WASHINGTON (AP) — The impact of the massive spending bill that President Donald Trump signed into law on Independence Day is expected to filter down to infants and toddlers — a segment of the population that is particularly vulnerable to cuts to the federal social safety net.

Many middle-class and wealthy families will see benefits from the new legislation, but programs that help low-income families keep babies healthy have been cut back. While state money funds public schools and preschool in some cases, programs supporting the youngest children are largely backed by the federal government.

The law extends tax cuts that Trump passed during his first term in office and pours billions more into border security as the president seeks to broaden his crackdown on immigration. To pay for these initiatives, the law cuts Medicaid and food stamps — programs relied upon by poor households with children — by more than $1 trillion.

The legislation Republicans called Trump’s “big beautiful bill” is set to deliver some gains for families with children. It increases tax credits, including one that now allows parents to deduct up to $2,200 per child from their tax bills. And it introduces investment accounts for newborns dubbed “Trump Accounts,” each seeded with $1,000 from the government.

Still, advocates say they do not make up for what children are likely to lose under the new law. And they fear what comes next, as the next Trump budget proposes more cuts to programs that help parents and babies.

Medicaid cuts could add to strains on families

Over 10 million Americans rely on Medicaid for health care. About 40% of births are covered by Medicaid. Newborns, too, qualify for it when their mothers have it.

The new law doesn’t take little kids or their parents off Medicaid. It institutes Medicaid work requirements for childless adults and adults with children over the age of 13. But pediatricians warn the cuts will be felt broadly, even by those who do not use Medicaid.

The Medicaid cuts are expected to put a financial strain on health care providers, forcing them to cut their least profitable services. That’s often pediatrics, where young patients are more likely to use Medicaid, said Lisa Costello, a West Virginia pediatrician who chairs the federal policy committee for the American Association of Pediatrics.

The ripple effects could exacerbate an existing shortage of pediatricians and hospital beds for children.

“Any cuts to that program are going to trickle down and impact children, whether that’s pediatric practices who depend on Medicaid to be able to stay open or children’s hospitals,” Costello said.

States also use Medicaid to pay for programs that go beyond conventional medical care, including therapies for young children with disabilities. Under the new law, states will foot a greater portion of the bill for Medicaid, meaning optional programs are at risk of getting cut.

Advocates worry that if an adult loses Medicaid coverage, it could ratchet up household stress and make it more difficult for parents to make ends meet, both of which can negatively impact youngsters. And parents who lose their health insurance are less likely to take their children to the doctor.

“When parents lose their health insurance, they often think that their children also are no longer eligible, even if that’s not the case,” said Cynthia Osborne, a professor of early education and the executive director of the Prenatal-to-3 Policy Impact Center at Vanderbilt University.

The law increases tax credits for parents who qualify

The law increases the child tax credit to $2,200 per child, up from $2,000. But parents who don’t earn enough to pay income tax will still not see the benefit, and many will only see a partial benefit.

The measure also contains two provisions intended to help families pay for child care, which in many places costs more than a mortgage. First, it boosts the tax credit parents receive for spending money on child care. The bill also expands a program that gives companies tax credits for providing child care for their employees.

Both measures have faced criticism for generally benefiting larger companies and wealthier households.

“It’s a corporate business tax break,” said Bruce Lesley, president of the advocacy group First Focus on Children. “It makes their child care dependent upon working for an employer who has the credit.”

‘Trump Accounts’ will be opened with $1,000 for newborns

The law launches a program that creates investment accounts for newborn children. The “Trump Accounts” are to be seeded with $1,000 from the government, and children will be able to use the money when they become adults to start a new business, put the money toward a house or go to school.

Unlike other baby bond programs, which generally target disadvantaged groups, the federal program will be available to families of all incomes.

The program’s backers have pitched the accounts as a way to give young people a boost as they reach adulthood and teach them about the benefits of investing. Critics have argued that families in poverty have more immediate needs and that their children should receive a larger endowment if the goal is to help level the playing field.

A food assistance program faces cuts

The Supplemental Nutrition Assistance Program (SNAP) faces the largest cut in its history under the law. It will, for the first time, require parents to work to qualify for the benefit if their children are 14 or older. But even households with younger children could feel the impact.

