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At Health Forward Foundation, we’re committed to providing timely updates on key local and federal policy developments that impact the health and well-being of our communities. This resource is designed to help our advocacy partners stay connected to the issues, opportunities, and decisions shaping our region.
The following updates cover developments across our service area in Kansas and Missouri from the past month — with implications for county budgets, housing, emergency services, health care access, and civic participation. Several of them will appear on ballots this November.
Emergency Medical Services sales tax returns to the November ballot
On September 8, Commissioners voted unanimously to place a half-cent countywide sales tax for emergency medical services on the November ballot. Allen County EMS runs on a budget of just over $2.5 million, with about half of that funding coming from property taxes. Rural EMS is expensive to staff, and the current funding streams have not kept pace with rising costs. If approved, the sales tax is projected to generate about $1.2 million a year dedicated to EMS.
Voters narrowly defeated a similar proposal in November 2024. Commissioners have been candid that the earlier campaign did not explain the measure well, and the Commission has contracted for a public education campaign to support voter clarity this election.
It is worth noting that sales taxes are regressive, meaning households who are paid the lowest wages spend a larger portion of their income on sales tax. At the same time, a dedicated revenue source would ease some of the budget pressure the county currently faces, potentially freeing up funding for other community needs. It is up to Allen County voters to weigh these considerations and vote accordingly in November.
A $1.9 billion budget adopted for fiscal year 2027 On September 3, the Johnson County Board of County Commissioners adopted a $1.9 billion budget for fiscal year 2027. The combined mill levy will remain essentially unchanged from this year.
A quick note on terms, since this language comes up throughout budget season. A mill is one dollar of tax for every thousand dollars of a property’s assessed value, and the assessed value is a fraction of what a home would actually sell for — in Kansas, that amount is 11.5 percent for a home. So a rate of 24 mills on a $250,000 house in Johnson County works out to roughly $690 a year in county taxes. Here is the part that matters: when a county holds its mill levy flat but property values rise, the tax bill still goes up. That gap between a flat rate and a higher bill is what Kansas residents have been showing up to talk about this budget season.
County leaders have been direct that this budget is a bridge and not a long-term solution. The county’s own five-year forecast projects a budget gap of nearly $22 million by 2031, with reserves falling below target before the end of the decade.
County and municipal budgets fund the services that shape the health of residents and the community — public health, mental health crisis response, and housing supports among them. The choices Johnson County makes over the next two years about how to close a structural gap will determine whether those supports hold. This is a good moment for partners and community members to make sure they are part of the conversation at the county level.
2027 budgets adopted and property tax rates set On September 3, the Unified Government Board of Commissioners approved the 2027 Wyandotte County and Kansas City, Kansas budgets, holding the current mill levy rates for both the city and the county. Interim County Administrator Alan Howze described the budget as balancing fiscal discipline with strategic investment in infrastructure and neighborhoods.
The Unified Government’s own Community Health Improvement Plan named employment, income, and affordable housing as the largest barriers to health in the county — a reminder that a county budget represents how a community has chosen to invest in the services that shape the health of its residents.
A health care sales tax question heads to the November ballot This November, Wyandotte County voters will decide whether to implement a countywide sales tax dedicated to health care services.
Kansas spends about $32 per person on public health. That is the highest level the state has ever invested, and it still ranks 34th nationally and falls below the $48 per person average among neighboring states. More than 114,000 Kansans have lost KanCare coverage since the end of pandemic-era continuous enrollment, and without expanded Medicaid, most have few options to regain it. Wyandotte County also carries a health care workforce shortage that further strains access to care.
As noted above, sales taxes are regressive. Households earning the lowest wages spend a larger share of their income on taxed goods, and those are often the same households that sales tax revenue is meant to serve. Both of those things are true at once, and voters deserve to weigh them with clear information. Our role is to make sure residents have that information well before Election Day. In our Missouri service area
Concordia creates a land use category for cottage homes On August 3, the Concordia Board of Aldermen approved a bill defining “Cottage Homes” and establishing a residential land use category for them. In practical terms, that creates a place in the city code for smaller, lower-cost homes on smaller lots — homes that many zoning codes written decades ago effectively prohibit.
What Concordia is addressing here is what planners call the missing middle. For most of the last century, American zoning codes have offered two housing options: a detached single-family house on a large lot, or a multi-unit apartment building. Everything that used to sit between those two — duplexes, fourplexes, townhomes — represents the missing middle. Those middle housing types are the ones that historically housed young families, older adults downsizing but staying in their community, households who are paid low wages, and working people generally. Cottage homes sit squarely in that category.
