National media attention has focused on Rep. Paul Ryan’s (R-WI) drastic restructuring of the Medicare program, detailing the Vice Presidential candidate’s efforts to transform the current benefit guarantee into a “premium support” program for future enrollees.

But Romney/Ryan’s most devastating changes would impact programs that serve society’s most vulnerable citizens. American who rely on Medicaid, food stamps and Pell grants won’t be afforded the luxury of retaining their existing benefits, should Romney and Ryan implement their plans; these programs would experience immediate reductions if the Ryan budget becomes law (via CBPP):

1. CUTS FOOD STAMPS BY $133 BILLION: Ryan’s budget would send the Supplemental Nutrition Assistance Program (SNAP, or food stamps) back to the states as a block grant and cut the program by $134 billion. According to the Center on Budget and Policy Priorities, “an average of almost 10 million people would have to be cut from the program in the years from 2016 through 2022 to achieve the required savings.” If the cuts were to come from benefits, rather than kicking families out of the program, “All families of four — including the poorest — would see their benefits cut by about $90 a month in fiscal year 2016, or more than $1,100 on an annual basis.” Ryan continually claims that the food stamp program is “unsustainable,” even though the numbers show that’s simply not the case.

2. CUTS MEDICAID BY 1/3%: Ryan would treat Medicaid in the same way: transform the exiting matching-grant financing structure into a pre-determined block grant that will not keep up with actual health care spending and send it back to the states. This would shift some of the burden of Medicaid’s growing costs to the states, forcing them to — in the words of the CBO — make cutbacks that “involve reduced eligibility for Medicaid and CHIP, coverage of fewer services, lower payments to providers, or increased cost sharing by beneficiaries—all of which would reduce access to care.” The reductions to Medicaid kick in right away: between 2013 and 2022, the budget makes $1.4 trillion in cuts to Medicaid —a 34 percent reduction. As a result, states could reduce enrollment by more than 14 million people, or almost 20 percent—even if they are were able to slow the growth in health care costs substantially.

3. 30 MILLION AMERICANS WOULD LOSE HEALTH COVERAGE: Romney and Ryan would repeal the Affordable Care Act, including the subsidies for middle-class Americans to purchase coverage and the expansion of the Medicaid program for lower-income Americans. As a result, more than 30 million Americans would lose access to insurance. The popular regulations that prohibit insurers from denying coverage to people with pre-existing conditions and rescinding coverage would also be repealed.

4. CUTS PELL GRANTS FOR 1 MILLION STUDENTS: Ryan consistently claims that increases in financial aid are driving up the cost of higher education, even though evidence doesn’t back him up. The budget Ryan authored, according to an analysis by the Education Trust, would eliminate Pell Grants entirely for one million students. In 2011, 74 percent of Pell Grant recipients had family incomes of $30,000 or less. These cuts would come despite the fact that the price of a college degree has skyrocketed 1,120 percent over the last three decades.