The law kicks some immigrants — including those with legal status — off food assistance. It makes it more difficult for individuals to qualify by changing how it considers their utility bills.

SNAP has historically been funded by the federal government, but under the new law, states will have to shoulder some of the financial burden. Cash-strapped governments could decide to implement new requirements that would make it more difficult for people to qualify, said Katie Bergh, a senior policy analyst with the Center on Budget and Policy Priorities. Some states may decide to exit the program altogether.

“When young children lose access to that healthy nutrition, it impacts them for the rest of their lives,” Bergh said. “This bill fundamentally walks away from a long-standing nationwide commitment to making sure that low-income children in every state can receive the food assistance that they need.”

___

The Associated Press’ education coverage receives financial support from multiple private foundations. AP is solely responsible for all content. Find AP’s standards for working with philanthropies, a list of supporters and funded coverage areas at AP.org.

Moriah Balingit, The Associated Press

Elon Musk’s plan to create a new political party puts him in the company of a long line of business and political titans looking to upend the two-party system that has dominated U.S. politics since almost the beginning.

From the Anti-Masonic Party in the early 1800s to last year’s ill-fated No Labels, nascent political parties have been a near-constant feature of U.S. politics. Some are impactful, others ephemeral, but few endure for long.

Though the Republican and Democratic parties have had a lock on political power since the Civil War, they have remade themselves over and over, often when faced with the prospect of losing voters to third parties.

The name Musk chose, the America Party, is bland compared to some of history’s more memorable movements — the Know-Nothing Party, the Bull Moose Party, the Dixiecrats.

Musk’s plans remain murky, but some of his public comments suggest he’s eying a limited goal, focusing on a handful of House races to gain influence without trying to win a majority.

“One way to execute on this would be to laser-focus on just 2 or 3 Senate seats and 8 to 10 House districts,” Musk wrote on X. “Given the razor-thin legislative margins, that would be enough to serve as the deciding vote on contentious laws, ensuring that they serve the true will of the people.

Here’s a look at how third parties have made their mark through American history, even without winning the White House or congressional majorities.

Anti-Masonic Party

The first third party, the Anti-Masons emerged in 1828 in opposition to the Freemasons, a secret society. The disappearance of William Morgan, a former Mason who had threatened to expose secrets, fueled widespread paranoia about the shadowy group, which many believed was covertly controlling the government.

The Anti-Masons evolved into a broadly anti-elite party. They were the first party to hold a convention to nominate a presidential candidate and to adopt a party platform, pioneering enduring staples of American democracy.

They held seats in the House for a decade, peaking at 25 after the 1832 election. That year, Anti-Mason presidential nominee William Wirt won Vermont, becoming the first third-party candidate to get electoral college votes, though his seven electoral votes did not affect Andrew Jackson’s decisive victory over Henry Clay.

The Anti-Masons were largely absorbed into the Whig Party.

Free Soil Party

“Barnburner Democrats” and “conscience Whigs,” anti-slavery factions, joined with remnants of the short-lived abolitionist Liberty Party to form the Free Soil Party after the Mexican American War. Free Soilers won a handful of House seats between 1848 and 1854.

Former President Martin Van Buren, who had served one term as a Democrat a decade earlier, was the Free Soil presidential nominee in 1848 but didn’t win any electoral votes.

As the U.S. expanded westward, the Free Soil Party advocated banning slavery in the new territories but not abolishing it in the places it already existed. The party described its principles with the slogan “free soil, free speech, free labor and free men.” Free Soilers pitched opposition to slavery on economic rather than moral grounds, arguing that expanding slavery would take jobs from Northern whites.

The party dissolved after the Kansas-Nebraska Act of 1854 thrust slavery further into the political fray, upending the political coalitions. Despite its short life, however, the Free Soil Party laid the groundwork for the Republican Party.

‘Know-Nothings’

The outgrowth of a secretive nativist movement, the anti-Catholic American Party opposed immigration, especially of Catholics. If asked about the party, members would say they “know nothing,” leading to the nickname.

Know-Nothing nominee Millard Fillmore, a former Whig Party president, won Maryland and its eight electoral votes in the 1856 election.

