Opinion Columns & Blogs

On Medicaid expansion, let’s start with the facts

Dan Hawkins
Dan Hawkins

Gov. Laura Kelly launched her tenure by selling false hope to rural Kansans. This is especially disappointing in light of her promise to set a new tone in the statehouse. To put it bluntly, Medicaid expansion will not solve the financial issues facing rural hospitals. Politics and special interests ensure that Medicaid expansion consistently is put forward as the only answer. But it’s simply not true.

It’s important to look at what Medicaid expansion would actually do. Medicaid expansion provides taxpayer-funded health coverage to able-bodied adults between the ages of 19 and 64. These are predominantly childless adults in their prime working years. In fact, if they were to work at least 31 hours a week they would be eligible for Obamacare and would have no need for free health care from the state of Kansas. Vulnerable Kansans such as the elderly, low income parents, low income pregnant women, children in low income families, the disabled and many others are already covered. Medicaid expansion is a system that provides taxpayer funded healthcare to able bodied adults between the ages of 19 and 64, that is it!

In her State of the State, Gov. Kelly made the case that Expansion would cure what ails rural hospitals. This is blatantly false. Rural hospitals would receive very little funding from Medicaid expansion. Out of all the hospitals spread throughout the state of Kansas, the 10 largest hospitals would receive over half of the expansion dollars. Nearly 25 percent of expansion dollars would go to the two largest hospitals alone. It’s not rural hospitals who will benefit.

Gov. Kelly made special mention of the recent closures of hospitals in Fort Scott and Independence. The closures are unfortunate, but in neither case would expansion have saved these hospitals. The amount of taxpayer dollars these hospitals would have received from expansion was nowhere near the millions of dollars in debt they had incurred. Medicaid expansion is Kansas taxpayers sending over $187 million to the 10 large hospitals accounting for 55% all dollars that go to hospitals statewide. Hospitals that can afford to send a team of lobbyists to advocate on their behalf. As is so often the case, the big special interests get the goldmine while the working-class taxpayers get the shaft.

The other reason Medicaid expansion is presented as the only way forward is politics. Digging deep into health care policy and crafting solutions is boring. It’s much easier to create political talking points and label anyone who opposes your agenda as a cold, heartless person. If Medicaid expansion were to become law, it would fail. Its supporters will find a new political solution to tout, likely placing all healthcare under the control of the government. Meanwhile rural Kansas and all taxpayers will be in an even worse situation than now. It’s time to lay the politics aside and start talking about potential solutions including rural super health clinics, telemedicine and nurse practitioners practicing independently. In addition, there are opportunities to use Federally Qualified Health Centers to provide primary care to a segment of the population being discussed.

I appreciate Gov. Kelly’s interest in our healthcare system, specifically in rural areas. There is much we can do in this area. I’m willing to work in a bi-partisan fashion with her and my colleagues to find solutions. Bipartisanship must start with the truth. The only way we can work together to find bipartisan solutions is if we deal with the real facts. Otherwise bipartisanship is just a fancy buzzword for politics as usual.

Rep. Dan Hawkins is the majority leader of the Kansas House and former House Health and Human Services chair.

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