraud. Republicans are eyeing reforms to Medicare, where the Congressional Budget Office (CBO) warns that rising deficits could trigger sequestration cuts. One potential bill would refine the Medicare Drug Price Negotiation Program to protect incentives for rare disease treatments, addressing concerns that price controls stifle innovation. These efforts align with the view that entitlement programs must be sustainable to survive, balancing compassion with fiscal discipline.
Critics, particularly Democrats, argue the OBBBA’s reforms risk harming vulnerable populations. The CBO estimates that 8.6 million Americans could lose Medicaid coverage by 2034 due to stricter eligibility and work requirements, with another 5.1 million losing ACA subsidies if enhanced premium tax credits expire. Nearly 11 million could face SNAP benefit cuts, especially families with school-aged children now subject to work mandates. Progressives claim these changes shift costs to states, straining budgets and potentially reducing access. Republicans counter that the bill protects core beneficiaries by targeting only the ineligible, including undocumented immigrants and able-bodied adults who refuse work, while saving $1.25 trillion overall.
The OBBBA and related House efforts are a pragmatic response to a federal government teetering on fiscal insolvency, with a national debt projected to hit $59 trillion by 2035. The reforms embody the principle that safety nets are for those who need them, not those who game them. By rooting out fraud, tightening oversight, and promoting work, the House is delivering on Trump’s mandate to restore accountability. As the bill moves to the Senate, where debates over provider taxes and tax cuts loom, the challenge will be maintaining these gains without diluting their impact. Future hearings and legislation will likely build on this foundation, ensuring entitlement programs serve their purpose without bankrupting the nation. The fight for fiscal sanity has begun, and the House is leading the charge.