Though they won only a handful of House seats, the Know-Nothings showed there was a deep interest in anti-immigration policies and the political salience of ethnic and religious divisions.

Populists

Agricultural distress late in the 19th century catalyzed the rise of the Populists, who advocated aggressive economic and political reforms.

Known formally as the People’s Party, Populists wanted to nationalize railroads, enact a graduated income tax and directly elect senators. They supported the free coinage of silver in opposition to the gold standard’s fixed monetary supply.

In the 1896 presidential election, the Populists cross-nominated Democratic nominee William Jennings Bryan, remembered for his “Cross of Gold” speech calling for free silver. The movement was largely absorbed into the Democratic Party after that.

The party was a force in only two presidential elections, but many of its reforms — including a graduated income tax and the direct election of senators — were adopted during the later progressive era.

Progressive Party (Bull Moose Party)

The Bull Moose Party formed to back Teddy Roosevelt’s 1912 campaign to return to the White House, which he ceded after losing the Republican nomination to William Howard Taft in 1908.

Roosevelt came in second in the electoral college, finishing ahead of Taft, by then the incumbent. Roosevelt’s 88 electoral votes were the most ever won by a third-party presidential candidate. By splitting the Republican vote with Taft, he allowed Democrat Woodrow Wilson to win.

The Bull Moose platform included women’s suffrage, an eight-hour workday and a crackdown on big business. Roosevelt’s strong showing showed the popularity of such reforms, and many were later embraced by both major parties.

Dixiecrats

Southern Democrats opposed to civil rights legislation formed the segregationist States’ Rights Democratic Party. Better known as the Dixiecrats, the party lasted for just one presidential election, nominating South Carolina Gov. Strom Thurmond, who won four Southern states in 1948.

The success of the Dixiecrats broke decades of Democratic dominance in the South and made clear that civil rights was a potent wedge issue, an insight that Richard Nixon would later exploit in his “southern strategy” to win over white voters in the South.

Reform Party

Billionaire Ross Perot put fiscal conservatism at the center of his largely self-funded presidential campaigns in 1992 and 1996.

Perot won 19% of the popular vote in 1992, enough to help tilt the election to Bill Clinton. Perot’s campaigns put a spotlight on the federal budget deficit and the growing national debt, a major force in 1990s policymaking.

Jonathan J. Cooper, The Associated Press

LOS ANGELES (AP) — Growing up, Sage Sol Pitchenik wanted to hide.

“I hated my body,” the nonbinary 16-year-old said. “I hated looking at it.”

When therapy didn’t help, Pitchenik, who uses the pronoun they, started going to the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, the country’s biggest public provider of gender-affirming care for children and teens. It changed their life.

But in response to the Trump administration’s threat to cut federal funds to places that offer gender-affirming care to minors, the center will be closing its doors July 22. Pitchenik has been among the scores of protesters who have demonstrated regularly outside the hospital to keep it open.

“Trans kids are done being quiet. Trans kids are done being polite, and trans kids are done begging for the bare minimum, begging for the chance to grow up, to have a future, to be loved by others when sometimes we can’t even love ourselves,” Pitchenik said, prompting cheers from dozens of protesters during a recent demonstration.

They went to the center for six years.

“There’s a lot of bigotry and just hate all around, and having somebody who is trained specifically to speak with you, because there’s not a lot of people that know what it’s like, it meant the world,” they told The Associated Press.

The center’s legacy

In operation for three decades, the facility is among the longest-running trans youth centers in the country and has served thousands of young people on public insurance.

Patients who haven’t gone through puberty yet receive counseling, which continues throughout the care process. For some patients, the next step is puberty blockers; for others, it’s also hormone replacement therapy. Surgeries are rarely offered to minors.

“I’m one of the lucky ones,” said Pitchenik, who received hormone blockers after a lengthy process. “I learned how to not only survive but how to thrive in my own body because of the lifesaving health care provided to me right here at Children’s Hospital Los Angeles.”

Many families are now scrambling to find care among a patchwork of private and public providers that are already stretched thin. It’s not just patient care, but research development that’s ending.

