Public health specialists say Trump’s budget bill will harm health care structures, patients in Douglas County

Representatives from public health sectors and from the Haskell Friends and Family group spoke at a panel Thursday, attesting to the long-term negative health impacts of Trump’s budget bill across the nation and in Douglas County.

The town hall was hosted by the Saving Institutions task force of the Lawrence chapter of Indivisible.

Members of Alliance for a Healthy Kansas, LMH Health and the Haskell Family and Friends coalition were invited to answer questions about Trump’s H.R.1 bill, legally titled the “One, Big, Beautiful Bill Act.”

Speakers addressed the Trump administration’s impact on their organizations, what that would mean for residents of Douglas County and how the community could provide support. 

Impacts on health care and insurance coverage

Speakers emphasized that although the effects of the H.R.1 Bill are not immediately apparent, they will have creeping and devastating impacts across various levels of the health care system over many years.

Marissa Alcantar, the policy and advocacy manager with Alliance for a Health Kansas, said that around 108,000 Kansans may lose access to health insurance because of changes to Affordable Care Act (ACA) tax credits that make subsidies harder to access and less financially generous.

Alcantar said that this would have an outsized effect on populations that rely more heavily on marketplace insurance, including young adults, small business owners and caretakers.

“Most Kansans on the marketplace plans are expected to pay hundreds, if not thousands of dollars more each year,” she said.

Simultaneously, Medicaid will face $1 trillion in cuts over the next decade as the bar for eligibility rises.

“You get the sense that there are barriers being put up to disqualify people,” said Rob Chestnut, chief financial officer at LMH Health and former Lawrence city commissioner. “Certainly eligibility requirements, status, as far as immigration status … become much more the forefront. So we’re going to have to learn that law and just be there for our patients to figure out how we can do the best job we can to qualify people for Medicaid.”

Alcantar and the alliance advocate for Kansas to adopt an expansion of KanCare, its Medicaid program. Per the alliance’s website, “expanding Medicaid will help cover 150,000 Kansans who can’t afford health insurance today.”

According to Alcantar, increased work reporting requirements for Medicaid expansion will even impact Kansas, as “Medicaid beneficiaries in non-expansion states like Kansas are going to have less access to retroactive coverage.”

Overall, the Congressional Budget Office estimates that 16 million more Americans will be without health insurance in 2034 than currently projected under H.R.1 policies.

Chestnut said rural hospitals will face financial challenges due to changes in provider taxes and slower payments from government entities such as the Veterans Affairs Department. LMH is in a position to absorb many of these costs and continue operations, he said.

Yet as patients face losing insurance and thus preventive care, Chestnut anticipates that far more people will end up in the E.R. unnecessarily.

“In Douglas County, what will happen is those patients will go from having some kind of insurance to no insurance,” he said. “Now, we are going to take care of those patients. However, what ends up happening is the responsibility for providing that care and any reimbursement shifts from Medicaid to the hospital and whatever resources that we can work with the patients.”

He also said that LMH’s decision to stop accepting certain kinds of Medicare Advantage in September 2024 was unpopular with many patients, but it was in consideration of both finances and patient care.

Medicare Advantage goes through insurance companies that require more reauthorizations, issue more denials and leave patients waiting on urgently needed care, per Chestnut. However, he anticipates more patients across the nation will be pushed toward Advantage plans under the new bill.

Chestnut also anticipated more difficulty accessing mental health care and substance abuse services due to federal employee cuts eliminating public health experts.

“Fewer employees working in substance abuse and mental health services, which is already really difficult for us to access here in Kansas, may become even more limited or locked down because of that red tape,” he said.

Ultimately, Chestnut said LMH is committed to offering more charity care for patients, but its capacity is further tested when community partners within Lawrence’s tight-knit health system, such as Bert Nash Community Mental Health Center and Heartland Community Health Center, face funding cuts.

LMH’s approach, according to Chestnut, is to “pick up the slack.”

The hospital is considering models to increase points of access, such as providing urgent care, or introducing more wraparound services to help patients navigate enrollment in Medicaid, Medicare and Medicare Advantage.

As Chestnut addressed the need for preventive care, which reduces labor and financial strain on the health care system down the road, one attendee asked his thoughts on the city charging fees for recreation centers. The attendee said the facilities at the rec centers made exercise accessible, which was a form of preventive care.

Chestnut agreed that charging for these facilities was the wrong move.

“The bottom line is — for health care — is the more access, especially young people, have to activity, the better,” he said. “That’s just it.”

Speakers and audience also addressed eligibility changes to the Supplemental Nutrition Assistance Program (SNAP), which many people know as food stamps or food assistance.

As of now, around 4,600 Douglas County residents will experience a delay, if not a total loss of their November SNAP benefits.

Read here for more coverage on SNAP and the county’s emergency response plan.

Some implications for Haskell Indian Nations University

Thad Holcombe, former minister of Ecumenical Campus Ministries at KU, spoke as a member of Haskell Family and Friends. He specified that he is not Indigenous, nor was he speaking on behalf of Haskell.

Holcombe highlighted cuts to Federal TRIO programs, saying that these actions would reduce staffing at Haskell and administrative support for students.

Per the Institute for College Access and Success, TRIO faces “near elimination, depriving students from families with low incomes, first generation college students, and students with disabilities of critical support services at institutions that promote achievement throughout the educational pipeline.”

These losses are poised to be particularly harrowing to the university, which underwent sudden and brutal staff cuts in February, although many of those positions have been restored. 

Douglas County resources

Much of the community commentary during the event’s Q&A focused on how to galvanize community action and secure resources for vulnerable populations.

Here are some of the panel’s recommendations:

• Douglas County’s Senior Resource Center located in Lawrence can help people 65 years and older navigate medicare enrollment 
• People can donate to the community fund being established to help cover the funding gap for SNAP; more information is included in the article linked above 
• The Lawrence Farmers Market is raising funds to sustain its Double Up Protein Bucks program
• Just Food is sending out regular calls for volunteers as they face an increase in service usage due to impacts on SNAP
• LMH has extensive volunteer opportunities to help improve patient care
• The Douglas County Food Policy Council advocates for a sustainable local food system
• Haskell Foundation donations support education and social support programs and the university

Wulfe Wulfemeyer (they/them), reporter and news editor, has worked with The Lawrence Times since May 2025. They can be reached at wulfe@lawrencekstimes.com.

Read their complete bio here. Read their work for the Times here.

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