Leading up to the 2026 midterm election, Democratic candidates across the country and in Ohio made big promises to reverse major Republican cuts to two safety net programs — Medicaid and SNAP.
Those cuts came from President Donald Trump’s One Big Beautiful Bill.
Now, sweeping wins have shifted power at the federal and state levels of government to Democrats. In the next months and years, the new leaders will have to prove that they can follow through on their campaign statements. And in Ohio, Democrat Amy Acton will oversee any changes made to the SNAP and Medicaid programs as governor.
But rolling back the One Big Beautiful Bill is unlikely to be simple, health policy experts in Ohio say. How will these leaders carry out their promises? How soon could things change? And what will it mean for the hundreds of thousands of people in places like Cuyahoga County who rely on the programs?
What promises were made about SNAP and Medicaid?
During the campaign, all of the Democrats running for federal office in Cuyahoga County — including Sherrod Brown, Brian Poindexter and Shontel Brown — said they supported repealing cuts to Medicaid and SNAP that were made in the One Big Beautiful Bill.
Those cuts came in many forms. The bill reduced federal SNAP funding by kicking legal immigrants off the rolls, adding stricter work requirements and cutting how much money states get to administer the program. The bill worked similarly for Medicaid, removing legal immigrants from the rolls, adding new work requirements for recipients and limiting ways states could raise money for the program.
All three of the federal Democrats in Northeast Ohio won Tuesday night. The next day, New York Democrat Hakeem Jeffries — who is widely expected to become House speaker — released a plan for House Democrats‘ first 100 days in office. It included reversing Medicaid cuts and restoring SNAP funding.
How would Democrats reverse Medicaid and SNAP cuts?
Democrats are flying high after sweeping electoral victories. But the realities of governing, especially with a Republican president, will likely make their goal of reversing Medicaid and SNAP cuts tougher to accomplish, policy experts said.
Unless Democrats can convince several Republicans to join them, they would likely have to use a special process that allows them to pass a bill with a simple majority — instead of 60 votes — in the Senate. That type of bill would likely have to be “budget neutral,” said Emily Campbell, president and chief executive officer for the Center for Community Solutions, a local think tank focused on social service programs. That means finding money to pay to reverse the cuts. She doesn’t know where that might come from.
Once that’s determined, the bill would need to be signed into law by Trump, who championed the changes to Medicaid and SNAP as paring back waste, fraud and abuse. That’s an unlikely scenario, said John Corlett, the state’s former Medicaid director and a senior visiting fellow at the Center for Community Solutions.
What may be more likely is a compromise, he said. That could look like delaying the changes made by the One Big Beautiful Bill, some of which still haven’t rolled out, he and Campbell said.
On the Medicaid side, that includes new limits on how states can raise money to pay for the health insurance program, which will go into effect in July 2027. On the SNAP side, that includes a provision to cut each state’s funding for the program based on how frequently they miscalculate their residents’ benefits. That is set to go into effect next October.
A spokeswoman for Congresswoman Shontel Brown wrote in a statement that delaying the next set of SNAP cuts is a “key part of ongoing Farm Bill negotiations, which House and Senate leaders are trying to resolve before the end of the year.”
Brown is seeking to become the Chair of the Agriculture Committee next year in order “to reverse the largest cuts to SNAP in history,” she added.
Still, Brian O’Rourke, a senior healthcare policy analyst for the Health Policy Institute of Ohio, said that fully reversing the social service cuts would likely be a lengthy process, though he didn’t specify exactly how long.
“They need to write legislation. They have to debate it, and they somehow have to pass it, at least through the Senate,” O’Rourke said. “… It feels like a longer-term thing.”
In the meantime, Medicaid, SNAP cuts will keep rolling out
Unless and until the Democrats reverse the SNAP and Medicaid cuts, the One Big Beautiful Bill is still the law of the land. And federal Democrats won’t be sworn into office until early January.
So changes that the One Big Beautiful Bill already put in place — such as kicking many legal immigrants off the Medicaid and SNAP rolls, or adding stricter work requirements for SNAP — will stick for the time being.
And it means new Medicaid work requirements will almost certainly go into effect as scheduled in Ohio on Jan. 1, O’Rourke said.
