Federal cuts to Medicaid and food-assistance programs are expected to place greater strain on Arlington’s most vulnerable residents and the social services that support them.
Arlington County officials, health-care workers and nonprofits are still scrambling to determine the local impacts of the new federal spending bill approved last week.
However, they foresee significant challenges following legislators’ approval of legislation that paves the way for $1 trillion in cuts to Medicaid funding and a $186 billion reduction in spending on the Supplemental Nutrition Assistance Program (SNAP) over the next 10 years.
In fiscal year 2024, Arlington was home to 29,307 Medicaid recipients, around 8,000 of whom were covered under Medicaid Expansion. Meanwhile, about 10,000 Arlington residents receive benefits from SNAP, according to county data from last June.
While existing nonprofits such as the Arlington Free Clinic and Arlington Food Assistance Center (AFAC) help to fill gaps in the social safety net, experts warn that direct and downstream impacts of the new spending bill may put these organizations to the test.
Arlington County Board Chair Takis Karantonis said that the county is “actively monitoring the implementation and aftermath of this legislation” to respond to the local impacts.
“It is too soon to fully grasp all the potential impacts the federal budget reconciliation bill will have on Arlington County, but the Board is deeply concerned that the legislation will have devastating effects on our residents and our community,” he told ARLnow. “The cuts to the social safety net are especially concerning as thousands of people in Arlington rely on these programs.”
How Medicaid cuts could impact Arlington
The County Board increased the county’s stabilization fund by $11.5 million this fiscal year.
Created for situations where there’s a significant drop in federal funding, the fund now stands at $33 million. Despite the over 50% increase in that fund, the county still depends heavily on federal spending for a wide range of programs, from schools to housing vouchers.
For instance, Arlington relies on more than $40 million in federal human services-funding each year — some of which is now at risk.
Brian Marroquin, chair of the county’s Social Services Advisory Board, is particularly concerned about any reductions to Medicaid Expansion, which serves adults 19-64 who earn below 138% of the Federal Poverty Level.
According to Marroquin:
There are more than 8,000 Arlington residents who are on Medicaid Expansion (see state Medicaid dashboard here). The majority of these folks are employed – contrary to stereotypes of people in poverty. Also, undocumented people are barred from receiving Medicaid expansion. But, because of low wages and high cost of living in our region, they earn less than $21k for an individual or $44k for a family of four. What happens when someone loses Medicaid? They go without care for as long as they can. They go to work sick. They take Tylenol to treat chronic and potentially life-threatening conditions. When they can no longer put it off, they reluctantly go to the ER and run the risk of ending up with medical debt, which can harm their credit score for years. Those who don’t interact with these public benefit systems often assume that free clinics can bear the burden, but those systems are already taxed and cannot handle the demand without more support.
Compared to other counties in Virginia, Arlington has a relatively low Medicaid coverage rate. As of 2023, about 12% of county residents were enrolled in the program, the fourth-lowest rate in the state.
Even so, Marroquin warned that coming changes may cause more Arlington residents to fall through the cracks. For instance, the nonprofit Arlington Free Clinic, which provides services to low-income residents without insurance, served 1,500 people in 2024 — a much smaller number than those currently covered under Medicaid Expansion.
Arlington Free Clinic CEO Lesley Daigle said that the clinic will continue to act as a safety net option of last resort.
“Whatever the cause, factors that lead to a loss of coverage impact all of us and are a clear reminder of AFC’s importance as the healthcare safety net option of last resort,” Daigle told ARLnow. “The role we play in the Arlington community has never been more important.”
Hospital impacts
Julian Walker, vice president of communications for the Virginia Hospital and Healthcare Association, said the association was “deeply disturbed” by the budget plan’s cuts, particularly the Senate’s version of the bill, which was ultimately approved by the House.
Walker said the cuts “jeopardize the stability and survival of hospitals, pose real harm to access to care for hundreds of thousands of Virginians, and significantly weaken our economy and employment.”
“[The bill] would cost Virginia hospitals more than $2 billion annually in essential funding that helps them sustain their operations, employ people in communities across the Commonwealth, and care for people in their moment of need,” Walker said. “The effect of that financial impact would be devastating to hospitals.”
Walker said the cuts could lead to the closure of hospitals in more rural parts of Virginia while others could have cuts to services or reduce employment.
SNAP cuts
Beyond the cuts to Medicaid, the tax cut bill will also slash SNAP benefits, commonly known as food stamps.
Marroquin said cuts to programs like Medicaid and SNAP put intense pressure on local nonprofits like AFAC, Arlington’s largest food pantry.
“Destabilizing household budgets like this increases demand not only for Arlington DHS, but also from safety net nonprofits who already face budgetary pressures either because of direct cuts and/or because of decreased giving from donors who may be affected by cuts as well,” Marroquin said. “It’s hard to understate the domino effect from these federal changes.”
AFAC CEO Charlie Meng told ARLnow he expects to see increased demand for its services as a result of cuts.
“A reduction in SNAP means that [families] will be coming to us more often,” Meng said. “Unfortunately, it also means that the food that we provide to our families is really not enough for them over the long haul.”
News of SNAP cuts come as the pantry experiences record-high referrals and referral participation rates. It currently serves about 4,000 families per week, and Meng predicts this number could reach 5,400 by November.
The County Board approved an additional $750,000 in one-time funds for AFAC last year following years of growing demand.
“While I don’t know that [the county government] has plans, I know that they’re planning very seriously, and I trust that those plans involve, you know, organizations like AFAC that provide needed services to the county citizens,” Meng said.
In an email to AFAC supporters earlier this month, Meng wrote that the organization is facing some financial obstacles after overspending its food budget by $1.2 million last year to meet demand.
“Maintaining this level of service in the year ahead will be a challenge,” Meng wrote. “We have started the new year with a budget deficit almost guaranteed, so meeting the inevitable surge in demand for food assistance will be very difficult without your support.”
The county’s FY 2026 budget funds less than 10% of AFAC’s budget, in addition to providing $105,000 to Meals on Wheels and $150,000 in one-time funding for Food Security Mini-Grants. These will benefit several local nonprofits announced this September.
Cascading problems
Part of the concern, Marroquin said, is the Medicaid and SNAP cuts could hit exactly at the time when locals laid off from federal jobs earlier this year need that safety net the most.
“The job market doesn’t produce jobs with consistent, predictable hours and benefits like it once did,” Marroquin said. “So, piling on bureaucratic reporting requirements will mean that many people who are working in precarious jobs will lose health insurance anyway.”
He warned that this will likely lead to worse health outcomes.
“Once they do get sick, rather than manage illness through primary care they’ll have to go to the emergency room — ending up with worse health outcomes themselves and increasing waiting times and cost for everyone,” he said. “Free clinics and charity care cannot make up this gap.”
One of Marroquin’s biggest frustrations is the Medicaid cuts could reverse recent progress in driving down the uninsured rate in Virginia.
“It’s lamentable because we were moving in the right direction with Virginia’s uninsured rate reaching an all-time low of 8%, down from nearly 18% in 2013,” Marroquin said. “This misguided policy will likely reverse that trend.”
