特朗普的“美丽法案”对医疗补助、食品券和马萨诸塞州意味着什么

特朗普的“美丽法案”对医疗补助、食品券和马萨诸塞州意味着什么

【中美创新时报2025 年 5 月 24 日编译讯】(记者温友平编译)根据众议院本周通过的预算协调法案,贫困、饥饿和慢性病可能会增加,而最富有的美国人将获得巨额税收减免。社会保障削减打击最贫困家庭,而减税则惠及最富有家庭。《波士顿环球报》记者凯蒂·约翰斯顿对此作了下述报道。

国会预算办公室的分析显示,在马萨诸塞州,数十万低收入居民可能失去食品援助和医疗保险,导致贫富差距进一步扩大,而不断上涨的成本正使那些本已苦苦挣扎的人们更加捉襟见肘。

该法案现已提交参议院审议,将对医疗补助计划 (Medicaid) 施加工作要求,并扩大 SNAP 福利的工作要求,同时取消对合法居留但没有绿卡的逃离迫害的移民提供食品和医疗援助。

社会安全网的破坏可能导致马萨诸塞州每年损失超过15 亿美元,因为州政府增加了对这些福利的拨款,并因该州 继续 使用自有资金向没有资格享受联邦医疗补助的低收入移民(包括无证儿童和孕妇)提供医疗服务而对其进行处罚。

众议院共和党人表示,特朗普总统的“宏伟而美丽的法案”中的限制措施将减少浪费和欺诈,并促进个人责任。

该法案中税收抵免的延长也将使最富有的美国人受益匪浅。根据税收与经济政策研究所的数据,收入最低的五分之一居民明年将仅获得该法案净减税的1%,而收入最高的五分之一居民将获得68%的减税。

“这项法案的目的是给全国最富有的人减税,”马萨诸塞州预算与政策中心主席维维安娜·阿布雷乌-埃尔南德斯说。“他们通过削减全国最弱势群体生存所需的服务预算来实现这一目标。”

该法案要求19岁至64岁之间的医疗补助(Medicaid)受益人每月至少工作、接受培训或参与志愿服务80小时,除非他们身有残疾或有未成年子女等特殊情况。根据预算与政策优先中心的数据,在马萨诸塞州,这将使目前接受MassHealth(该州的医疗补助计划)的16.2万居民失去资格,并使多达35万人面临失去资格的风险。根据马萨诸塞州蓝十字蓝盾基金会去年的一份报告,超过四分之三的65岁以下MassHealth成员来自工薪家庭。

然而,根据预算和政策优先中心的研究,工作要求不会增加就业,但会导致人们失去福利,承担更多医疗债务,并延迟医疗。

补充营养援助计划(Supplemental Nutrition Assistance Program)的更多受助人也将被要求工作。除了那些已经被要求工作的人之外,有6岁以上子女的受助人,包括65岁以下的祖父母,也必须每周工作至少20小时,或参加职业培训或社区服务,才能领取三个月以上的福利。倡导者表示,对于那些无力承担托儿费用或没有交通工具的父母来说,这是站不住脚的。

根据众议院法案,合法移民也将失去申请SNAP(补充营养援助计划)的资格。无证移民已被禁止享受相关福利。

据马萨诸塞州法律改革研究所称,总计有超过 25 万名马萨诸塞州居民(包括儿童)面临失去部分或全部 SNAP 福利的风险,占目前接受援助人数的四分之一以上。

该计划实施以来,各州将首次需要支付部分 SNAP 福利,具体比例取决于其支付错误率,从 5% 到 25% 不等。各州承担的行政成本也将上升,从 50% 到 75%。联邦 SNAP 计划,俗称食品券,在经济衰退期间一直是稳定经济的力量,在州资源减少时,它支持家庭,进而支持地方经济。

在马萨诸塞州,SNAP 每年为经济贡献超过 26 亿美元,惠及超过 5500 名农民和零售商。反饥饿非营利组织“面包计划”( Project Bread)的首席执行官艾琳·麦卡利尔(Erin McAleer)称,拟议的削减计划“是我们有生以来对食品援助最具破坏性的打击”,该组织表示,这将迫使该州每年承担 7.1 亿美元的新成本。

一些州甚至可能选择完全停止提供 SNAP 福利。

随着参加 MassHealth 的人数减少,医院、疗养院和社区卫生中心的收入也会减少;人们的病情会更加严重,急诊室也会挤满人——这些变化也会影响没有参加 MassHealth 的患者。

追踪工作要求、更频繁的资格更新以及其他变化带来的行政成本将给州财政带来额外负担。倡导者表示,为了弥补这些变化,各州可能会削减福利或收紧资格要求。有些州甚至可能会提高税收。

毫无疑问的是,该法案可能会对收入不平等产生影响。

国会预算办公室表示,众议院的措施将使收入分配中最低十分之一的家庭资源在未来八年内减少 2% 至 4%(主要由于医疗补助和 SNAP 的丧失),同时使收入最高 10% 的家庭资源增加同样的幅度(主要是因为减税)。

“这会让病人病得更重,”马萨诸塞州法律改革研究所高级卫生法律师凯特·西蒙兹说。“这会让穷人更穷……这会让富人更富。”

该研究所高级经济正义倡导者维多利亚·内格斯 (Victoria Negus) 表示,无论参议院采取何种措施,该法案都会造成损害。在本次选举中,选民最关心的问题之一就是食品杂货的价格。

“这项方案总体上向美国人民表明:我们优先考虑富人和少数人、关系密切者和特权阶层的需求,而不是这个国家所有那些辛勤工作却无法维持生计、无法负担温饱或支付医疗费用的家庭,”她说。“这在消除饥饿和贫困以及 改善健康状况的努力中是一次巨大的倒退。”

