100,000 San Antonio residents could lose Medicaid under GOP budget, Joaquin Castro warns

More than 100,000 San Antonio residents could lose Medicaid coverage under the Republican budget resolution that narrowly passed the House Tuesday, U.S. Rep. Joaquin Castro said.

Castro, a San Antonio Democrat, made the statement in an Instagram video shot on the steps of the U.S. Capitol building ahead of the vote. He said he would vote against the resolution.

Castro was joined by every other Democrat in the House and one Republican — U.S. Rep. Thomas Massey of Kentucky — in opposing the resolution. The measure passed on a narrow 217-215 margin after an arduous whip effort on the right, according to multiple media reports.

“I’m voting NO on the Republican plan to cut hundreds of billions of dollars from Medicaid and nutrition assistance to fund tax cuts for billionaires,” Castro said in the caption of his Instagram clip. “More than 4 million Medicaid recipients in Texas — mostly children and seniors — could lose their health care under this plan.” 

In the video, Castro added that Texas is already the least insured state in the country.

A more reserved version of the budget already passed the Senate, where it will return to committee. In other words, President Trump’s “big beautiful bill” still has a way to go to become law.

Although the House budget resolution doesn’t name Medicaid specifically, it instructs the Energy and Commerce Committee, which oversees the program, to find $880 billion worth of cuts, the Associated Press reports. Critics warn those cuts are likely to come from Medicaid.

The Supplemental Nutrition Assistance Program (SNAP), the nation’s food-stamp program, also is potentially on the chopping block. The resolution directs the House Agriculture Committee to cut $234 billion through 2034 from programs under its purview, with most or all of the funds expected to come from SNAP, according to a Center on Budget and Policy Priorities report.

The rate of reliance on SNAP assistance in San Antonio is higher than the state average, according to University Health. At least one in four households on San Antonio’s South Side rely on SNAP, for example.
The version of the budget that passed the House drastically expands the scope of the cuts in the narrower resolution adopted by the Senate. That proposal called for $1 billion in SNAP cuts as opposed to the House’s figure of $234 billion over the same period.
The proposed whittling away of entitlement programs will help pay for some of the $4.5 trillion in tax cuts for the ultra-wealthy laid out in the House measure. Bernie Sanders calls this a “reverse Robin Hood” — taking from programs for the poor to give cuts to the wealthy.

Despite attempting to partially pay for the tax cuts by slashing programs for the poor, the cuts could increase the deficit by $2.8 trillion, according to the Committee for a Responsible Budget, a nonprofit advocating for federal fiscal discipline.

Initially, the vote faced an uphill battle in the House. Several Republicans — including not just Kentucky’s Massey but also U.S. Reps. Tim Burchett, Warren Davidson and Victoria Spartz — came out against the resolution.

The AP reports Trump called the handful of skeptical Republicans and invited them to the White House. In the end, Massey was the party’s sole holdout.

“If the Republican plan passes, under the rosiest assumptions, which aren’t even true, we’re going to add $328 billion to the deficit this year,” Massey told CSPAN from the Capitol. “We’re going to add $295 billion to the deficit the year after that, and $242 billion to the deficit after that — under the rosiest assumptions. Why would I vote for that?”

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This article appears in Feb 19-25, 2025.