Democrats are set to take control of Congress in January as sweeping cuts to Medicaid and SNAP begin to hit households, including thousands of Philadelphians who have already lost benefits.

The One Big Beautiful Bill Act cuts nearly $1 trillion from Medicaid and about $200 billion from SNAP over 10 years; since eligibility changes began in September 2025, 36,000 Philadelphia residents have lost SNAP benefits.

Across Pennsylvania, SNAP enrollment fell by about 239,000 from July 2025 to September 2026, with roughly 123,000 people losing benefits because of eligibility changes and work requirements, including those in Philadelphia.

Medicaid coverage changes have begun for some immigrants, and an estimated 183,000 Philadelphia residents enrolled through the Affordable Care Act Medicaid expansion could be affected starting Jan. 1; state estimates say more than 70,000 people in Philadelphia and 300,000 statewide could lose coverage.

Advocates warn that six-month renewal cycles, new reporting rules and work or community-service requirements could make benefits harder to keep while adding significant administrative burdens for recipients and states.

Democrats campaigned on reversing the Republican cuts, warning they could leave children hungry, close rural hospitals and cost lives; the White House argues the reductions curb waste and target aid to those who need it, while researchers and advocates say Medicaid and SNAP reduce hunger and poverty and save lives.

Although Democrats won their largest midterm popular-vote margin since the Watergate scandal, enacting their agenda will be difficult while Donald Trump remains president and can veto legislation.

Democrats lack the two-thirds majorities needed to override a presidential veto, so experts say they may have to use their congressional leverage to negotiate changes through other legislation and funding bills.

Restoring safety-net funding will likely require cooperation from Trump, who appears to be preparing for partisan fights.

Pennsylvania has begun covering 75% of SNAP administrative costs, up from half, and could owe as much as $400 million toward benefits by next October; the Senate version of the pending 2026 Farm Bill would delay the state-payment requirement by a year.

Experts urge Democrats to prioritize restoring benefits and explaining upcoming changes to constituents, while also recommending restored enhanced Affordable Care Act tax credits and expanded Earned Income Tax Credit and child tax credit.

Newly elected Democrats say voters expect action, not excuses, despite the obstacles in Washington.