One year after Congress passed H.R.1, the federal tax and spending bill known as "The One Big Beautiful Bill," Oregon faces a $421 million Medicaid funding shortfall and tens of thousands of residents have already lost food assistance.

The consequences are landing in Marion County, where families cannot claim an exemption from new SNAP work requirements because the county has a WorkSource Center.

The bill, signed July 4, specifically targets two funding mechanisms Oregon used to maximize federal Medicaid dollars: state-directed payments and provider taxes. The governor's office estimates Oregon will lose $4.7 billion in federal Medicaid funding through 2031.

Since July 2025, about 62,000 Oregonians have lost SNAP food benefits statewide, with more than 25,000 cut off for not meeting work requirements, according to Oregon Department of Human Services data.

ODHS says more than 313,000 of the state's 740,000 SNAP recipients may ultimately be affected. Oregon is distributing $13 million less per month in SNAP benefits than one year ago.

Food bank visits across Oregon and Southwest Washington hit a record 2.9 million in 2025, a 51% jump over two years, according to the Oregon Food Bank.

Marion County leaders were already bracing for food insecurity before H.R.1's cuts took full effect. When a federal shutdown threatened to halt SNAP benefits in late October 2025, the Board of Commissioners discussed spending $100,000 per week to fund emergency food baskets through Marion Polk Food Share.

"The federal government is not functioning, and I am not okay with allowing that to trickle down into our community leaving so many individuals and families without resources for the vital nutrition they need to survive," Board Chair Danielle Bethell said at the October 29, 2025 meeting.

Medicaid work requirements start in January

Starting in January 2027, Oregon Health Plan members ages 19 to 64 must prove 80 hours per month of work, volunteering, or school attendance to keep coverage. OHA projects approximately 200,000 Oregonians will lose health coverage as a result of the work requirement and more frequent eligibility checks.

Oregon joined 25 other states and the District of Columbia in suing the U.S. Department of Health and Human Services on June 29, arguing the agency misled states about medical exemptions before imposing stricter rules.

Attorney General Dan Rayfield said the requirements "create unnecessary barriers for people who are already sick. History shows what happens next: Eligible people lose coverage despite doing nothing wrong."

OHA is training roughly 1,000 workers to handle the new requirements and plans to send notices to OHP members later in 2026, according to OPB's reporting on the agency's implementation efforts.

State response and the budget gap

State lawmakers allocated $111 million and nearly 400 positions during the 2026 short legislative session to begin implementing H.R.1. OHA also faces a $90 million current budget hole and plans to ask the Legislature for an additional $35 million from the general fund, according to the Lund Report.

A workgroup convened by Gov. Tina Kotek has presented more than 40 options to close the Medicaid gap, including across-the-board cuts, eliminating optional benefits like physical therapy and adult dental care, and changes to prescription drug purchasing.

State Rep. Ed Diehl, R-Scio, supports H.R.1, pointing to tax relief for workers: "I think Oregonians are benefiting from that right now, with the deductions for overtime and tips. Those are hitting the people who need it the most, who are living paycheck to paycheck."

U.S. Rep. Cliff Bentz, Oregon's sole Republican in Congress, did not respond to OPB's request for comment. He posted on X in April 2026 calling the bill the "Working Families Tax Cuts."

ODHS estimates Oregon needs an additional $340 million annually to cover H.R.1's changes to SNAP alone. The state's SNAP administrative cost share rises from 50% to 75% starting October 2026, and Oregon's 14% payment error rate could trigger an additional $450 million in state costs in the 2027-29 budget cycle if it isn't reduced below 6%.