Editor’s note: This is part of an ongoing series highlighting the local impact of Trump’s policies in key counties in MI, PA, WI, and FL.

Lake County residents are facing very real public health challenges, raising concerns about proposed federal budget cuts and their potential impact on residents in one of Michigan’s vulnerable counties.

According to the 2016 Community Health Needs Assessment issued by Michigan’s District Health Department #10, Lake County ranked 79th out of 83 counties on “health outcomes” — a measure of how long people live and how healthy they feel while alive. In the same report, residents of Lake County ranked last of 83 counties across Michigan in how healthy they reported feeling.

With their health and economic security on the line, many Lake County residents find themselves relying on programs such as Medicaid and Medicare to help combat the rising costs of their health care expenses. But the support those programs offer for local residents could be scaled back dramatically if the Trump Administration successfully implements proposed budget cuts.

According to a review by the American Ledger, Trump’s 2020 budget proposal would make steep cuts to both programs. Over 10 years, President Trump’s budget would cut $575 billion dollars from Medicare, which generally provides health insurance for Americans over the age of 65. In a statement, Chip Kahn, President of The Federation of American Hospitals, said this part of Trump’s proposed budget, “imposes arbitrary and blunt Medicare cuts to hospitals who care for the nation’s most vulnerable. The impact on care for seniors would be devastating.”

President Trump’s proposed budget would also cut Medicaid by $1.5 trillion over 10 years, and allocate $1.2 trillion into a new state block grant program, which could significantly decrease the amount of coverage received by those currently enrolled in the program.

Simultaneously, the Trump administration has also pushed for the imposition of work requirements on Medicaid beneficiaries.

Nearly 4,000 Lake County residents are enrolled in Medicare and slightly more on Medicaid.

For many Lake County residents, losing access to health insurance could be life or death. The county is one of the poorest in the state.

The 2016 assessment also found that 39.3% of Lake County adults suffer from arthritis, 16.3% from chronic obstructive pulmonary disease (COPD), 14% from diabetes, 13.7% from cardiovascular disease, and 9.2% of residents reported having had a heart attack.

Nearly 82% of residents require medication for high blood pressure, and 20% of residents have reported emergency room visits twice in the last year.

Over the course of his campaign in 2016, then-candidate Donald Trump repeatedly promised to protect programs like Medicare and Medicaid.

“I’m not going to cut Social Security like every other Republican and I’m not going to cut Medicare or Medicaid,” Trump said in 2015. His proposed budget cuts once occupying the White House appear to undercut that promise entirely.

It remains unclear what kind of electoral impact, if any, the President’s proposed budget cuts could have on his re-election, particularly in Lake County where voters flipped from supporting Democrat Barack Obama’s reelection in 2012 to Trump’s campaign in 2016.