Whitney Premeaux always dreamed of becoming a mom. Fifteen years ago, that dream came true as she welcomed her son Dayton into the world.
But as Dayton grew, so did his health challenges.
The now 15-year-old was diagnosed with a rare genetic disorder called tuberous sclerosis complex, or TSC, which causes tumors to grow on his vital organs.
"He has them in the brain, the heart, the kidneys," Premeaux said. "Ninety-five percent of Dayton's brain is made up of tumors."
That's led to more complications and more diagnoses — intractable epilepsy, visual impairment, autism and developmental delays. Premeaux said things started to get dire in 2018 when Dayton began experiencing violent episodes.
"He would scream, cry, hit, bite and bang his head into the ground or walls," she said. "Every night, instead of singing lullabies and reading our favorite bedtime stories, we were praying to survive another day."
Things started to look up when Dayton was granted a Medicaid waiver. They got access to in-home care attendants, behavior support and respite services, among other things.
But now Premeaux and her family are at risk of losing those services, as Congress debates a spending plan that could severely reduce federal funding for Medicaid and the Supplemental Nutritional Assistance Program — also known as SNAP, or food stamps.
On Thursday, the U.S. House narrowly passed a sweeping spending bill that would slash about $3.8 trillion in taxes and scale back social safety net programs including Medicaid and SNAP. The final vote tally was 215-214.
"The House has passed generational, truly nation-shaping legislation to reduce spending and permanently lower taxes for families and job creators, secure the border, unleash American energy dominance, restore peace through strength and make government work more efficiently and effectively for all Americans," House Speaker Mike Johnson said after the vote.
The goal of the plan — known as the "One Big Beautiful Bill Act" — is to slash taxes and steer more money toward the military and border security. To do so, House Republicans proposed changing the funding structure of SNAP, so states will have to chip in more. They've also added work requirements for able-bodied recipients who don't have dependents.
House Republicans applied those work requirements to Medicaid as well. Currently, the bill would require childless adults without disabilities to work 80 hours per month to qualify for benefits.
Supporters like Houston-area Republican Rep. Dan Crenshaw say the goal isn't to take Medicaid away from those who need it, but to make sure no one is taking advantage of the system.
"There's people who shouldn't even be on it, who aren't eligible, but still are," Crenshaw said during a recent interview with Fox Business. "They don't know it and even though they don't use it, that costs the government something. So, there's actually a lot we can do without ripping any food from anyone or ripping away people's Medicaid."
Meanwhile, House Democrats slammed Republicans for the cuts.
"Let me be clear: these programs are lifelines for millions of working families — the same folks Republicans were elected to represent," Dallas Democrat Rep. Jasmine Crockett wrote in a statement. "This bill would strip health care from 14 million Americans — including nearly 130,000 people in my district who rely on Medicaid. And it would rip food from the tables of at least 3 million Americans, including 115,000 folks in my district who rely on SNAP to feed their families."
Trump's tax bill now heads to the U.S. Senate for consideration.
Premeaux, who spoke to reporters on a media call earlier this month, said her son is a powerful example of how devasting it could be to lose federal Medicaid funding, but the impacts will affect communities across the state.
"The program is also a vital lifeline to help folks get regular check-ups, access cancer screenings, manage chronic illness and more," she said.
The Joint Economic Committee estimates roughly 1.4 million Texans will lose health insurance because of Medicaid cuts. The state already has the highest number of uninsured residents in the country.
"There are so many working Texans who don't make enough money," said Lynn Cowles, Director of Health and Food Justice at Every Texan. "They can't afford health insurance, they can't afford to put full meals on the table, and so we have these public assistance programs to help them get by."
It's not just people enrolled in Medicaid who will be affected. Cowles says Medicaid funding helps keep Texas hospitals operating.
"If Medicaid dollars can't fund these hospitals, you're talking about not only the hospital closing but taking all of the jobs and infrastructure with it," she said. "These funding cuts are going to affect literally everybody in Texas."
SNAP is just as vital for many Texas families: The state has the second-highest rate of food insecurity in the nation and roughly one in 10 families receives SNAP benefits every month.
The current proposal to cut SNAP benefits would alter the program's funding structure, requiring states to chip in about 25% of the costs for SNAP. That would require Texas to put $2 billion of the state's budget toward SNAP, said Liz Pancotti, managing director of policy and advocacy at Groundwork Collaborative. That's expected to balloon to $17 billion over the next 10 years.
"To close that funding gap, Texas would have to pass legislation and would likely have to reduce benefits, reduce eligibility or both," Pancotti said. "These are really dire consequences."
It also raises the question of where that funding would come from, she added.
"Does it come from K-through-12 public education budgets?" she said. "Does it come from health and Medicaid budgets? Texas would be faced with some pretty tough choices about where to find that money."
Those economic impacts could trickle down to local economies as well. If low-income Texans are spending more of their own income on health care and groceries, they'll have less to spend in their communities.
"If consumer demand ultimately drops as a result of these, you could see the knockdown effects on small businesses," Pancotti said. "Spending on hospitality and leisure or at local retailers could really fall because people are forced to spend more of their income on essentials like groceries and health care."
Rural parts of the state would be hit especially hard. Unemployment rates are higher in rural communities, where job opportunities are more scarce or the distance too far for some low-income families who may not have access to transportation for work travel.
And that could have an outsized economic impact in these places if the One Big Beautiful Bill Act passes in the Senate, said El Paso Precinct 3 County Commissioner Iliana Holguin, whose district is made up of primarily small, rural communities outside the city of El Paso.
"Grocery stores keep small communities intact," Holguin said. "If people can no longer afford groceries or have to move to find work to meet these new requirements, grocery stores in small communities will inevitably close and towns will begin to empty."
Families like Whitney Premeaux's who utilize social safety nets say they know first-hand the system isn't perfect. But she said she wants lawmakers to come up with a solution that allows her and others to keep their benefits.
"The system is broken, outdated and failing," she said. "But budget cuts will leave families hopeless."
Got a tip? Email Rebekah Morr at rmorr@kera.org.
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