Surviving High Prices & Budget Cuts

Federal funding has been slashed for local healthcare and human services providers. Here’s what to know to face challenging days. 

By Jim Gorant

Sheri has been clean for three years. The Morristown resident has a job and a place to live as she wages her ongoing battle with opioid use disorder. She takes part in therapy and receives regular injections of medication, all of it paid for by Medicare. “The thought of not having healthcare and access to my medications that are keeping me alive and clean really does something to me,” she says. “I don’t know where I would be right now, probably suffering in the horrors of addiction and God knows what else. The Brixadi shot costs over $1,000 without the insurance that I have now. There is no way that I can afford that if I were to ever lose my Medicaid.”

She might. 

For everyone in Dover, Morris County, throughout the state, and across the U.S., change is coming. The provisions of the Federal Reconciliation Bill H.R. 1, sometimes called the “One Big Beautiful Bill,” will alter several programs, but none more notably than those for low-income residents: Medicaid, SNAP (Supplemental Nutrition Assistance Program), as well as the insurance markets created by the Affordable Care Act. Most of the changes don’t take effect until late 2026/early 2027, with others phasing in over the following five years, but the impacts are already being felt.

“The emergency food system is under strain at the same time healthcare is in a spiral,” says Heather Thompson, executive director of Table to Table, a nonprofit food rescue

organization. “Those two things together could have a devastating impact.”

MEDICAL SERVICES

NJ FamilyCare, the state’s Medicaid program, served roughly 1.85 million people in

2025, according to the New Jersey Department of Human Services (DHS). About 36% of the beneficiaries were children, and another 17% were classified as “aged, blind, and disabled.” In Morris County, the numbers included 20,000 households with Medicaid recipients.

DHS estimates that 375,000 people are at risk of losing coverage, most of them low-income residents who were allowed to gain Medicaid benefits through the Affordable Care Act expansion. The drop-off stems, in part, from a requirement that beneficiaries work or volunteer at least 80 hours a month, and that they file paperwork verifying their status twice a year, instead of just once, as is presently mandated. They’ll also have to submit a co-pay of up to $35 for services. “It might not seem that big, but those extra burdens could cause people to lose coverage, even for those who may be eligible,” says Fran Palm, the CEO of Zufall Health, a Dover healthcare staple, which also has other state locations.

The work/volunteer and filing provisions will also apply to a wider group of people,

encompassing adults 18-64 years old (instead of 18-54) without dependents. Some non-

citizen groups will simply lose eligibility, including refugees, individuals granted asylum,

Cuban/Haitian entrants, victims of domestic violence, trafficking victims, and temporary

humanitarian parolees.

These will not be the only changes for those buying insurance through Get Covered New Jersey, the marketplace created by the Affordable Care Act. For roughly 450,000 of the more than 513,000 enrollees, cuts to the program and expiring credits will lead to higher rates—somewhere between 13% and 18%, according to projections. At the same time, the enrollment period will drop from three months to six weeks, stretching from Nov. 1 to Dec. 15. The bill eliminates policy auto-renewals, so Affordable Care Act enrollees must renew in that shortened window or likely lose coverage.

FOOD INSECURITY

Nearly $2 billion in SNAP benefits went to more than 800,000 New Jerseyans in 2024, with 10,229 households in Morris County. In the future, New Jersey will have to pick up a larger share of those costs, which could run between $100 million and $500 million annually, according to state DHS estimates. The program’s administrative costs had been shared 50-50 between the federal and state governments. However, under the new law, the federal government will pay 25% and New Jersey will have to make up the difference, roughly $90 million, with about $78 million of that total coming from the counties.

At the same time, the program will experience eligibility changes similar to those for Medicaid. The work/volunteer (80 hours), age ranges (18-64), and verification frequency (every six months) are the same, although there are exemptions for veterans, people experiencing homelessness, and recent foster care residents. Several non-citizen groups will lose coverage, including Haitian arrivals, refugees, people who have been granted asylum, survivors of human trafficking, domestic abuse victims, deportees withheld because they face violence, parolees, and certain native tribe members who are not citizens.

A related program, SNAP-Ed, which educates users on how to eat nutritionally on a limited budget, has already been eliminated. That program served 5,000 people in Morris County in 2024, according to Zufall Health, which administered the program. In Dover, Zufall is seeking ways to avoid laying off its SNAP-Ed team.

“It’s very difficult out there. We’re talking about the most at-risk segment of the population, and a lot of people are under tremendous stress. More people are showing up at food banks, not only for food but to ask questions,” says Thompson, whose Table to Table sources food waste from 400 facilities and donates it to more than 300 distribution outlets. Some of those serve Dover, including nourish.NJ, Community Hope, and MCOHA (Morris County Organization For Hispanic Affairs). Those food banks and others—Sacred Heart & Holy Rosary Roman Catholic Church, the Foodshed Alliance, and Grow it Green—hope to pick up at least some of the shortfall.

Faith Kitchen in Dover serves lunch daily to 70 to 100 people and distributes approximately 30 bags of groceries a week to town residents, who can come once every three weeks. Executive Director Judy Miller says that if more people started showing up, they “might be unable to increase the food amounts due to rising costs, but,” she adds, “I always have faith that there will be enough. The Interfaith Food Pantry Network serves Morris County residents and supports approximately 800 families in Dover annually. They also help people navigate applications and the paperwork needed to enroll in programs and remain eligible. Zufall Health and the Community FoodBank of New Jersey have trained staffers ready to help residents apply for and retain eligibility, too, and are open to anyone.”

ASK QUESTIONS

Officials say that, while there is some possibility that Congress could make late adjustments to H.R. 1, that is far from a sure thing. They say that anyone who requires federal services for themselves or their family must be aware of these changes and be their own advocates. The Department of Human Services also plans to add advisors who can answer questions and assist people in filling out paperwork and verifying their details on time. Leaning on those resources might be the best anyone can do right now. 

“Reach out to state and county social services,” says Palm of Zufall Health, ticking off a list of steps people can take. “Make sure they know how to find you. Keep your address current. Find people who can help with the paperwork.”

All of those steps imply what Carolyn Lake, executive director of the Interfaith Food Pantry Network, says is the most important of all: “Remember, it’s okay to ask for help.”

Jim Gorant is a journalist and author of the New York Times bestseller The Lost Dogs. He is a New Jersey native.