COMBAT renewal heads to the November ballot In November, Jackson County voters will decide whether to extend a quarter-cent countywide sales tax known as COMBAT. First approved by voters in 1989, the tax generates more than $20 million a year to fund programs that address the upstream causes of violence and crime, including domestic violence services, substance use prevention and treatment services, legal aid, and life skills and workforce training. The program operates under the Prosecuting Attorney with oversight from the COMBAT Commission.
Community conditions that shape health, like systemic racism and economic opportunity, also shape the prevalence of violence. The organizations doing violence prevention in our communities are addressing housing stability, economic opportunity, and access to mental health care, because that is where violence actually begins. Local dollars that reach that work show up later as fewer emergency room visits, less trauma carried by children into adulthood, and life expectancy gaps that finally start to close.
Voters approved all five ballot questions on August 4
Kansas City voters approved every one of the five citywide questions on the August ballot. Health Forward was particularly interested in the funding for the Housing Trust Fund and the renewal of the Central City Economic Development Sales Tax.
Question 1: $100 million for the Housing Trust Fund — passed with 75.6 percent
The passage of KCMO Question 1 authorizes the city to issue $100 million in general obligation bonds to replenish the Housing Trust Fund, which finances affordable housing development, preservation, and revitalization projects, with a focus on homes for families who are paid very low to moderate wages. This is the largest single infusion the Housing Trust Fund has received since it was established, and it builds on the $50 million voters approved in 2022. The city expects to issue the funding in roughly $20 million batches across five rounds of competitive funding.
Question 3: Central City Economic Development sales tax renewal — passed with 69.2 percent
Voters also renewed the Central City Economic Development sales tax, a one-eighth-cent tax collected citywide and used to fund affordable housing, small business support, and community-led revitalization projects on the Eastside of Kansas City. The tax was first approved in 2017 and has since awarded more than $88 million across 58 projects. Because it is a continuation at the same rate, shoppers will not see a change in what they pay.
Health levy allocation moves through City Council
One item currently moving through City Council is the Health Commission’s recommendation for changes to how health levy dollars are allocated. The levy generates roughly $70 million a year in property tax revenue, with about $31.5 million of that going to safety net providers. For nearly a year, the Council has been working through a dispute about how those dollars should be distributed, whether the pool should be opened to providers who do not currently receive levy funding, and what accountability should attach to the contracts.
The proposal under consideration would keep health levy funding going to the six current safety net providers while opening the city’s $400,000 Health Innovation Fund to providers that do not currently receive levy dollars. It also directs the city manager to develop reporting and accountability requirements and to move toward a reimbursement-based model for future health levy contracts.
Both the larger safety net providers and the smaller, community-rooted clinics are assets that provide vital services to Kansas Citians. The question in front of the Council is how to strengthen the whole system rather than choose among its parts. We will share more as the Council process continues.
Federal budget and the continuing resolution
Congress passed a continuing resolution funding the federal government at current levels through December 11, or until full-year appropriations bills pass.
It is worth naming why that matters. A shutdown on October 1 would have meant real disruption for the people our partners serve, and this is the first year in recent memory that we have not faced a looming or imminent threat of an October 1 federal government shutdown.
One important note: the resolution delays implementation of an Office of Management and Budget rule overhauling the Uniform Guidance that governs how federal grants are administered. That rule would have required senior political appointees to review federal grant proposals beginning in October. For nonprofit organizations, this is a reprieve rather than a resolution. The rule is expected to resurface in negotiations, and organizations whose work centers racial equity, immigrant health, and economic justice have real reason to stay engaged on it.
The December 11 date sets up a broader year-end funding negotiation after the midterm elections. We will be watching it closely.
Missouri’s congressional map and the November ballot
With less than two months until the November election, the dispute over which congressional maps Missouri will use is not fully settled. On Thursday, September 10, at the direction of the Missouri Supreme Court, the Missouri Secretary of State instructed local election authorities to use the 2022 congressional map for the November election.
A separate federal case has kept the question open. On September 21, a federal appeals court, the 8th U.S. Circuit Court of Appeals, ruled that Missouri must use the 2025 congressional map instead. The three judges said that because Missourians voted using the 2025 congressional district map in the August primary, switching back to the 2022 districts for November would be unconstitutional. But the ruling has no immediate effect. The U.S. Supreme Court has already paused the 2025 map, and that pause stays in place until the Supreme Court says otherwise. The case is now likely to head to the Supreme Court for the final decision. For now, Missouri voters are voting under the 2022 districts, and many of those ballots are already in the mail.