“It doesn’t have to be permanent, necessarily. We don’t know what will happen in the long run,” O’Rourke said. “….But from the state level, the Ohio Department of Medicaid has mostly set up that process already.”
Even if the newly elected federal Democrats eventually manage to pause or repeal Medicaid work requirements, there’s a chance Ohio would implement them anyway. Acton said during her campaign that she supported adding Medicaid work requirements, and Ohio’s state legislature has also historically supported them.
Before the election, Signal Cleveland asked Acton’s campaign whether she would move forward with work requirements in Ohio if Congress repealed them at the federal level. Her campaign did not answer these questions.
What will Governor-elect Amy Acton do when it comes to Medicaid?
Acton promised to “fight” attacks on Medicaid coming from Columbus or Washington, D.C.
But following Tuesday’s Democratic victories, she’s got fewer foes to face off against. Democrats control the U.S. House and Senate. Ohio Republicans lost their supermajority in the Statehouse. They still control it, though, so Acton will still have to negotiate with them over the state budget, where much discussion about Medicaid spending occurs. But they no longer have the votes to override her vetoes of their decisions.
Instead, Corlett said, Acton will have a number of opportunities to focus on a separate campaign promise — helping eligible Ohioans stay on Medicaid by cutting red tape and shortening wait times.
There are a number of levers she could pull to do this, he added. For example, residents who are medically frail do not have to meet the new Medicaid work requirements. But many of them will have to submit documentation to prove that, due to the way Ohio plans to implement the law. Acton could reverse that, Corlett said, and allow medically frail residents to attest to their condition next year without adding the burden of documentation.
Acton and newly elected Democratic Attorney General John Kulewicz could also join a lawsuit against the new Medicaid work rules, Corlett said.
Brought by 25 states and Washington, D.C., against the federal government, it argued that the Trump administration should not require medically frail people to prove their health condition would “significantly impair” their ability to work. A federal judge ruled in favor of this argument, meaning the states who joined in the lawsuit may get more flexibility when putting their work rules in place.
Acton hasn’t said publicly whether she’d join the lawsuit.
Can Acton address SNAP cuts?
The One Big Beautiful Bill slashed in half the amount of money it provides to Ohio to help pass out SNAP benefits. The money is used to pay county staff who help residents sign up for SNAP and Medicaid. The state could backfill the cuts, though last year it did not for most urban counties, including Cuyahoga.
Acton’s first budget proposal (next summer) will likely contend with this, Campbell said. Before the election, Acton’s campaign told Signal Cleveland she would look for solutions to fill funding gaps created by the One Big Beautiful Bill.
“How much state resources go to cover that federal cut, and then how those resources are distributed, is something that I’m sure we’ll see in the budget … that the governor proposes,” Campbell said.
What do the election results mean for the Cuyahoga County Health and Human Services levy that passed?
The One Big Beautiful Bill’s cuts to funding for SNAP administration trickled down to Cuyahoga County’s Job and Family Services department, which estimated it would lose $7.5 million to $10 million a year as a result.
When the county pitched voters on a new Health and Human Services levy this fall, officials said some of the taxes raised could go toward backfilling those cuts. Without it, county leaders feared staffing would shrink and wait times would grow for people needing SNAP and Medicaid. The levy passed by 60% on Tuesday.
There is a possibility of new federal or state pushes to allocate money to offset those cuts. But “in the short term, nothing changes,” said Campbell, whose organization endorsed the levy. The cuts went into effect this October, putting pressure on the county to act quickly. The levy will start bringing in dollars early next year.
“We’re doing a lot of speculation about what Congress may or may not do, or what a Governor Acton and her administration may or may not try,” Campbell said. “Until something does change at the state or federal level, counties have to operate under the current regulations.”
Signal Cleveland asked Cuyahoga County whether it would recalibrate how it spends new levy dollars if SNAP and Medicaid cuts are restored. In a statement, county spokesperson Kelly Woodard wrote that impending shifts in state and federal leadership could bring changes to federal programs, but noted that those would take time.
“Meanwhile there are people in our community who need access to food and healthcare today,” Woodard wrote. “… If those needs change, we will adjust our allocation of resources to help the most vulnerable in our community where and how they need it most.”
