In 2017, Republicans and Democrats in the Kansas Legislature joined together to expand Medicaid, passing legislation that would have allowed the state to accept federal funding and give thousands of working Kansans access to health insurance. Then-Gov. Sam Brownback vetoed the measure, citing a budget crisis caused by his own tax experiment.
That veto has had devastating consequences. In the years since, six rural hospitals in our state have closed, costing surrounding communities thousands of jobs. Today, 60 of our 104 remaining rural hospitals are at risk of shutting their doors, a higher percentage than any other state in the country. Kansas has lost out on $6.5 billion in federal funds — money the state’s taxpayers paid, which could be going to support those hospitals. Instead, several counties have had to shift tax dollars away from essential services to keep our remaining hospitals afloat. To make matters worse, Kansas is now facing a health care worker shortage, helpless as doctors, nurses and hospital staff leave for higher pay in neighboring states — each one of which has already expanded Medicaid.
Most important, thousands of working Kansans who would have had health insurance haven’t had it, meaning that far too many of our friends, neighbors and co-workers have gone without getting care.
I’m determined to expand Medicaid this upcoming legislative session, once and for all. It won’t be easy — many Republicans have apparently reversed course since voting for it just before I took office — but I believe that if the nearly 80% of Kansans who agree with expansion speak up, legislators will be forced to listen.
That’s why in the next few months before legislators come back to Topeka, I will be traveling around the state, meeting with hospital staff, business leaders, law enforcement, pastors — everyone who has a stake in making sure Kansans get the physical and mental health care they need. I’m calling it the Healthy Workers, Healthy Economy Tour, because it’s clear that Medicaid expansion is the single most effective way we can support workers and businesses, all at once.
On the road, I’ll point out three things: First, that Medicaid expansion lowers costs for everyone. If an uninsured Kansan goes to the emergency room and can’t pay for care, the hospital often has to raise prices for everyone else to cover the costs. That’s why studies show that places where Medicaid has not been expanded see outrageous spikes in the cost of private health insurance.
Second, I’ll emphasize that Medicaid expansion improves health care in rural areas. Right now, too many Kansans have to drive hours or wait months to receive basic care because the nearest doctor is far away or completely booked up. Expansion would help our remaining hospitals keep their doors open and recruit more doctors and nurses so it’s faster and easier to get care.
And third, I’ll explain how Medicaid expansion grows our economy. Since I’ve taken office, Kansas has attracted more than $17 billion of private investment, but that number would be even higher if we had a more robust health care system to attract businesses and workers. Businesses already in the state would benefit too. It’s common sense: A healthier workforce is a more productive workforce.
Of course, I expect I’ll hear from critics. One of their biggest arguments is that somehow Medicaid expansion would encourage Kansans not to work. The truth is, 140,000 Kansans work but don’t have health insurance. Expansion would be the answer for those who work in child care, wait tables, take care of our elderly or hold down jobs in other industries that don’t offer health insurance but are essential to our economy.
Detractors may also say that the state can’t afford it. The 40 other states that have expanded Medicaid have clearly found it worthwhile to pony up 10% of the costs relative to the federal government’s 90%. Studies have shown states make that investment back by saving on other services, attracting more workers and boosting the economy.
I’ve proposed five plans to expand Medicaid. I believe the sixth will be the charm. We’re headed into an election year when legislators will have to answer to voters for their inaction: Why they are allowing hospitals in their communities to close? Why they are standing by as we lose workers to other states? Why do they look the other way as Kansans die from preventable causes? And why they are holding our economy back?
Enough is enough. It is time for the Legislature to stand up for their communities and their constituents.
Laura Kelly is governor of Kansas.