Massive cuts under President Donald Trump’s signature spending bill could be an “unmitigated disaster” for kids, even though they aren’t the direct targets of the largest slash to Medicaid and food stamps in the nation‘s history, some who work with families and social services said.

While kids will still be eligible for their coverage under federal health care and food programs, cuts outlined in the “One Big Beautiful Bill” will impact the adults in children’s lives, causing challenges for whole families. The bill could reduce access to free school lunches and create additional hoops for parents who rely on federal assistance.

Melissa Boteach, chief policy officer for Zero to Three, which advocates for infants and toddlers, said the “sweeping and draconian cuts and changes” will affect babies and kids on multiple levels because they rely on adults.

“Babies can’t take care of themselves,” Boteach said. “The attacks on the basic supports that families rely on, from health care to nutrition to early education and child care, have meant that not only have babies lost access to services and supports, but that there’s been increased chaos and fear in their communities, which in turn, affects their relationships with their caregivers, and that affects their brain architecture and development.”

In Maryland, nearly 700,000 people, or 1 in 10 households, are served by the Supplemental Nutrition Assistance Program, known as SNAP and sometimes referred to as food stamps. Nearly half of those households include children.

The Trump changes expand SNAP work requirements for some, including parents of children 14 and older, and shifts some of the payment burden to states. Nationwide, 22.3 million families are expected to lose some or all of their SNAP benefits, with an average drop of $146 per month, according to the Urban Institute. In Maryland, 369,000 families could be impacted and those with children could lose $81 a month on average.

LaMonika Jones, director of Maryland Hunger Solutions, said that on top of this, all states, including Maryland, are already grappling with increased administrative costs.

“They have to figure out, number one, ‘How am I going to cover these costs where I’ve never had to pay these before?’” Jones said. “And it’s going to come at the expense of essential services that our families and our households take advantage of.”

U.S. Rep. April McClain Delaney, a Democrat who represents rural Western Maryland and northern Montgomery County, said Maryland‘s strong federal and state delegations have focused on plugging the holes “as best we can.” Still, while states could maybe absorb one or two changes, it’s a “world of hurt” when all the cuts come together, she said.

“Everyone in my district is going to feel the impacts of this,” McClain Delaney said. “But sadly, I think our children will the most.”

SNAP cuts can impact entire communities, including how many schools are able to provide free breakfast and lunch for all their students.

Schools or districts with at least 25% of students on public assistance like SNAP automatically qualify for free meals. The process cuts down on paperwork and reduces stigma for kids whose families can’t afford to pay, said Erin Hager, a professor at the Johns Hopkins Bloomberg School of Public Health.

“If we see cuts in SNAP and Medicaid, then the likelihood that those districts will be able to continue those programs goes down dramatically,” Hager said.

If parents have to apply on their own, the added administrative burden means some families won’t do it. That’s especially true if there are additional risk factors, such as households where some family members are undocumented, Jones said. That means “we’re running the risk of a high number of students and children in the state of Maryland experiencing food insecurity.”

And that could lead to all sorts of adverse outcome for kids, affecting their weight, blood pressure, school attendance and academic outcomes, said Hager, who is also a nutritional epidemiologist.

“Beyond the child, the impact on the families of knowing your child’s going to have access to a healthy school meal, it reduces stress for the parent,” Hager said. “Access to healthy, free school meals has been consistently shown to be a positive thing for families and communities.”

In Maryland, 1 in 4 people are enrolled in Medicaid, which in 2024 included 530,000 children between the ages of 0 and 17, according to The Hilltop Institute at the University of Maryland, Baltimore County. Around 175,000 Marylanders could lose Medicaid coverage, and the state could lose $2.7 billion in federal funding.

The changes to Medicaid around work requirements will largely affect childless adults but will also impact children, said Morgan Henderson, director of analytics and research at Hilltop. Other states instituting work requirements has led to a “tremendous amount of confusion.” People may assume they’re included in the changes and not apply for coverage they’re entitled to.

“The research indicates when adults lose their Medicaid coverage, as some will, rightly or wrongly,” Henderson said, “the children in that household, they also tend to lose coverage.”

Under the bill, some Medicaid beneficiaries are going to have to redetermine their coverage every six months instead of annually. The additional paperwork will put a strain on the overall system, especially when it comes to case workers — who are the same people who work on children’s cases said Hilltop’s executive director, Alice Middleton.

And when more people go uninsured, the entire health care landscape can bear the cost, Henderson said. People will go to emergency rooms to seek care even if they can’t pay, and not all hospitals can afford to cover the costs. Those hospitals may cut off expensive services or in extreme cases, close, though he noted Maryland hospitals bear a “pretty modest” risk. Hospitals may also try to negotiate higher rates for commercial patients, which can drive premiums up for everyone.

Tanesha Williams likely couldn’t afford to see her health care costs rise. Williams has insurance through her job and said when she’s looked into independent coverage, it’s been expensive. With two kids on Medicaid, Williams has used the coverage for her teenager and toddler’s blood testing, specialist visits, allergy medicine and even surgery and physical therapy.

While her kids aren’t likely to lose coverage, Williams said that if she ever had to go without Medicaid, she’d have to go into debt, have to give up basic necessities or even delay care, leading to long-term health detriments. Those are choices that could be facing families.

“It’s like a well-oiled machine. All the working parts have to be efficient,” the Perry Hall mom said. “With parents being able to work and provide housing for their child and not have to cut back on paying their rent or things like that, it cuts down on like homelessness. It cuts down on hunger.”

Williams works at a child care center that offers Head Start, free early childhood education for low-income families. Children often need documented medical visits to attend school, something they can’t get without health coverage.

School can also be where kids eat most of their meals. Summer and after-school programs, where kids are also fed, were left scrambling when the U.S. Department of Education withheld over $110 million from the state earlier this month. That was restored, but steeper cuts loom.

To make up for cuts, states may have to consider scaling back investments in early childhood, the years during which most brain development occurs, Boteach said. Budget woes have already trickled down to young children statewide, including the freezing of the child care scholarship.

“When these cuts go into effect, the children who lose access to health care, the children who lose access to services to identify and help with disabilities, the children who lose access to nutrition, that is not just going to affect them in those three years,” Boteach said. “That will affect them throughout their life course.”

About the Education Hub

This reporting is part of The Banner’s Education Hub, community-funded journalism that provides parents with resources they need to make decisions about how their children learn. Read more.