One practical note for partners: this fight generated a year of conflicting headlines, and some voters will arrive at the polls in November genuinely unsure which district they live in. Point people to their local election authority, which will have the correct district on their sample ballot.
The continued fight over mail ballots
Another election dispute remains in litigation as the fight over mail ballots continues.
A March executive order directed the Postal Service to take on a gatekeeping role in mail voting. That would have required new ballot envelope designs with an intelligent mail barcode, advance Postal Service approval of those designs, and the upload of each voter’s name and address to a new federal electronic portal — with the Postal Service able to refuse to deliver ballots it deemed noncompliant. A federal judge blocked these requirements, finding that Congress has never delegated its elections authority to the Postal Service and that compliance in the remaining weeks before the election is practically impossible. The administration appealed to the First Circuit and filed an emergency application with the Supreme Court.
On Monday, September 14, the U.S. Supreme Court weighed in, allowing the order blocking the new mail ballot requirements to remain in place. This means it is unlikely that the new mail ballot rules will apply to the November 2026 election. We will continue monitoring as any remaining appeals play out.
Confusion is itself a barrier to participation. It will be particularly important for trusted community partners to point voters to verified election information, such as their local election authority.
Supreme Court clears the way for expanded use of a federal voter database
On September 25, the U.S. Supreme Court ruled that the Department of Homeland Security may resume offering states an expanded version of a federal database called SAVE, short for Systematic Alien Verification for Entitlements. A lower court had blocked the expansion on privacy grounds, and the underlying lawsuit continues.
The database was built to check eligibility for public benefits. Over the past year it has been reworked so that states can run entire voter rolls through it at once to check citizenship, rather than looking up one person at a time.
The near-term effect on the November election is limited. Federal law already bars states from conducting systematic voter roll purges within 90 days of an election, so states can only run individual checks between now and Election Day. But this is worth watching closely in our region. Both Kansas and Missouri are registered users of the system, and Missouri was among the first states in the country to run its voter list through the expanded version. The errors that followed were not hypothetical. Dozens of Missouri county clerks wrote to state legislative leaders last year warning that the system was flagging people they knew to be citizens, including voters they had personally registered at naturalization ceremonies. The mistakes cluster among people born outside the United States who later became citizens.
Here is the practical piece for partners. Naturalized citizens are citizens, with the same right to vote as anyone born in the United States, and a database error does not change that. If someone you serve receives a letter questioning their registration or their citizenship, encourage them to contact their local election authority directly. We will continue to monitor this case as it moves forward.
Proposed changes to the 2030 census, with public comment open through October 13
On September 10, the Census Bureau published a proposed rule that would make two significant changes to the 2030 decennial census.
The first would rewrite the residence criteria, the rules that determine who is counted and where. Under the proposal, people who are not U.S. citizens and do not hold lawful permanent resident status would be excluded from the apportionment count, and the Bureau would use administrative records to verify status.
The second would prohibit questions about race, ethnicity, and sexual orientation on the census questionnaire, citing privacy and disclosure concerns. Questions about sex, date of birth, and household relationship would remain.
Both changes reach directly into the work our partners do. The decennial census is the only source of complete, block-level data on race and ethnicity, and that data is used to calculate many disparity measurements that help us understand our communities. Without it, there is no consistent way to track how health outcomes differ across neighborhoods, or to show whether an intervention is closing a gap. Census counts also move money. The federal share of most Medicaid and CHIP spending is calculated using per capita income derived from census data, and census-derived designations help determine where Federally Qualified Health Centers are located and which areas qualify as medically underserved. An undercount in our region would mean fewer federal dollars reaching the communities that most need them, and a less accurate picture of who lives here.
The public comment period is open through October 13, 2026. Comments can be submitted at regulations.gov under docket number USBC-2026-0628. As a reminder, submitting public comment on a proposed federal rule is considered administrative advocacy, so it does not count as a lobbying activity.
As a reminder, our Kansas and Missouri policy agendas, our issue briefs on the impacts of H.R. 1, housing and health, property tax policy, digital equity, food as medicine, the community health workforce, and voting and health, our testimony templates, and district-level data infographics for both sides of the state line are all available on our website and free for you to use.
That wraps up this month’s local and federal policy update. Health Forward stands with you in this work. Together, we can build inclusive, powerful, and healthy communities.
