Trump Defends Sen. Marshall Over Patient Debt Lawsuit Reports
The dispute puts a sitting senator's medical billing practices at the center of a competitive Kansas Senate race, where legal and political arguments are now intertwined.
President Donald Trump posted a public defense of Sen. Roger Marshall (R-Kan.) on Monday, October 13, 2026, after reports surfaced that Marshall, a former obstetrician-gynecologist, had sued hundreds of patients for unpaid medical bills, according to The Hill.
In a post on his Truth Social platform, Trump argued that Marshall was legally required to pursue the unpaid debts and that failing to do so could have exposed the senator to criminal liability. The specific statute or regulation Trump cited as the basis for that legal obligation was not identified in available public statements as of this publication. The document that would clarify that claim is the relevant federal or state medical billing compliance regulation Marshall's practice operated under.
Marshall represented Kansas in the U.S. House from 2017 to 2021 before winning his Senate seat in the 2020 election, according to congressional records. He is a licensed physician who operated an obstetrics and gynecology practice in Kansas prior to entering Congress.
The reports about the patient lawsuits emerged in the context of Marshall's 2026 Senate reelection campaign. Trump's post, per The Hill's account, included criticism of Marshall's Democratic challenger, though the specific challenger was not named in the available source material. The identity of that challenger and the current polling in the Kansas Senate race are not confirmed in the source material reviewed for this story. FEC filings for the Kansas Senate race, available at FEC.gov, would show current fundraising totals for both candidates.
The core factual dispute involves whether Marshall's medical practice was legally compelled to file suit against patients with unpaid balances or whether the decision to litigate was discretionary. Medical debt collection practices vary by state law and by the terms of individual insurance contracts and federal programs such as Medicare and Medicaid. The specific payer mix and contractual obligations of Marshall's former practice have not been identified in publicly available records reviewed for this story. Those obligations, if they existed in writing, would appear in participation agreements with insurers or federal program contracts held by the practice.
Patient debt lawsuits by physicians and hospital systems have become a documented pattern nationally. A 2022 investigation by KFF Health News and NPR identified hundreds of U.S. Hospitals filing suit against patients for unpaid bills, including some nonprofit institutions. Whether Marshall's practice was a nonprofit or for-profit entity, and which payers it contracted with, are facts that would appear in Kansas business registration records and any applicable Medicare provider enrollment files.
Trump's defense of Marshall is consistent with a pattern the White House has followed during the 2026 midterm cycle of publicly supporting Republican incumbents facing competitive races. The White House has not issued a formal written statement beyond the Truth Social post, according to available records as of this publication date.
The Kansas Senate seat is among those being monitored in the 2026 midterm election cycle. Party committees on both sides have directed significant resources toward competitive Senate races this cycle. GOP and Democratic Party Groups Pour Millions Into House Swing Seats, a pattern that extends to Senate contests as well, according to FEC disbursement data.
What remains unknown is the total number of patient lawsuits filed by Marshall's practice, the aggregate dollar amounts sought, the outcomes of those cases, and whether any of the suits involved Medicare or Medicaid patients, which would implicate federal program rules. Kansas court records, which are public, would contain the case filings. Marshall's office had not issued a detailed public response to the underlying billing reports, beyond the claims relayed through Trump's post, as of the time of this publication.
The specific legal authority Trump referenced as mandating debt collection litigation has not been confirmed in any statute or regulation cited in publicly available materials reviewed for this report. That determination would require review of the federal False Claims Act provisions, Kansas state medical licensing board rules, and any payer contracts Marshall's practice held during its operation.