“It is a disappointment to see this abrupt closure disrupting the care that trans youth receive. But it’s also a stain on their legacy,” said Maria Do, community mobilization manager at the Los Angeles LGBT Center. “I think it showcases that they’re quick to abandon our most vulnerable members.”

The closure comes weeks after the Supreme Court upheld Tennessee’s ban on gender-affirming care for minors, amid other efforts by the federal government to regulate the lives of transgender people.

The hospital initially backed off its plans to close after it announced them in February, spurring demonstrations, but later doubled back.

The center said in a statement that “despite this deeply held commitment to supporting LA’s gender-diverse community, the hospital has been left with no viable path forward” to stay open.

“Center team members were heartbroken to learn of the decision from hospital leaders, who emphasized that it was not made lightly, but followed a thorough legal and financial assessment of the increasingly severe impacts of recent administrative actions and proposed policies,” the statement said.

California Attorney General Rob Bonta has warned that by closing the center, the hospital is violating state antidiscrimination laws, but his office hasn’t taken any further actions. Bonta and attorney generals from 22 other states sued the Trump administration over the executive order in February.

“The Trump administration’s relentless assault on transgender adolescents is nothing short of an all-out war to strip away LGBTQ+ rights.” Bonta told the AP in an email. “The Administration’s harmful attacks are hurting California’s transgender community by seeking to scare doctors and hospitals from providing nondiscriminatory healthcare. The bottom line is: This care remains legal in California.”

LGBTQ+ protesters and health care workers offer visibility

Still wearing scrubs, Jack Brenner, joined protesters after a long shift as a nurse in the hospital’s emergency room, addressing the crowd with a megaphone while choking back tears.

“Our visibility is so important for our youth,” Brenner said, looking out at a cluster of protesters raising signs and waving trans pride flags. “To see that there is a future, and that there is a way to grow up and to be your authentic self.”

Brenner, who uses the pronoun they, didn’t see people who looked like them growing up or understand what being trans meant until their mid-20s.

“It’s something I definitely didn’t have a language for when I was a kid, and I didn’t know what the source of my pain and suffering was, and now looking back, so many things are sliding into place,” Brenner said. “I’m realizing how much gender dysphoria was a source of my pain.”

Trans children and teens are at increased risk of death by suicide, according to a 2024 study from the Centers for Disease Control and Prevention.

Brenner described encountering young patients in the emergency room who are trans or otherwise on the gender-nonconforming spectrum and “at the peak of a mental health crisis.” Brenner wears a lanyard teeming with colorful pins emblazoned with the words “they/them” to signal their gender identity.

“I see the change in kids’ eyes, little glints of recognition, that I am a trans adult and that there is a future,” Brenner said. “I’ve seen kids light up when they recognize something of themselves in me. And that is so meaningful that I can provide that.”

Beth Hossfeld, a marriage and family therapist, and a grandmother to an 11- and 13-year-old who received care at the center, called the closure “patient abandonment.”

“It’s a political decision, not a medical one, and that’s disturbing to me,” she said.

Anna Furman, The Associated Press

Just weeks ago, President Donald Trump said he wanted to begin “phasing out” the Federal Emergency Management Agency after this hurricane season to “wean off of FEMA” and “bring it down to the state level.”

But after months of promises to overhaul or eliminate the federal agency charged with responding to disasters, Trump and his administration are touting a fast and robust federal response to the devastating Texas floods. In doing so, they are aligning more closely with a traditional model of disaster response — and less with the dramatic reform the president has proposed.

The president approved Texas Gov. Greg Abbott’s request for a major disaster declaration just one day after it was submitted, activating FEMA resources and unlocking assistance for survivors and local governments. Homeland Security Secretary Kristi Noem told Trump in a presidential Cabinet meeting Tuesday morning that FEMA was deploying funding and resources quickly. “We’re cutting through the paperwork of the old FEMA, streamlining it, much like your vision of how FEMA should operate,” Noem said.

Noem said the rapid delivery of funds to Texas resembled the “state block grants” model Trump has promoted. It’s an idea that would replace FEMA’s current system of reimbursing states for response and recovery expenses at a cost-share of at least 75%.

But ex-FEMA officials say it’s unclear how the response differs from FEMA’s typical role in disasters, which is to support states through coordination and funding. Instead, they say, the vigorous federal response underscores how difficult it would be for states to take on FEMA’s responsibilities if it were dismantled.

