Kansas Governor Laura Kelly dedicated this year’s fall to traveling around her state and talking with constituents and community leaders about expanding Medicaid.
In a state where 60 rural hospitals are at risk of closing, forcing the legislature to expand Medicaid would be a lifeline, she said in an interview with The Daily Yonder. Her new campaign, “Healthy Workers, Healthy Economy” aims to help residents understand what Medicaid expansion could mean for rural hospitals, rural residents, and the state’s economy.
“There’s no doubt that Medicaid expansion is not enough to rescue rural hospitals,” she said. “But without Medicaid expansion, there is no doubt that rural hospitals will close.”
In 2013, the Affordable Care Act expanded Medicaid coverage to most adults with incomes up to 138% of the Federal Poverty Level, or about $41,400 a year for a family of four. To date, nine states – Alabama, Florida, Georgia, Kansas, Mississippi, Tennessee, Texas, South Carolina, and Wyoming – have not expanded Medicaid.
North Carolina’s Governor Roy Cooper signed legislation into law that directed the state to expand Medicaid, but the implementation of that expansion has been stalled awaiting legislative action.
Kelly said since 2013, Kansas has seen eight of its rural hospitals close. The latest, Herington Hospital in Herington, Kansas, closed on October 9 after 104 years. The hospital said the decision stemmed from lengthy financial struggles and low patient volumes.
More could follow. According to a study released in July by the Center for Healthcare Quality and Payment Reform (CHQPR), more than half of Kansas’ rural hospitals, 60 out of 104 (58%), are at risk of closure. The report found that the states with the most rural hospitals at risk of closing are Kansas, Texas, Tennessee, Mississippi, Georgia, and Alabama – all of which have failed to expand Medicaid.
Study after study has shown that health outcomes for rural residents in states that did not expand Medicaid are worse than outcomes for their counterparts in states that did expand Medicaid. In 2020, a look by Kaiser Family Foundation at more than 400 studies done since 2013 found that states that did expand Medicaid saw improvements in healthcare access, financial security, and health outcomes among other things.
Kelly said Kansas only needs to look to its neighbors to see the benefits.
“We can only judge the impact of not expanding Medicaid by looking at the states around us that have,” she said. “It’s clear that Kansas has sicker populations and populations with more mental health issues.”
Brian Barta, CEO of William Newton Hospital in Winfield, Kansas, (population 11,726 in 2021), said failure to expand Medicaid impacts more than just rural residents. His hospital saw revenues decline after the pandemic. According to reports, the hospital had $41.5 million in total patient revenue in 2022, with $49.3 million in total operating expenses. Even with $3.5 million in grants and other revenue, the hospital still ended 2022 being $4.3 million in the red.
“It is estimated that Medicaid expansion will help over 150,000 Kansans and continued failure by the state legislature to support Medicaid expansion undermines the physical, emotional, and economic health for all of Kansas,” Barta said during a September press event announcing Kelly’s “Healthy Workers, Healthy Economy” campaign.
The closure of a rural hospital impacts more than just rural residents though, Kelly said. Closed rural hospitals mean communities lose much-needed jobs and tax revenue.
“When a rural hospital closes, it impacts not just the physical health of our communities, but it also impacts the economic health of our communities,” she said.
Kelly said expanding Medicaid is her number one priority for the 2024 legislative session. While some other governors have taken action through executive order, Kelly said her hands are tied. Under the previous administration, legislation was passed that required any Medicaid expansion could only be done by the legislature. So far, she’s tried five times to get that kind of legislation passed.
And while it’s not the first time she’s fought this fight, this time, she said, she’s taking it to the voters.
“Expanding Medicaid and ensuring that every Kansan has access to affordable, high-quality health care is the smartest, sanest way to keep our state moving forward,” Kelly said. “I encourage every Kansan to call their legislator and tell them to demand that legislative leadership give them a chance to vote for Medicaid expansion.”
She said she recognizes that her efforts may not influence legislators and that constituents may not either. But with every legislative seat up for re-election in 2024, if she can’t move legislators, she hopes her efforts will at least influence the outcome of the election, she said.
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