The cuts could lead to nearly 30,000 jobs lost across Missouri and Kansas health care systems and food suppliers, a new study found.
As Congress looks to cut billions of dollars in federal spending over the next decade, states are anxiously awaiting how current proposed cuts to Medicaid and other programs may impact their own budgets and benefits their residents receive.
The Republican-controlled Congress is asking committees to slash their budgets over the next decade by $1.5 trillion and pay for a $4.5 trillion extension of tax cuts endorsed by President Donald Trump in 2017. Those tax cuts largely benefit corporations and wealthy Americans.
The nonpartisan Congressional Budget Office said in an analysis that to cut the amount of spending the Trump administration is requesting, cuts to Medicaid and Medicare are inevitable.
Under the plan proposed by the House of Representatives, Medicaid, the joint federal and state program that helps with medical costs for people whose income and resources are very limited, could be subject to $880 billion in cuts over the next 10 years.
And the Supplemental Nutrition Assistance Program (SNAP), which provides food benefits to low-income families, would see about $230 billion in cuts over the same period.
The plan could result in a $95 billion loss in federal funding for states in 2026 alone, according to a new report from the Commonwealth Fund. And as the details are ironed out, the report shows that Missouri and Kansas have plenty on the line when it comes to their federal funding and potential economic slowdown in their states.
Missouri could see a $2 billion reduction in federal funding across Medicaid and SNAP over the next decade, according to the report.
Kansas, which has not expanded Medicaid eligibility under the Affordable Care Act and receives less federal money as a result, stands to lose $485 million in federal funds over the same period.
Researchers at the Commonwealth Fund, a group that studies health care access, also found that the downstream economic effects of potential cuts could mean more than a $2.4 billion hit in Missouri’s gross domestic product in 2026 alone.
In Kansas, the cuts could amount to $556 million in economic losses through ripple effects such as cuts to jobs in hospitals, pharmacies, grocery stores, agriculture and more.
“If a nurse in a hospital loses her job because of a cutback, then that means she can’t afford to do things like pay her rent or pay her grocery bills,” said Leighton Ku, one of the study’s lead researchers and the director of the Center for Health Policy Research at George Washington University. “So there are repercussions that ripple through the rest of the economy.”
What’s at stake with cuts in Missouri and Kansas
The study found that if $880 billion in federal Medicaid funding were to go away, each state would see an 11.8% reduction in federal spending.
For SNAP, states could see a 20.6% reduction in federal SNAP dollars.
In Missouri, direct health care jobs are estimated to see the biggest losses, with an estimated 11,300 jobs cut as a result of the change in spending. Combined with other potential job loss as a result of Medicaid cuts, nearly 22,000 would be lost.
“The way us economists think about it,” said Timothy McBride, a health economist at Washington University in St. Louis, “is that spending on one side is matched by income on another. So if the federal government cuts $880 billion, that’s $880 billion in revenue to hospitals, doctors and drug companies or managed care companies.”
Another 2,400 Missouri jobs are estimated to be lost as a result of spending changes to the SNAP program.
The report estimates that between cuts to Medicaid and SNAP in Missouri, the end result could mean a $2.4 billion decrease in the state’s GDP and a $175 million reduction in state and local tax revenue.
It’s a different picture in Kansas, where state lawmakers haven’t expanded Medicaid and fewer people are part of the program. The analysis estimates that the state could lose about $485 million in federal funds across cuts to Medicaid and SNAP.
Kansas could lose about 2,700 in direct health care jobs and another 2,900 food industry or other jobs.
“I think of both Kansas and Missouri as being agriculture food production states,” Ku said. “The people who produce food, who process food, who grow food, they’re going to suffer cutbacks to (SNAP).”
Food pantries are seeing threats to their federal funding from multiple directions. But because the federal government pays all of the cost for SNAP and states only match the costs for administering the program, they are worried about what it means for their ability to provide food for those most in need.
“For every one meal that a food bank provides, SNAP provides nine,” said Karen Siebert, the public policy and advocacy adviser at Harvesters in Kansas City. “If these costs were shifted to the states, there’s no way our state budgets on either side of the state line could absorb that.”
“We’re concerned that folks are going to be turning to our charitable food pantries, which do not have resources to absorb those kinds of cuts,” she said.
Impacts may be outsized in rural communities, where more people rely on Medicaid, SNAP
In both Kansas and Missouri, rural counties tend to have a higher reliance on Medicaid or SNAP than other areas of the state.
That means rural areas could feel the pinch from the proposed cuts more than others.
“In the U.S., Medicaid coverage is higher in rural areas than in urban areas, across the whole U.S.,” McBride said. “That does mean the geographic impact will probably be somewhat higher in rural areas versus urban.”
McBride pointed to the financial margins of hospitals, which he said are lower than what most people would expect. In rural communities, margins for hospitals are often zero or negative. If Medicaid dollars were to be reduced, that could put rural hospitals in an even more difficult place, he said.
And for rural grocery stores that participate in SNAP, a reduction in SNAP recipients or spending could paint a bleak picture.
“A lot of grocery stores have really, really high purchasing minimums to even keep going and get a distributor willing to drive their truck to their area to deliver the food,” Siebert said.
“There are so many people who have SNAP benefits in these communities, and if the local grocery store cannot accept those, they may go to other communities where they can use their SNAP dollars,” she said. “And then, they’re going to use their other money there, too, and it takes all of that money out of the community.”
It’s still unclear what components of the House or Senate budget plans may move forward, making it difficult for recipients of the federal funds to plan.
“Depending on how these cuts are made, more people might become uninsured, more people might lose access to health care, more people might become hungry,” Ku said. “In general, if the state has a more sustained loss, and there’s unemployment, this is not going to help the state economies. This is going to hurt the state economies.”