That was the message Monday at a public forum in Lawrence hosted by supporters of Medicaid expansion. Alliance for a Healthy Kansas started several weeks ago traveling across the state, talking about the need for the Kansas Legislature to “have the discussion” about the expansion.
About 45 people gathered at Plymouth Congregational Church for the alliance’s stop in Lawrence.
Karen Shumate, chief operating officer at Lawrence Memorial Hospital, told the group LMH provides $30 million worth of care each year that’s not paid for — approximately $6 million of which could be paid if Kansas expanded Medicaid.
Shumate went on to say that, though the Affordable Care Act has caused a “huge regulatory burden” that was supposed to be offset by Medicaid expansion, LMH is “very lucky to be operationally and financially sound.”
“But we’re a rarity in health care today, especially looking around the state,” she said.
Looking back on her childhood in rural Chase County, Shumate said she was 40 miles from the nearest hospital, Newman Regional Health in Emporia. She would later attend nursing school at Emporia State University Newman School of Nursing and have a decades-long career there.
Newman used to be a full-service hospital such as LMH, Shumate said, but it’s now classified as a Critical Access Hospital, a designation that allows it federal dollars through a program designed to keep small hospitals afloat.
“They’ve suffered greatly over the years and had a lot of different problems, reimbursement being one of them. So, I think about that, and I think about where my mother used to live,” said Shumate, her voice breaking. “She would have been 100 miles from a hospital providing full services. That hits me, when we talk about rural Kansas.”
Gov. Sam Brownback has remained opposed to expansion, which could deliver health care to a total 150,000 uninsured Kansans.
In Douglas County, there are about 11,000 people who don’t have health insurance, almost 5,000 of whom the Alliance for a Healthy Kansas and LMH estimated would be eligible if Medicaid were expanded in the state. The alliance purported that newly insured people would flush about $4,300 each into the local health care system per year, for a total of approximately $21 million.
As of Monday night, the Kansas Hospital Association was estimating Kansas had forfeited $1.3 billion in federal funding for expansion.
Thirty-one states and the District of Columbia have expanded Medicaid programs since Jan. 1, 2014. The federal government has fully funded coverage for newly eligible adults under the expansion in those 31 states. By 2020, the federal government will phase down funding to 90 percent.
“Nineteen states have chosen not to do this, but Kansas is even a little special in that group,” said Sheldon Weisgrau, of the Health Reform Research Project. “They’re debating it in their legislatures. They’re talking about it. In Kansas, we’re not even having the discussion.”
Weisgrau said Kansas has some of the most restrictive income eligibility requirements, which bar any childless adult, no matter their income.
Kansas Department of Health and Environment Secretary Susan Mosier has testified to legislators against expansion, saying Kansans with disabilities were still waiting for Home and Community Based Services — an issue that should be dealt with first, she said.
Weisgrau said Monday that was a “false choice.”
While being steamrolled on the issue in the Kansas Legislature, Weisgrau said the main objection he heard was that the expansion was part of the Affordable Care Act.
“We have to get past that,” he said. “Obamacare has been the law of the land for more than six years. It’s not going anywhere. We have to figure out how to make it work and design a program that is palatable here in Kansas.”
Jon Stewart, with Heartland Community Health Center, and Sherri Vaughn, a physician with Total Family Care, spoke Monday about patients who fell in the coverage gap and limited their health care visits because of it.
Stewart said he heard of a mother bringing her children to Heartland who denied undergoing a mammogram or cervical screening.
“Her response stunned me: ‘If can’t do anything about it, why would I want to know?’” Stewart said. “'If I cant receive treatment, why would I even want to know?’ — that’s a picture of the reason people forego care.”
Monday’s meeting also served as a call to action. The alliance passed around a petition to support Medicaid expansion, and they asked attendees to talk to their legislators and show up at the statehouse during the next legislative session.
“We’re Douglas County; our elected officials have been there all along the way supporting change,” said Beth Llewellyn, CEO of Health Care Access. “Part of it, in terms of trying to educate and help, is about reaching our energy outside of Douglas County.”