Health Forward’s statement on the “Big Beautiful Bill”

We are deeply grieved that the budget reconciliation bill — referred to by its proponents as the “Big Beautiful Bill” — has now become law. This budget, narrowly adopted by Congress and signed by President Trump on Independence Day, ignores the very real struggles and hopes of most Americans. The simple hope we all share — to be healthy, to have our stomachs full, and to have our most basic needs met.

The deep cuts included in this bill take away lifesaving benefits from working people giving tax cuts to the wealthy. The new budget will threaten the health of working individuals and families, harm our treasured older adults and the systems who support them, jeopardize the stability of our health systems, undermine the economic stability of states — forcing tradeoffs over critical needs causing more loss of vital health and safety programs, and threaten the overall health and well-being of communities in our region.

We are grateful to everyone who raised their voice in opposition to this bill. Because of our collective action, key changes were made to the bill before it passed. Congress ultimately decided not to reduce the federal Medicaid matching percentage, and important revisions to provider taxes and state-directed payments helped lessen the bill’s impact on health care practitioners.

Our priority is to understand the impact of this law on our region and continue the philanthropic practices which support strong and thriving communities through the nonprofit organizations who support them. We appreciate our partners who have shared their stories and the challenges they are facing. We welcome your continued input to help us stay informed about the impact of this legislation, and we are committed to learning with and from you to guide our current and future support.

Here is what we know today about the impact of the “Big Beautiful Bill” on Kansas and Missouri

• Nearly 170,000 Missourians and as many as 75,000 Kansans — including seniors, children, and people with disabilities — will lose their health insurance due to changes in Medicaid and the Affordable Care Act (ACA).
• Work requirements for Medicaid will inevitably lead to eligible people losing their coverage — not because they are unemployed, but because they will face barriers meeting burdensome reporting requirements. Additionally, states are not prepared or funded by the federal government to administer complex and costly verification of work requirements. This will extend time delays in redetermination of Medicaid eligibility and create gaps in coverage and care. Missouri already leads the nation in exceeding federal limits on eligibility determinations.
• Most Missourians and Kansans who buy private insurance through the Marketplace will see a significant increase in premiums when they renew their coverage next year.
• Missouri will be limited in its ability to pay its share of Medicaid. In Missouri, a change to the rules around provider taxes will cost the state about $675 million each year. Combined with the loss of federal matching dollars, Missouri’s Medicaid program will lose around $1.9 billion per year in total funding.
• Our region’s rural communities will experience significant Medicaid cuts. A temporary fund of $50 billion created to support rural hospitals will only cover a fraction of the estimated $155 billion in cuts to rural health practitioners. This will threaten the closure of rural hospitals in our states, resulting in job losses and reduced access to essential care.
• People who have immigrated through official channels, including refugees and asylum seekers who meet the requirements to participate in these programs, will be denied Medicaid and Medicare coverage.
• States will be required to pay a portion of food assistance (SNAP) benefits, and work requirements for recipients have been expanded. Households with working-age parents and children may lose some or all their nutritional support, potentially affecting an estimated 8,000 people in Kansas and 40,000 people in Missouri.

The road ahead: standing together to protect our future

The next 18 months will be a critical period to shape the future of our communities. We must continue to partner to improve participation in our democracy and ground narratives and stories in truth. We must ensure that all impacted communities can register to vote, access clear, correct, and relatable information about the policies that affect their lives at all levels of government, in and outside of election cycles. We must increase voter turnout and ensure all voters are equipped with accurate information.

In addition to increasing support of our health care safety net and public health partners, Health Forward has deepened support of organizations working in civic engagement and advocacy. Recently, we awarded over $6 million to 50 organizations doing this work, and we experienced a notable increase in applications — clear evidence that we are at an inflection point. Civic engagement is a primary tool to build fair and just communities for everyone. We encourage more organizations to enter this space to help create community conditions that promote health and economic well-being for all. We encourage community-based organizations to engage with us to explore ideas and opportunities for collaboration.

Now is the time to raise our voices and share stories about how this bill will affect us, our families, and our neighbors. We must continue to speak out, stand firm, and humanize the harsh realities of this legislation. Please share your story with us, and stay tuned for upcoming funding opportunities dedicated to uplifting community voices and individual experiences.

The work to improve our communities was hard before these new harms. We understand the toll that crisis, stress, and scarcity places on organizations and individuals. We know many of our nonprofit leaders are weathered by the constant assault on their existence this year, however they are not weakened. We will continue to be thoughtful about how we support the wellness of our partners and foster a greater sense of community. Please remain in conversation with us about how to support the well-being of nonprofit leaders and staff.

Finally, we are steadfast in our commitment to the health of our region and our partners — through leadership, advocacy, and resources. Now is the time to lean into the moment and to lean on one another. Together, we will continue to stand in the gap toward inclusive, powerful, and healthy communities with the urgency and resolve this moment demands.