Moral issue of KanCare expansion important to many Kansans

By David Sanford, March 08, 2018

Portrait of David Sanford

Although an overwhelming majority of Kansans favor expansion of KanCare (Kansas’ Medicaid program) to provide health insurance for an estimated 150,000 low-income residents, the issue continues to stall in our Legislature as well as with the new governor, Jeff Colyer.

A recent column in The Eagle questioned whether Medicaid expansion is a “moral issue.” Proponents of expansion certainly perceive it as such. Providing coverage will improve the health of 150,000 Kansans who are currently locked out of our health-care system. Most have jobs with employers who can’t – because of the high cost – provide health insurance as a benefit.

Whether you consider that a moral issue, it’s a system that needs to be fixed so everyone has access to care, not just those of us who have the privilege of having employer-sponsored insurance. This “moral issue” is at the heart of the Christ-centered health care ministry of GraceMed.

Look at a couple of points about current and future Medicaid costs to Kansans. Kansas pays 45 percent of the costs for the current KanCare program. Under the expansion, the state would pay 5 percent this year and never more than 10 percent in the future. So the point that the cost to Kansans will increase while the federal match decreases is true, but a bit misleading.

As to the payments received by hospitals to offset the cost of uncompensated care – known as Disproportionate Share Hospital allotments – it is true that these are to be reduced in the future. Medicaid expansion was always intended to replace these payments. By not accepting expansion, the state has chosen to allow hospitals to go unpaid for the costs of care to uninsured patients.

Medicaid expansion has proven critical to the survival of rural hospitals in the states that have accepted the program. Rural hospitals tend to be more financially vulnerable than urban hospitals and are more in need of the additional resources expansion would deliver. Recent research finds that rural hospitals in states without Medicaid expansion are six times more likely to close than those in expansion states.

It’s a fact that when people have insurance, they utilize health care services more often. The uninsured tend to use community health clinics, emergency departments and hospitals only when it is absolutely necessary – many times too late to address the onset of chronic disease issues.

Relatedly, the uninsured have a much higher incidence of filing bankruptcy due to overwhelming health-care costs. This is another issue helped by Medicaid expansion. Enrollees in expansion states have much lower rates of bankruptcy filing and bills sent to collections, and higher credit scores as a result.

KanCare expansion isn’t the ultimate answer to our health-care woes. It doesn’t directly bring down pharmaceutical costs or the high cost of liability insurance for medical providers. The list could go on and on.

But expanding KanCare is one of the solutions we need to embrace to ensure that 150,000 hardworking Kansans have access to quality primary, specialty, hospital and emergency care without living in fear of getting sick or injured. We can continue to work on other issues in the days ahead, but this is the right short and long-term decision for Kansas.

David Sanford is chief executive officer of GraceMed Health Clinic in Wichita.

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