Kansans lament passage of Trump’s ‘big, beautiful bill’

TOPEKA — President Trump’s spending and tax cut bill, which will add billions to the country’s budget, generated a tidal wave of predictions about the effects on vulnerable Kansans.

In her role leading the Democratic Governors Association, Kansas Gov. Laura Kelly said states cannot make up the financial losses from the “disastrous budget” in H.R. 1, which the president refers to as “one, big beautiful bill.” The House passed the measure on Thursday, sending it to the president for his signature.

“While Washington Republicans continue to talk about ‘cost shifts,’ Democratic governors have been clear that it will be impossible for states to respond to such massive cuts by backfilling with state resources,” Kelly said. “We cannot gut health care or let children go hungry in the name of giving tax breaks to the wealthy.”

The bill was passed by the Senate on Wednesday, with Kansas Sens. Roger Marshall and Jerry Moran voting in favor.

In the House, Kansas Rep. Sharice Davids, a Democrat, was the sole vote from the Sunflower State against the bill, with Republican Reps. Tracey Mann, Ron Estes and Derek Schmidt voting to pass.

Kansas stands to see costs for its Supplemental Nutrition Assistance Program increase by at least $15 million, said Erin La Row, spokeswoman for the Kansas Department for Children and Families.

That’s what it will cost Kansas to make up its share of administrative costs. The match is currently 50/50 and the bill increases that to a 75/25 split, La Row said. In federal fiscal year 2025, Kansas paid just more than $30 million for its share, and that would increase to about $45 million.

Kansas would take an even larger financial hit in the state-federal cost share for SNAP benefits.

The bill penalizes states that have larger than acceptable error rates in processing SNAP benefits. Kansas had an error rate in 2023 of 12%. La Row said its 2024 rate dropped to 9.98%, which puts the state in a category to cost-share 10% of the $413 million in SNAP benefits that were issued.

“The state would have to cost share just over $41 million (10%) under the Senate version,” La Row said in an email. “These changes would become effective Oct. 1, 2027.”

If Kansas lowers its error rate to 5% or less, the bill drops cost-sharing to zero. 

Kansas House Speaker Dan Hawkins said in a news release that Gov. Laura Kelly was “fearmongering” about possible budget effects. He referred to the 2023 error rate of 12% as the highest in the region and said Kelly and DCF failed to comply with federal demands to improve efficiency.

“If Governor Kelly truly wants to avoid a hole in the state budget, she needs to stop pointing fingers at the Trump Administration and focus on her own Administration’s repeated failure to effectively manage the SNAP program,” Hawkins said. “A 12% error rate is unacceptable. Hard stop.”

The solution is to drop the error rate to 5% or below, he said, and the state budget won’t be affected.

Medicaid costs

Kansans also can expect to see Medicaid cuts that will jeopardize Kansas hospitals and nursing homes, according to reports by the United Methodist Health Ministry Fund and the REACH Healthcare Foundation. 

Kansas stands to lose nearly $3.9 billion in Medicaid funding, with Kansas hospitals standing to lose as much as $2.65 billion in funding over 10 years, the two organizations said in a news release.

A report from the National Rural Health Association and Manatt Health, released Tuesday, found that rural hospitals will lose 21 cents out of every dollar they receive for funding Medicaid, the joint state and federal public health insurance program that serves more than 360,000 Kansans.

Cindy Samuelson, spokeswoman for the Kansas Hospital Association, said Medicaid covers nearly one-third of all births in Kansas and cares for nearly two-thirds of all nursing home residents statewide.

“Kansas hospitals rely on Medicaid reimbursement, which accounts for 15% of inpatient days on average,” she said. “Most Medicaid spending in Kansas supports the elderly and disabled, meaning cuts would impact those who need care the most.”

Reduced Medicaid funding translates to uninsured Kansans, which Samuelson said would drive up costs of uncompensated care, which shifts those costs to businesses and private insurance payers. Sixty-seven percent of Kansas hospitals are operating in the red, she said.

In a nod to the impact Medicaid cuts would have on rural hospitals, the Senate included a $50 billion rural hospital fund in its bill, but that’s not enough, said David Jordan, president and CEO of the United Methodist Health Ministry Fund. In a research brief, Jordan’s organization said Kansas rural hospitals would receive about $811 million from that fund.

“It will not offset the billions of dollars that Kansas and Kansas hospitals lose from the bill,” he said. “As you know, Kansas has more financially vulnerable hospitals than any other state in the country and the average hospital in Kansas is operating with a -9.9% average. Our hospitals cannot afford to absorb billions of dollars in Medicaid cuts without cutting services and/or possibly closing their doors.”

No ‘common sense’

Statements about the spending bill flowed throughout the week, challenging House representatives to make changes, which didn’t happen.

“At a time when families are struggling to make ends meet, they just voted on a bill that, along with the tariffs, will make things even worse by stoking inflation and raising interest rates,” said Kansas Sen. Cindy Holscher, who is running for governor, after the Senate vote. “Nothing about this bill says ‘common sense,’ and everything about it says ‘extremism.’ ”

Julie Govert Walter, executive director of the North Central-Flint Hills Area Agency on Aging, last week listed seven concerns in a letter to the editor about the bill’s effects on older adults, caregivers and people with disabilities.

“These proposed large cuts to the Medicaid program will have a significant impact on our state’s ability to continue these essential (home and community-based) services over time,” she said. “You cannot bleed a system this significantly and expect all of it to remain healthy.”

Among the seven issues she addressed was expected closures of rural hospitals and clinics as a result of funding cuts to Medicaid. 

“Not having available health care will speed the economic deterioration of vulnerable Kansas communities and adversely affect the tax bases of counties and cities dependent on a stable population,” Govert Walter said.