“This is a defining event that can help them realize that a Federal Emergency Management Agency is essential,” said Michael Coen, FEMA chief of staff in the Obama and Biden administrations. “Imagine if an event like this happened a year from now, after FEMA is eliminated. What would the president or secretary (Noem) offer to the governor of Texas if there is no FEMA?”

The Department of Homeland Security and FEMA did not immediately respond to questions about Noem’s remarks, including whether FEMA was doing something different in how it moved money to Texas, or why it resembled a block-grant system.

FEMA will have multiple roles in Texas

While Noem and Trump have emphasized that Texas is leading the response and recovery to the floods, that has always been FEMA’s role, said Justin Knighten, the agency’s director of external affairs during the Biden administration.

“The state is in the lead. FEMA is invited into the state to support,” Knighten said. He said that while Texas’ division of emergency management is one of the most experienced in the country, even the most capable states face catastrophes that overwhelm them: “When there’s capacity challenges and resource need, that’s where FEMA steps in.”

One of FEMA’s primary roles will be to coordinate resources from other federal agencies. If the state needs the Army Corps of Engineers to help with debris removal, Health and Human Services for mortuary support and crisis counseling, or EPA for water quality testing, FEMA arranges that at the state’s request and then reimburses those agencies. “FEMA becomes a one-point entry for all federal support,” Coen said.

The agency also coordinates first-responder support — like search-and-rescue teams deployed from across the country — and reimburses those costs. It administers the National Flood Insurance Program, which gives homeowners and renters access to flood coverage not typically included in general policies.

Those with insufficient insurance or none at all will rely heavily on FEMA’s Individual Assistance program, which supports survivors with needs like temporary housing and home repairs. On Wednesday, the agency is opening disaster recovery centers where households can get help applying for assistance, according to Texas Emergency Management Chief Nim Kidd. The Public Assistance program will reimburse state and local governments for most or all of the costs of infrastructure repairs.

States would have trouble replacing FEMA

While Trump and Noem often say they want states to take on more responsibility in disaster response, experts say the tragedy in Texas underscores how even the most capable states need support.

“It’s true that Texas is very capable, but I think it’s something that people forget that FEMA pays for a lot of state and local emergency capacity,” said Maddie Sloan, director of the disaster recovery and fair housing project at the policy nonprofit Texas Appleseed. The Texas Division of Emergency Management’s budget of over $2 billion is mostly funded through federal grants.

“If a state like Texas asks for federal assistance within two days, the smaller states that are less capable don’t stand a chance,” said Jeremy Edwards, FEMA’s deputy director of public affairs during the Biden administration.

States would have to set up their own recovery programs and to coordinate with each federal agency if they were given block grants in lieu of FEMA involvement. “Without FEMA, a governor or a state has to be calling around and have a Rolodex of the whole federal government to call and try and figure out what support they can get,” Coen said.

There are plenty of reforms that could improve how FEMA reimburses states and helps survivors, experts said, but eliminating it risks big gaps in recovery. “We have spent a lot of time encouraging FEMA to be better, but if FEMA goes away, there is no help for individual families,” Sloan said.

Uncertain future for federal disaster response

Trump has deflected questions about what the Texas response means for FEMA’s future. A 12-member review council established by the president and charged with proposing FEMA reforms will meet for the second time Wednesday. Abbott and Kidd are both on the council.

At the first meeting, Abbott called FEMA “slow and clunky” and said reforms should “streamline the effort.” He has praised Trump’s quick disaster declaration in Texas.

While no large reforms to the agency have been enacted yet, smaller policy changes could impact Texas’ recovery.

This spring, the administration did away with FEMA’s practice of door-to-door canvassing to help households enroll for assistance, calling it “wasteful and ineffective.” Many of the impacted areas in Kerr County and beyond still lack power and accessible roads, which will make it difficult for households to apply immediately for help.

Abbott’s request for hazard mitigation funding, a common add-on to public and individual assistance that helps communities rebuild with resilience, is also still pending. Trump has not approved any hazard-mitigation assistance requests since February.

Gabriela Aoun Angueira, The Associated Press