本文由《波士顿环球报》 “金钱、权力与不平等”团队撰写,该团队负责报道大波士顿地区的种族贫富差距问题。

题图:四月,一名女子在华盛顿特区抗议特朗普总统为富人减税的政策。 图片来源:BRYAN DOZIER/Middle East Images/AFP via Getty Images

附原英文报道:

What Trump’s ‘beautiful bill’ means for Medicaid, food stamps, and Massachusetts

Safety net cuts hit poorest families, while tax breaks benefit the richest

By Katie Johnston Globe Staff,Updated May 24, 2025

A woman protested against President Trump’s tax cuts for the wealthy in Washington, D.C., in April. BRYAN DOZIER/Middle East Images/AFP via Getty Images

Poverty, hunger, and chronic illness will likely increase while the wealthiest Americans reap huge tax breaks under the budget reconciliation bill passed by the House this week.

In Massachusetts, hundreds of thousands of low-income residents could lose food assistance and health care coverage, leading to an even greater divide between rich and poor at a time when rising costs are straining those already struggling to get by, an analysis by the Congressional Budget Office shows.

The bill, which now heads to the Senate, would impose work requirements for Medicaid and expand them for SNAP benefits, and take food and health aid away from immigrants fleeing persecution who are here legally but don’t have green cards.

This disruption of the social safety net could cost Massachusetts more than $1.5 billion a year by increasing state contributions for these benefits and penalizing the state for continuing to use its own funds to provide health care services to low-income immigrants who aren’t eligible for federal Medicaid, including undocumented children and pregnant women.

House Republicans say the restrictions in President Trump’s “big, beautiful bill” would reduce waste and fraud and promote personal responsibility.

The extension of the tax credits in the bill would also disproportionately benefit the wealthiest Americans. The fifth of residents earning the least would get just 1 percent of the bill’s net tax cuts next year, according to the Institute on Taxation and Economic Policy, while the top fifth would get 68 percent.

“The purpose of this bill is to give tax cuts to the richest people in the country,” said Viviana Abreu-Hernandez, president of the Massachusetts Budget and Policy Center. “They are doing this by cutting the budget for services that the most vulnerable populations in the country need to be able to survive.”

The bill would require Medicaid recipients between the ages of 19 and 64 to work, train, or volunteer at least 80 hours a month, unless they are disabled or have dependent children, among other exceptions. In Massachusetts, this would disqualify 162,000 residents currently receiving MassHealth — the state’s Medicaid plan — and put up to 350,000 at risk of losing it, according to the Center on Budget and Policy Priorities. More than three-quarters of MassHealth members under age 65 were part of working families, according to a report last year by the Blue Cross Blue Shield of Massachusetts Foundation.

Work requirements don’t increase employment, however, according to Center for Budget and Policy Priorities research, but do result in people losing benefits, taking on more medical debt, and delaying medical care.

Work requirements would also be levied on more recipients of the Supplemental Nutrition Assistance Program. In addition to those already required to work, recipients with children above the age of 6, including grandparents up to age 65, would have to work — or be enrolled in job training or community service — at least 20 hours a week to receive benefits for more than three months. For parents who can’t afford child care or don’t have transportation, this is untenable, advocates say.

Immigrants here legally would also become ineligible for SNAP under the House bill. Undocumented immigrants are already barred from benefits.

All told, more than 250,000 Massachusetts residents, including children, are at risk of losing some or all of their SNAP benefits, according to the Massachusetts Law Reform Institute — more than a quarter of those currently receiving aid.

For the first time in the program’s history, states would have to pay for a portion of SNAP benefits, ranging from 5 to 25 percent, depending on their payment error rate. States’ share of administrative costs would also rise, from 50 to 75 percent. The federal SNAP program, known colloquially as food stamps, has been a stabilizing force during recessions, supporting families and, in turn, local economies when state resources are dropping.

In Massachusetts, SNAP adds more than $2.6 billion a year to the economy, benefiting more than 5,500 farmers and retailers. The proposed cuts — which Erin McAleer, chief executive of the anti-hunger nonprofit Project Bread calls “the most devastating attack on food assistance in our lifetime” — would force the state to absorb $710 million in new costs each year, the organization said.

Some states might even opt to stop offering SNAP benefits entirely.

With fewer people on MassHealth, hospitals, nursing homes, and community health centers would get less revenue; people would get sicker and crowd emergency rooms — changes that would also impact patients without MassHealth.

Administrative costs for tracking work requirements, more frequent eligibility renewals, and other changes will put an additional burden on state coffers. To compensate for these changes, states may cut back on benefits or tighten eligibility requirements, advocates said. Some might raise taxes.

What isn’t in doubt is the effect the bill could have on income inequality.

The House measure would decrease household resources in the lowest tenth of the income distribution by 2 to 4 percent over the next eight years — mainly due to the loss of Medicaid and SNAP — and increase resources for households in the top 10 percent by the same margin — largely because of tax reductions — according to the Congressional Budget Office.

“It’s going to make sick people sicker,” said Kate Symmonds, a senior health law attorney at the Massachusetts Law Reform Institute. “It’s going to make poor people poorer. … It’s going to make wealthy people richer.”

Regardless of what the Senate does, the bill will cause harm, said Victoria Negus, senior economic justice advocate at the institute, following an election in which one of voters’ biggest concerns was the cost of groceries.

“This package as a whole says to the American people: We are prioritizing the needs of the wealthy and the few, the well connected and the privileged, over every family in this country who is working hard to get by and does not make enough money to put food on the table or afford health care,” she said. “It is a monumental step back in efforts to end hunger and poverty and improve health outcomes.”

This story was produced by the Globe’s Money, Power, Inequality team, which covers the racial wealth gap in Greater Boston.


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