When issues such as abortion were raised on the 2024 campaign trail, President Donald Trump would often wave away his allies’ hardline anti-abortion stances, hiding behind his professed belief in states’ rights to make their own decisions about whether to maintain or restrict access to reproductive health care. Post-election, the truth came out: Trump was definitely going to be interfering further with reproductive care access from the Oval Office.
But with his multi-trillion dollar tax cut legislation — a version of which passed out of the Senate Tuesday and is moving toward a final vote in the House before landing on Trump’s desk — the president and Congress actually are letting the states decide the fate of key programs. Yet the range of options the bill leaves them with, after making its sweeping cuts, makes that choice almost impossible, state officials warn. Those decisions include whether or not and how to adequately fund Medicaid, Medicare and the Supplemental Nutrition Assistance Program (SNAP) in the face of historic federal cuts.